bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minifragment Plate Fixation of High-Energy Navicular Body Fractures
Authors: Evans Jason , Beingessner Daphne , Agel Julie , Benirschke Stephen K. 
Published: July 2011

Background: The purpose of this study was to assess the ability of miniplate fixation in navicular fractures to restore medial column stability, maintain reduction, and determine the impact this approach may have on the development of avascular collapse of the navicular. We hypothesized that comminuted fractures of the navicular can be safely reduced and maintained to union with minifragment plate fixation with a low incidence of avascular collapse. Materials and Methods: A retrospective chart review was performed on 24 patients with navicular fractures treated with open reduction and internal fixation with minifragment plate fixation at a level one trauma center over a period of 6 years. Results: All fractures united. No patient developed a deep infection. There was no loss of reduction. Isolated broken screws were evident in three patients (12.5%), with no plate breakage, and no implant failure by pullout. Four patients (17%) underwent plate removal for painful prominent hardware following fracture healing. Four patients (17%) developed radiographic arthrosis of the talonavicular joint. One patient (4%) had radiographic avascular collapse evident at 6 months and was treated with plate removal and an orthotic device. Conclusion: Minifragment fixation was a good alternative to independent lag screws for rigid stabilization of navicular body fractures Level of Evidence: IV, Retrospective Case Series
Salvage of Failed Total Ankle Arthroplasty with Fusion Using Structural Allograft and Internal Fixation
Authors: Berkowitz Mark J. , Clare Michael P. , Walling Arthur K. , Sanders Roy 
Published: July 2011

Background: The current study presents our experience with conversion of failed TAA to fusion. Materials and Methods: A retrospective review of all failed total ankles converted to fusion from 1999 to 2009 was performed at our institution. Results: Twelve total ankles were converted to isolated ankle fusions (Group I) and 12 converted to ankle-hindfoot fusions (Group II). All isolated ankle fusions were stabilized with anterior plate and screws with one nonunion. Structural bone graft was used in ten of 12. Mean outcome scores using the AOFAS-Ankle/Hindfoot score and Maryland Foot Score improved from preoperative values of 43 ± 13 and 56.7 ± 14 to 67 ± 12 and 71.2 ± 16 postoperatively, respectively ( p < 005). All Group II ankle-hindfoot fusion patients were fixed using either anterior plate and screws, intramedullary nail, or a combination nail:plate construct. All received structural allografts. Five patients developed nonunion including four subtalar nonunions Preoperative scores on the AOFAS-AHS and MFS were 48.8 ± 14 and 58.3 ± 14. Postoperative scores were 51.2 ± 17 for the AOFAS and 64.5 ± 14 for the MFS. These changes were not statistically significant. However, the difference in nonunions was significant, p 0.05. Conclusion: Failed total ankles can be successfully converted to fusion using structural bone graft and internal fixation. The primary risk appears to be nonunion of the subtalar joint when ankle-hindfoot fusion is required. We believe this risk can be decreased by using a separate approach for preparation of the subtalar joint. Level of Evidence: IV, Retrospective Case Series
Radiographic Evaluation of Minimally Invasive Distal Metatarsal Osteotomy for Hallux Valgus
Authors: Huang Peng-Ju , Lin Yuh-Chuan , Fu Yin-Chih , Yang Yi-Hsin , Cheng Yuh-Min , Cheng Yuh-Min 
Published: July 2011

Background: The use of minimally invasive surgical technique for hallux valgus is controversial. The purpose of this study was to retrospectively evaluate the radiographic results of a minimally invasive distal metatarsal osteotomy for correction of hallux valgus. Materials and Methods: From September 2005 to March 2008, a minimally invasive distal metatarsal osteotomy was performed in 82 patients (125 feet) for hallux valgus. The average age was 40.8 (range, 13 to 71) years. The mean followup period was 18.3 (range, 9 to 38) months. These patients were categorized into groups based on their gender, age, preoperative hallux valgus angle, and preoperative 1–2 intermetatarsal angle. The radiographs were reviewed for preoperative and final followup hallux valgus angle, 1–2 intermetatarsal angle, and malunion or nonunion. A final followup hallux valgus angle greater than 20 degrees was defined as “recurrence of deformity” and represented a poor radiographic result. Results: There were no nonunions but one case of plantarflexion malunion. One case had skin irritation due to prominent bone. A poor radiographic result occurred in 29 feet (23.2%). Of those 36 feet whose preoperative hallux valgus angle was equal or greater than 30 degrees, 23 feet had a poor radiographic result (63.9%). Of those 89 feet whose preoperative hallux valgus angle was less than 30 degrees, only six feet had a poor radiographic result (6.7%) ( p= 0.0001). The preoperative 1–2 intermetatarsal angle was found to have no statistically significant influence on poor radiographic results ( p = 0.0539). Both the age and sex of the patients had no statistically significant influence ( p = 0.8048 and 0.8604, respectively). Conclusion: Based on our results, we do not recommend use of this technique to treat moderate to severe hallux valgus (hallux valgus angle, 30) degrees. We believe a traditional open osteotomy with formal capsulorrhaphy would be a better choice of treatment. Level of Evidence: IV, Retrospective Case Series
Correction of Rigid Equinovarus Deformity Using a Multiplanar External Fixator
Authors: Cuttica Daniel J. , DeCarbo William T. , Philbin Terrence M. 
Published: July 2011

Background: The rigid equinovarus foot deformity is a challenging condition treated by the orthopaedic foot and ankle surgeon. Rapid surgical correction of the deformity may lead to skin and neurologic complications. Gradual correction of the deformity with a multiplanar external fixator may decrease these complications. The purpose of this study was to present the results of a group of patients with rigid equinovarus deformities corrected using a multiplanar external fixator. Materials and Methods: We retrospectively reviewed the results of correction of a rigid equinovarus deformity using multiplanar external fixation in a small group of patients. All patients underwent open Achilles lengthening, posterior capsule release, tibialis posterior tendon lengthening, flexor digitorum longus and flexor hallux longus lengthening, followed by application of a multi-planar external fixator with gradual correction of the deformity over a period of several weeks. Preoperative and postoperative deformity and AOFAS ankle-hindfoot scores were assessed. Results: A total of eight rigid equinovarus deformities in six patients were treated with a multiplanar external fixator. The average patient age at the time of surgery was 37.2 (range, 17 to 59 ± 15.0) years. Causes of the deformity included trauma in three patients, traumatic brain injury in two patients, and long-standing rheumatoid arthritis in one patient. The average preoperative AOFAS ankle-hindfoot score was 28.3 (range, 12 to 38 ± 7.7). The average postoperative AOFAS ankle-hindfoot score was 68.1 (range 38 to 86 ± 15.5) at an average followup of 71.9 (30 to 120 ± 36.2) weeks. All deformities were gradually corrected to a plantigrade foot using a multiplanar external fixator over an average time of 5 (range, 4 to 6 ± 0.8) weeks. After correction of the deformity, the external fixator was left in place for a time period equal to or twice the length of time it took to achieve correction. The average duration of external fixation was 10.8 (range, 8 to 16 ± 2.8) weeks. Seven of eight deformities maintained correction at final followup. There was one case of recurrence. Conclusion: Correction of a rigid equinovarus deformity using a multiplanar external fixator was a viable treatment option. It allowed for correction of the deformity in a controlled manner, helping to reduce the risk of neurovascular complications that may result from single stage surgical correction. The risk of wound complications still exists with the correction of such a complex deformity. Level of Evidence: IV, Retrospective Case Series
Alcohol Sclerosing Therapy is Not an Effective Treatment for Interdigital Neuroma
Authors: Espinosa Norman , Seybold Jeffrey D. , Jankauskas Linas , Erschbamer Matthias 
Published: July 2011

Background: Alcohol sclerosing therapy has been reported as a safe and effective means of treating interdigital neuromas, both with or without ultrasound. The use of ultrasound introduces beside the ultrasound device, increased cost, and the need for skilled technicians and may reduce usability, especially in the outpatient clinic. We report a series of patients with interdigital neuroma treated using ethanol sclerosing therapy in a clinic setting without the use of ultrasound. Materials and Methods: We retrospectively reviewed charts of 32 consecutive patients who were enrolled to receive a series of sclerosing ethanol injections from June 2009 to April 2010 for the treatment of a painful interdigital neuroma. Plain radiographs and MRI scans were obtained if clinically indicated to assistance with the diagnosis. Duration and quality of symptoms were recorded and current pain levels were evaluated on a visual analog pain scale. Previous treatments, including orthotic use, corticosteroid injection, or prior neuroma resection were reported. A solution of 1 ml consisting of 20% ethanol and 0.25% bupivacain solution was injected without the use of ultrasound into the affected webspace. The mixture was provided by the local pharmacy. Technical success was confirmed by the temporary resolution of pain following local anesthetic infiltration. If still symptomatic, an injection was repeated every 2 weeks, with most patients receiving a series of four injections. Pain was evaluated on a visual analog pain scale at each visit. Treatment success was defined as resolution of pain as expressed by the patient. Results: Of the 32 patients successful relief of symptoms was only achieved in seven patients, while 25 showed no significant reduction of symptoms and considered or underwent a surgical excision. Conclusion: Alcohol sclerosing therapy administered in the clinic setting without alcohol is not an effective treatment in the nonoperative management of painful interdigital neuromas and has been abandoned in our clinic. Level of Evidence: IV, Retrospective Case Series
Pantalar Arthrodesis for Post-Traumatic Arthritis and Diabetic Neuroarthropathy of the Ankle and Hindfoot
Authors: Herscovici Dolfi , Sammarco G. James , Sammarco V. James , Scaduto Julia M. , Scaduto Julia M. 
Published: July 2011

Background: Pantalar arthrodesis is an important salvage option for stabilizing the hindfoot and salvaging the limb following trauma or collapse. This report evaluates the healing rates and complications which occur in diabetics and posttraumatic patients. Materials and Methods: Twenty patients presenting with post-traumatic arthritis of the ankle-hindfoot (twelve) or with Type II or Type IIIA Charcot arthropathy (eight) were managed with a pantalar fusion. Followup averaged 46 months. Patients were evaluated using the Short Form-36 (SF-36), the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score, the Short Musculoskeletal Function Assessment (SMFA) and the Visual Analog Pain Scale (VAS). Results: There were no amputations in either group. Casting averaged 14.9 weeks, full weightbearing was achieved at 25.1 weeks and time to union averaged 44.1 weeks. Average age was 56.3 yrs. and BMI averaged 34.2. Fourteen patients (70%) had their surgery performed in multiple stages. Acceptable outcomes were noted for all patients for the SF-36, AOFAS and SMFA scores. VAS scores averaged 2.2. There were ten complications (50%); four patients (two in each group) required additional surgery. Conclusions: Pantalar arthrodesis is a reasonable salvage option for patients with severe post traumatic arthropathy and neuropathic arthropathy. Patients should be informed of the increased risks as well as the long periods of postoperative immobilization and nonweightbearing. We believe a pantalar arthrodesis can produce acceptable outcomes regardless of the cause of disability, with a staged or single approach, and whether the surgery is performed with plates and screws or an intramedullary device. Level of Evidence: IV, Retrospective Case Series
First Ray Resection Arthroplasty versus Arthrodesis in the Treatment of the Rheumatoid Foot
Authors: Rosenbaum Dieter , Timte Britta , Schmiegel Andreas , Miehlke Rolf K. , Hilker Arvid 
Published: July 2011

Background: Different options exist for the operative treatment of forefoot problems and deformities in rheumatoid arthritis (RA). The current study compared first ray and resection arthroplasty with respect to patient satisfaction, clinical and functional outcome. Materials and Methods: In a retrospective study 53 RA patients were investigated with a minimum followup of 2 years after corrective forefoot surgery. Two patient groups were distinguished: One group had been treated with arthrodesis of the first metatarsophalangeal (MTP) joint whereas the other group had been treated with a first ray resection arthroplasty. Both groups underwent resection arthroplasty at the lesser metatarsal heads. Our arthrodesis patients were significantly younger than patients with resection arthroplasty. Five patients had been treated bilaterally so that the results of 58 feet were analyzed. Results: Patient satisfaction was lower in the arthrodesis group as compared to the resection arthroplasty patients. However, the arthrodesis patients revealed better functional results and showed a push-off from the hallux. No significant radiographic difference was seen in the mean hallux valgus angles. Younger patients revealed a higher disease activity and a worse general health status than older patients. Pedobaro-graphic results demonstrated significant differences in selected foot regions, predominantly in the hallux. Peak pressures were significantly higher in the lateral midfoot and the hallux after arthrodesis as compared to the resection arthroplasty group. Conclusion: Patients with arthrodesis revealed better foot function during the dynamic roll-over process even though the resection arthroplasty patients were subjectively more satisfied. Level of Evidence: Level III, Retrospective Comparative Study
Operative Fixation of Unstable Ankle Fractures in Patients Aged over 80 Years
Authors: Shivarathre Deepak G. , Chandran Prakash , Platt Simon R. 
Published: July 2011

Introduction: Controversy exists regarding the surgical treatment of unstable ankle fractures in the very elderly age group of over 80 years. However, the literature regarding the prognosis of surgery in this elderly group is limited. The purpose of our study was to evaluate the results of patients above 80 years old who underwent operative fixation for unstable ankle fractures. Materials and Methods: Ninety-two consecutive patients, 80 females and 12 males, above 80 years of age had open reduction and internal fixation for unstable ankle fractures during the period of January 1998 to August 2007. The data was collected retrospectively from the case records and radiographs. The complications were noted and the risk factors for poor outcome were analyzed. The average age was 85.2 (range, 80.1 to 95.1) years. The minimum duration of followup was 9 months, with an average of 15 (range, 9 to 28) months. Results: The most common fracture pattern was Danis-Weber B type. The superficial wound infection rate was 7% (6 cases) and the deep infection rate was 4.6% (4 cases). The 30 day postoperative mortality was 5.4% (five cases). Eighty-six percent (75 out of 87 cases) were able to return back to their pre injury mobility at the last followup. Diabetes, dementia, peripheral vascular disease and smoking were found to be statistically significant risk factors associated with wound complications. Conclusion: The results of operative fixation of unstable ankle fractures were encouraging with good functional recovery and return to pre injury mobility status in most cases. Level of Evidence: IV, Retrospective Study
Medial Longitudinal Arch Deformation during Walking and Stair Navigation While Carrying Loads
Authors: Hageman Elizabeth R. , Hall Michelle , Sterner Eric G. , Mirka Gary A. 
Published: July 2011

Background: Understanding the biomechanics of the medial longitudinal arch (MLA) may provide insights into injury risk and prevention, as well as function of the arch-supporting structures. Our understanding of MLA deformation is currently limited to sit-to-stand, walking, and running. Material and Methods: Three-dimensional deformation of the MLA of the right foot was characterized in 17 healthy participants during several simulated activities of daily living. MLA deformation was quantified by both changes in arch length and navicular displacement during the stance phase of three motions: walking, stair ascent, and stair descent. Three levels of load were also evaluated: no load, a front load (13.6 kg), and a backpack load (13.6 kg). Force platforms and an eight-camera motion capture system were used to collect relevant lower extremity kinetic and kinematic data. Results: Motion type had a significant ( p < 0.05) effect on navicular displacement and arch length elongation with navicular displacement being greatest during stair descent, while the walking and stair descent conditions showed the greatest increase in arch length. External load did not significantly affect either of these two measures ( p > 0.05). Conclusion: Differences in the MLA deformation variables resulting from varied dynamic activities of daily living can be greater than those during walking and should be considered. Clinical Relevance: Detailing the mechanics of the MLA may aid in further understanding injuries associated with the MLA, and the results of the current study indicate that these mechanics change based on activity.
An improved transient-type ice-penetrating radar
Authors: Ye Shengbo , Zhou Bin , Wu Bingheng , Zhao Bo , Fang Guangyou 
Published: July 2011

AbstractA low-cost, compact, short-pulse ice-penetrating radar (IPR) system with a center frequency of 50 MHz for sounding glacier topography is presented. The radar was developed to measure ice thickness and to image internal structures and basal conditions of glaciers and ice sheets with a maximum range of ∼16000 ns and a depth resolution better than 2.5 m. The receiver of the IPR system employs asynchronous operation mode, avoiding the need for a cable between the transmitter and receiver. A new sampling technology using a high-speed field programmable gate array, which implements a 256-trace stacking algorithm to realize the analog-to-digital conversion, both simplifies the structure of the receiver and increases the sampling efficiency. The power consumption of the whole receiver is <1.5 W, which can be supplied by a laptop computer. Test measurements were made during the 5th China Expedition to the Grove Mountains in East Antarctica. Field tests show the capability of this system to measure ice thickness up to 650 m and to define internal layers within the ice body.
In situ measurements of firn compaction profiles using borehole optical stratigraphy
Authors: Hawley Robert L. , Waddington Edwin D. 
Published: July 2011

AbstractWe have developed a technique in which we use a borehole video camera and post-processing software to make a record of the optical brightness as a function of depth in polar firn. We call this method borehole optical stratigraphy. To measure firn compaction, we note the positions of optical features on the borehole wall detected by an initial ‘baseline’ log. We track the displacements of these features in subsequent logs. The result provides a measurement of the relative vertical motion and thus compaction of the firn over the survey period. We have successfully used this system at Summit, Greenland, to measure the depth distribution of firn column shortening experienced in a borehole over three 1 year periods. The uppermost 30 m of the firn at Summit is compacting as predicted by a simple steady-state model, implying that the firn density profile at Summit is at or close to steady state over the past ∼70 years.
Glacier hydromechanics: early insights and the lasting legacy of three works by Iken and colleagues
Authors: Flowers Gwenn E. 
Published: July 2011

AbstractThe association between basal hydrology and glacier sliding has become nearly synonymous with the early work of Almut Iken and colleagues. Their research published in theJournal of Glaciologyfrom 1981 to 1986 made an indelible impact on the study of glacier hydromechanics by documenting strong correlations between basal water pressure and short-term ice-flow variations. With a passion for elucidating the physics of glacier-bed processes, Iken herself made fundamental contributions to our theoretical and empirical understanding of the sliding process. From the theoretical bound on basal shear stress, to the inferences drawn from detailed horizontal and vertical velocity measurements, the work of Iken and colleagues continues to inform the interpretation of data from alpine glaciers and has found increasing relevance to observations from the ice sheets.
Understanding ice-sheet mass balance: progress in satellite altimetry and gravimetry
Authors: Pritchard H.D. , Luthcke S.B. , Fleming A.H. 
Published: July 2011

AbstractSatellite remote sensing has come to dominate the measurement of glacier and ice-sheet change. Three independent methods now exist for assessing ice-sheet mass balance and we focus on progress in two: satellite altimetry (ICESat) and gravimetry (GRACE). With improved spatial and temporal sampling, and synergy with ice flow measurements, both the mechanisms and causes changing mass balance can be investigated. We present examples of mass losses due to widespread, intensifying glacier dynamic thinning in northwest Greenland, but local ablation rates in the northeast that are unchanged for decades. Advances in GRACE processing reveal Greenland net ice-sheet mass loss continuing into 2010, at 195 ± 30 Gta-1. A similarly negative trend in the Gulf of Alaska has significant spatial and temporal variation, that highlights the importance of intense summer melting here. Strong summer melt on the Antarctic Peninsula also precipitated recent ice-shelf collapse and prompted rapid dynamic thinning of tributary glaciers at up to 70 m a-1. Thinning continued for years to decades after collapse and propagated far inland. While understanding of the physical mechanisms of change continues to improve, estimates of future behaviour, and in particular the near-future glacial sea-level contribution, still rely on projections from such observations. We introduce the suite of new sensors that will monitor the ice sheets into the future.