bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of temperature readings from a percutaneous thermal sensing microchip with temperature readings from a digital rectal thermometer in equids
Authors: Robinson Tatiana R. , Hussey Stephen B. , Hill Ashley E. , Heckendorf Carl C. , Stricklin Joe B. , Traub-Dargatz Josie L. 
Published: August 2008

Abstract
Objective—To compare temperature readings from an implantable percutaneous thermal sensing microchip with temperature readings from a digital rectal thermometer, to identify factors that affect microchip readings, and to estimate the sensitivity and specificity of the microchip for fever detection.
Design—Prospective study.
Animals—52 Welsh pony foals that were 6 to 10 months old and 30 Quarter Horses that were 2 years old.
Procedures—Data were collected in summer, winter, and fall in groups 1 (n = 23 ponies), 2 (29 ponies), and 3 (30 Quarter Horses), respectively. Temperature readings from a digital rectal thermometer and a percutaneous thermal sensing microchip as well as ambient temperature were recorded daily for 17, 23, and 19 days in groups 1 through 3, respectively. Effects of ambient temperature and rectal temperature on thermal sensor readings were estimated. Sensitivity and specificity of the thermal sensor for detection of fever (rectal temperature, ≥ 38.9°C [102°F]) were estimated separately for data collection at ambient temperatures ≤ 15.6°C (60°F) and > 15.6°C.
Results—Mean ambient temperatures were 29.0°C (84.2°F), −2.7°C (27.1°F), and 10.4°C (50.8°F) for groups 1 through 3, respectively. Thermal sensor readings varied with ambient temperature and rectal temperature. Rectal temperatures ranged from 36.2° to 41.7°C (97.2° to 107°F), whereas thermal sensor temperature readings ranged from 23.9° (75°F) to 42.2°C (75° to 108°F). Sensitivity for fever detection was 87.4%, 53.3%, and 58.3% in groups 1 to 3, respectively.
Conclusions and Clinical Relevance—The thermal sensor appeared to have potential use for initial screening of body temperature in equids at ambient temperatures > 15.6°C.
Treatment of Syndesmotic Disruptions with the Arthrex Tightrope™: A Report of 25 Cases
Authors: Cottom James M. , Hyer Christopher F. , Philbin Terrence M. , Berlet Gregory C. 
Published: August 2008

Background: The complexity of syndesmotic injuries, often with both bone and soft tissue injury mandates an expeditious diagnosis and treatment to avoid unfavorable long term outcomes. Various methods of fixation of the syndesmosis have been reported. We present the largest series evaluating the Arthrex Tightrope™ for management of syndesmotic injuries. Materials and Methods: Twenty-five patients with disruption of the distal tibiofibular articulation underwent treatment with an Arthrex Tightrope™. In 21 cases, a single tightrope was placed, and in four cases, two tightropes were utilized. Associated ankle fractures were treated using proper AO technique. Those patients with diabetes and/or neuroarthropathic changes foot or ankle were not included in this study. Postoperative evaluation parameters included radiographic measurements, a modified AOFAS scoring system and SF-12. Results: Average followup was 10.8 months. The mean time to full weight-bearing was 5.5 (range, 2 to 8) weeks. Postoperative radiographic analysis of the mean distance from the tibial plafond to the placement of the tightrope(s), medial clear space, average postoperative tibiofibular overlap and the mean tibiofibular clear space demonstrated no evidence of re-displacement of the syndesmotic complex at an average of 10.8 (range, 6 to 12) months. The modified AOFAS hindfoot scoring scale and SF-12 both demonstrated significant improvements; preoperative values were assessed in the office with the first patient visit as they are incorporated into the patient intake form that each patient fills out at the initial visit. Conclusion: Utilization of the tightrope in diastasis of the syndesmosis should be considered as a good option. The method of placement is quick, can be minimally invasive, and obviates the need for hardware removal. In this series, it maintained excellent reduction of the syndesmosis.
Results of Non-Surgical Treatment of Stage II Posterior Tibial Tendon Dysfunction: A 7- to 10-Year Followup
Authors: Lin Johnny L. , Balbas John , Richardson E. Greer 
Published: August 2008

Background: There are few long-term studies on the non-operative treatment of Stage II Posterior Tibial Tendon Dysfunction (PTTD). The purpose of this study is to describe the natural history and determine the efficacy of non-operative treatment of Stage II PTTD using clinical outcome scores. Materials and Methods: Patients with Stage II PTTD treated with a Double Upright Ankle Foot Orthosis (DUAFO) with a minimum followup of 7 years were identified retrospectively. Patients were evaluated with the AOFAS Ankle/Hindfoot Score, SF-36, Foot Function Index (FFI), Visual Analog Scale (VAS) for pain, and a custom questionnaire in addition to a comprehensive physical examination. Results: Thirty-three feet in 32 patients were included with an average followup of 8.6 years. Success defined as being brace-free and avoiding surgery was 69.7%. Five patients (15.2%) were unable to completely wean from a brace. Five patients went on to surgery. The mean AOFAS and FFI score was 78.4 and 18.4, respectively. Compared to national norms, SF-36 subscores for each age sub-category showed no significant difference in any of the age groups ( p < 0.05). Average VAS pain scale score was 1.9. Satisfaction was rated as “satisfied” in 20 patients (60.6%), “satisfied with minor reservations” in 11 patients (33.3%), partially satisfied in one (3.0%), and “unsatisfied” in one (3.0%). None of the patients rated as “satisfied with major reservations”. Conclusion: Treatment of Stage II PTTD with a DUAFO has been shown to be a viable alternative to surgery with a high likelihood of adequate function, avoidance of surgery, and being brace-free at 7- to 10-year followup.
Perioperative Differences between Bone Bridging and Non-Bone Bridging Transtibial Amputations for Wartime Lower Extremity Trauma
Authors: Gwinn David E. , Keeling John , Froehner Jerald W. , McGuigan Francis X. , Andersen Romney 
Published: August 2008

Background: The distal bone bridge transtibial amputation technique requires additional intraoperative surgical steps when compared to the non-bone bridging technique. Comparative functional data is not available showing a clearly superior outcome from either technique. Identifying perioperative differences could influence a surgeon's decision regarding the technique of amputation to be performed. This study's purpose was to compare perioperative differences between bone bridging transtibial amputation and non-bone bridging amputation techniques. Materials and Methods: A retrospective review from April 2004 to April 2007 identified 37 consecutive patients with 42 transtibial amputations as a result of wartime blast injuries. Twenty-two non-bone bridging and twenty bone bridging amputations were performed. Statistical comparisons of intraoperative time, tourniquet time, estimated blood loss, the need for postoperative transfusion and frequency of wound complications was performed. Results: The bone bridging amputation technique had significantly longer operative times (178.5 vs. 112.2 minutes, p < 0.0005) and tourniquet times (114.8 vs. 71.0 minutes, p < 0.0005). Regardless of technique used, amputations performed within the zone of injury had a 66.7% wound complication rate ( p < 0.0005). There was not a statistically significant difference in reoperation for wound complications between groups when controlling for zone of injury: bone bridge (6.3%) and non-bone bridge (0.0%). Amputation closure performed within the zone of injury was a significant predictor for subsequent wound problems regardless of amputation technique. Conclusion: Longer operative and tourniquet times should not be considered a contraindication to utilizing the bone bridging amputation technique in younger and otherwise healthy patients. Both amputation techniques have comparable rates of short term wound complications and associated blood loss. Wound closure for traumatic amputations should not be perfomed through the zone of injury.
Treatment of Chronic Achilles Tendinopathy and Ruptures with Flexor Hallucis Tendon Transfer: Clinical Outcome and MRI Findings
Authors: Hahn Frederik , Meyer Patrick , Maiwald Christian , Zanetti Marco , Vienne Patrick 
Published: August 2008

Background: In patients with chronic Achilles tendinopathy, augmentation with flexor hallucis longus (FHL) tendon transfer can be performed to improve pain and functional limitations. There are no reports of postoperative imaging for evaluating tendon integration, inflammatory alterations or degeneration of the FHL muscle. The purpose of this study was to evaluate postoperative MR imaging based on clinical outcome and isokinetic strength. Materials and Methods: 13 patients with chronic Achilles tendinopathy (10 ruptures) underwent augmentation with FHL transfer. Clinical parameters, isokinetic strength and outcome measurements (AOFAS, SF-36) were evaluated at an average followup of 46.5 months. Qualitative and quantitative analyses of postoperative MRI were conducted using the non-operated side for comparison. Results: All patients had a significant reduction of pain. The operated side had a torque deficit of 35% for plantar flexion. Ten patients returned to their former level of activity. MRI showed a complete integration of the FHL tendon in six patients. Fatty atrophy in the triceps surae was found in ten patients. The FHL was free of degeneration in all patients. Hypertrophy of the FHL of more than 15% was observed in eight patients. Conclusion: Augmentation with FHL transfer is a valuable option in the treatment of chronic Achilles tendinopathy with and without rupture. Our results demonstrate high patient satisfaction without donor site morbidity. The FHL tendon is well integrated into the Achilles tendon. Hypertrophy of the FHL muscle suggests functional incorporation into plantar flexion. The primary benefit of the operation is pain relief and increased muscle strength.
Outcome of Achilles Tendon Ruptures Treated by a Limited Open Technique
Authors: Jung Hong Geun , Lee Keun Bae , Cho Sang Gwon , Yoon Taek Rim 
Published: August 2008

Background: The optimal surgical management of Achilles tendon ruptures remains a topic of active debate. Recently, many authors have preferred the limited open method because it afforded sufficient visualization to ensure anatomic apposition of disrupted tendon fibers, minimized local blood supply disturbances, guaranteed free tendon movement, and produced excellent cosmesis. We report our initial experience with this technique and review the literature. Materials and Methods: The outcomes of 30 consecutive patients that underwent limited open repair for Achilles tendon rupture using Achillon® (Newdeal SA, Lyon, France) from June 2003 to May 2006 were retrospectively reviewed. There were 20 men and 10 women, of average age 38.6 years, and the average followup period was 18.5 months. Twenty of the injuries were sports-related, eight were caused by a fall, and two by a laceration. The clinical results were assessed using patient satisfaction, the ankle-hindfoot scale of the American Orthopaedic Foot and Ankle Society (AOFAS), and the occurrence of complications. Results: At last followup, sixteen patients were very satisfied, 11 were satisfied, and the remaining three were dissatisfied. Mean patient AOFAS score was 93.0 points. Surgical complications noted were re-rupture in two cases, deep infection in one, and sural nerve injury in one. All patients except the three patients with a re-rupture or infection, returned to work 2 months postoperatively and resumed light exercise at 3 months, and previous sporting activities by 6 months. Conclusion: The described limited open repair technique for Achilles tendon ruptures provided excellent cosmetic results, satisfactory functional results, and a high level of patient satisfaction. Level of Evidence: Level III, therapeutic study.
The Achillon® Achilles Tendon Repair: Is it Strong Enough?
Authors: Ismail Mohammed , Karim Amer , Shulman Ryan , Amis Andrew , Calder James 
Published: August 2008

Background: Open repair of the Achilles tendon is associated with wound breakdown, infection and percutaneous methods risk sural nerve injury. The Achillon® mini-incision technique can reduce these risks and may provide the opportunity for early active rehabilitation. The aim of this study was to compare the strength of the Achillon® method with the commonly used Kessler method and to assess whether the strength of the repair was related to tendon diameter. Materials and Methods: Simulated ruptures in sheep Achilles tendons were repaired using either the Achillon® method or a two-strand Kessler technique with a No. 2 Ticron suture (Tyco Healthcare, UK). Each tendon diameter was measured, and matched for both groups. Specimens were loaded to failure using an Instron tensile testing machine (Instron Limited, UK). Results: Mean load to failure for the Achillon® repair was 153 N ± 60 (range, 65 to 270), and the mean load to failure for the Kessler Repair was 123 N ± 24 (range, 75 to 150). This difference was not statistically significant ( p = 0.21). There was a statistically significant higher mean load to failure for wider tendons repaired by the Achillon® method ( p = 0.05), however mean load to failure was not related to tendon width in Kessler repairs ( p = 0.23). Conclusion: This is the first study to compare these two methods of repair. The Achillon® repair has comparable tensile strength to the Kessler Repair. Clinical Relevance: The Achillon® repair appears to be a biomechanically sound method of repair for the acutely ruptured Achilles tendon.
Comparison of Plantar Pressure, Clinical, and Radiographic Changes of the Forefoot after Biplanar Austin Osteotomy and Triplanar Boc Osteotomy in Patients with Mild Hallux Valgus
Authors: Cancilleri Francesco , Marinozzi Andrea , Martinelli Nicolò , Ippolito Massimiliano , Spiezia Filippo , Ronconi Paolo , Denaro Vincenzo 
Published: August 2008

Background: Boc's modification of the Austin procedure is a triplane distal osteotomy that achieves shortening and plantarflexion of the first metatarsal with a lateral translation of the metatarsal head. The clinical results and influence of the Austin and Boc osteotomies on plantar pressure have been compared retrospectively. Materials and Methods: The patients were divided into two groups: 30 Austin and 30 Boc osteotomies were performed with a mean followup of 37 (range, 29 to 56) months. Results: Sixty patients with mild hallux valgus deformities and central metatarsalgia, took part in the study. Pressure measurements were performed with a Diagnostic Support system® footplate. The average postoperative American Orthopaedic Foot and Ankle Society score of the Austin group was 81.9 and 86.4 for the Boc group. The pressure distributions under the fourth and fifth metatarsal head were comparable in both groups ( p > 0.05). The Austin group showed decreased load bearing under the hallux and the first metatarsal head ( p < 0.01), consistent with a persistent overloading of the second and third metatarsal head ( p > 0.05). The Boc group showed decreased weightbearing under the hallux with better load distribution beneath the second and the third metatarsal head ( p < 0.05). Correlation of the American Orthopaedic Foot and Ankle Society scores and pressure variables confirmed a significant negative correlation with altered hallux and central metatarsal head loading ( p < 0.01). Conclusion: The Boc triplane osteotomy seems to restore more physiologic loading of the forefoot in comparison to the Austin procedure, reducing the incidence of painful callus under the second and third metatarsal head.
Treatment of Select Open Calcaneus Fractures with Reduction and Internal Fixation: An Intermediate-Term Review
Authors: Loutzenhiser Lonnie , Lawrence Steven J. , Donegan Ryan P. 
Published: August 2008

Background: Open calcaneal fractures are devastating, high-energy injuries frequently occurring in multiply-injured patients. Unsatisfactory outcomes with significant complications rates are frequently reported. Our purpose was to assess outcomes of delayed ORIF for open calcaneal fractures with medial hindfoot wounds and limited posterior facet comminution. Materials and Methods: Following acute management of the open fractures, seven patients were determined to have stable medial hindfoot wounds and posterior facet comminution of three or fewer fracture fragments. The average age was 32.5 years. These patients were treated with operative management with a plate-and-screw construct using the extensile lateral approach. RAND-36 Item Health, AOFAS Ankle-Hindfoot Survey, and physical examinations were undertaken to access outcomes. Results: All open calcaneal injuries were initially treated with irrigation and debridement, intravenous antibiotics, and plaster immobilization. Definitive fixation was performed at an average of 11.7 days. Six of seven patients were multiply injured. Prior to injury, five were employed on a full-time basis. Four returned to their original or a comparable job. The results of the RAND-36 Item Health Survey and the AOFAS Ankle-Hindfoot scores were 56.7 and 71, respectively. There were no postoperative infections. No patients required additional operative hindfoot procedures. Five continued to use tobacco products. None reported chronic narcotic usage. Conclusion: Aggressive treatment of select open calcaneal fractures with delayed ORIF produced satisfactory functional results. Most patients were able to return to gainful employment. There were no infections or wound complications.
Mid-Term Results of Futura Hemi-Great Toe Implants
Authors: Konkel Kurt Frederick , Menger Andrea Gayle , Retzlaff Sharon Ann 
Published: August 2008

Background: This study reviews our mid-term results and patient satisfaction using the Futura hemi-great toe implant. Materials and Methods: The authors were able to contact 11 of 15 patients. They were seen for chart review and mid-term evaluation. Results: All patients but one were improved and satisfied at mid-term followup (average, 8 years). The one unsatisfied patient had Grade IV arthritis at the time of surgery. Conclusion: Futura hemi-great toe implants lead to an 83% good to excellent mid-term results and over 92% patient satisfaction with no measureable subsidence of the implant over an 8-year average followup. Patients with Grade IV Hallux Rigidus should not be considered for Hemi-Great Toe implants and are probably best served with arthrodesis or interpositional arthroplasty at this time.
Chronic Exertional Compartment Syndrome in the Medial Compartment of the Foot
Authors: Jowett Andrew , Birks Christopher , Blackney Mark 
Published: August 2008

Background: Chronic exertional compartment syndrome of the foot has been previously described. There has been debate over the exact number and location of compartments. The involvement of the medial compartment has been consistently described in case reports; however, there is little in the orthopaedic literature on the exact anatomy for the fasciotomy and the resultant long term outcomes. Materials and Methods: We present the results of five patients (seven feet) who were surgically treated by medial compartment decompression, releasing both superficial and deep fascial layers. There were three females and two males, average age of 23 (17 to 34) years. Decompression was bilateral in one, sequential in one, and unilateral in three. Three patients also had surgical treatment of chronic compartment syndrome elsewhere in their lower limbs. Results: Preoperative post exertional compartment pressure measurements were 67.8 (32 to 114) mm at 1 minute and 50.2 (28 to 97) mm at 5 minutes. At an average of 21 (9 to 57) month followup, all but one patient had significant relief of their symptoms. Conclusion: Chronic exertional compartment syndrome may affect multiple compartments in the lower limb of a single patient. When affecting the medial compartment of the foot, release of the superficial and deep fascia is a reliable treatment. It is safe to perform bilaterally and in association with other lower limb decompressions as required.
The Distance between the Sural Nerve and Ideal Portal Placements in Lateral Subtalar Arthroscopy: A Cadaveric Study
Authors: Tryfonidis Marios , Whitfield Christopher G. , Charalambous Charalambos P. , Baraza Wal K. , Blundell Chris , Sharp Robert J. 
Published: August 2008

Background: There have been limited studies assessing the relative safety of lateral portals for subtalar arthroscopy in terms of their distance from the sural nerve and its branches. The aim of this cadaveric study was to assess and compare the distance of lateral subtalar arthroscopy portal sites to the sural nerve and its branches. Materials and Methods: Twenty embalmed cadaveric lower limbs were dissected exposing the nerves and tendons and subtalar arthroscopy portals were replicated using pins. The anatomically important distances were measured with a digital caliper. Statistical analysis of the data was performed using SPSS for Windows 11.5 (SPSS Inc, Chicago, IL) using Friedman Tests and Wilcoxon Signed Ranks tests. Results: The median distance of the anterior and middle subtalar portals to the nearest nerve was 21.3 mm and 20.9 mm, respectively, and 11.4 mm for the posterior portal. There was no statistically significant difference between anterior and middle portals ( p = 0.87) but there was statistically significant difference between anterior versus posterior and middle versus posterior portals ( p = 0.001 in each comparison). Conclusion: The anterior and middle subtalar portals were both less likely to damage important structures than the posterior subtalar portal. Clinical Relevance: The results of this study can be of value to the surgeon when planning arthroscopic procedures to the subtalar joint from the lateral approach.
Nonlinear Finite Element Analysis of the Plantar Fascia Due to the Windlass Mechanism
Authors: Cheng Hsin-Yi Kathy , Lin Chun-Li , Chou Shih-Wei , Wang Hsien-Wen 
Published: August 2008

Background: Tightening of plantar fascia by passively dorsiflexing the toes during walking has functional importance. The purpose of this research was to evaluate the influence of big toe dorsiflexion angles upon plantar fascia tension (the windlass effect) with a nonlinear finite element approach. Materials and Methods: A two-dimensional finite element model of the first ray was constructed for biomechanical analysis. In order to imitate the windlass effect and to evaluate the mechanical responses of the plantar fascia under various conditions, 12 model simulations - three dorsiflexion angles of the big toe (45 degrees, 30 degrees, and 15 degrees), two plantar fascia properties (linear, nonlinear), and two weightbearing conditions (with body weight, without body weight) - were designed and analyzed. Results: Our results demonstrated that nonlinear modeling of the plantar fascia provides a more sophisticated representation of experimental data than the linear one. Nonlinear plantar fascia setting also predicted a higher stress distribution along the fiber directions especially with larger toe dorsiflexion angles (45 degrees > 30 degrees > 15 degrees). The plantar fascia stress was found higher near the metatarsal insertion and faded as it moved toward the calcaneal insertion. Conclusion: Passively dorsiflexing the big toe imposes tension onto the plantar fascia. Windlass mechanism also occurs during stance phase of walking while the toes begin to dorsiflex. From a biomechanical standpoint, the plantar fascia tension may help propel the body upon its release at the point of push off. Clinical Relevance: A controlled stretch via dorsiflexing the big toe may have a positive effect on treating plantar fasciitis by providing proper guidance for collagen regeneration. The windlass mechanism is also active during the stance phase of walking when the toes begin to dorsiflex.