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JAYPEE JOURNALS
International Scientific Journals from Jaypee
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List of All Articles
1.  Review Article
Foot and Ankle Surgery: The Indian Scenario in 2016
Mandeep S Dhillon, John Ebnezar, Rakesh John
[Year:2017] [Month:January-June] [Volume:4 ] [Number:1] [Pages:54] [Pages No:40-44] [No of Hits : 1504]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1068 | FREE

ABSTRACT

In this review, we try to analyze the current scenario of foot and ankle surgery in India, with special emphasis on the problems faced by the indigenous population and also the challenges faced by foot and ankle surgeons of our country. Chronic infections of the foot (like tuberculosis, leprosy), neglected or mismanaged trauma cases (which usually result from a lack of awareness in the people regarding foot and ankle problems), foot and ankle problems faced by sportspersons, geriatric population, etc., form the crux of the discussion in this article.

Keywords: Foot ankle surgery, Geriatrics, Health care, Leprosy, Polio, Sports, Tuberculosis.

How to cite this article: Dhillon MS, Ebnezar J, John R. Foot and Ankle Surgery: The Indian Scenario in 2016. J Foot Ankle Surg (Asia-Pacific) 2017;4(1):40-44.

Source of support: Nil

Conflict of interest: None

 
2.  Original Article
Diabetic Foot Infection: An Indian Scenario
Ashu Rastogi, Anil Bhansali
[Year:2016] [Month:July-December] [Volume:3 ] [Number:2] [Pages:56] [Pages No:71-79] [No of Hits : 971]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1052 | FREE

ABSTRACT

Introduction: Diabetes mellitus is assuming epidemic proportions and with that an increasing burden of diabetic foot complications. Diabetic foot infections (DFIs) contribute not only to morbidity, amputation, and increased health-care costs but also to mortality.

Aim: To review the literature regarding the epidemiology and management of DFIs in India.

Results: The socioepidemiology of diabetic foot and its complications in India is different from the West. There is a considerable delay in seeking a physician for foot problems, as patients continue invalidated and indigenous methods of treatment. At presentation, most of the foot ulcers are chronic, harbor infection, and neuropathic in origin compared to the West with predominantly neurovascular ulcers. A predominance of Gram-negative bacterial species is reported in DFIs, with Pseudomonas aeruginosa as the most common isolated organism. An initial empirical antibiotic choice covering Gram-negative bacteria is suggested.

Conclusion: There are very few studies on the countrywide prevalence of foot complications from India. In India, DFIs behave differently from the West because of sociocultural and economic differences. We need indigenous ways for prevention and management of DFIs in India.

Keywords: Amputation, Antibiotics, Diabetic foot, Diabetic foot infection, Foot ulcer, IWGDF, Osteomyelitis, Peripheral arterial disease.

How to cite this article: Rastogi A, Bhansali A. Diabetic Foot Infection: An Indian Scenario. J Foot Ankle Surg (Asia-Pacific) 2016;3(2):71-79.

Source of support: Nil

Conflict of interest: None

 
3.  Original Article
Management of Fractures of Distal third Tibia by Interlock Nailing
Satish R Gawali, Shashikant B Kukale, Pramod V Nirvane, Raman O Toshniwal
[Year:2016] [Month:January-June] [Volume:3 ] [Number:1] [Pages:63] [Pages No:15-22] [No of Hits : 893]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1043 | FREE

ABSTRACT

Introduction: Most of the distal third tibia is subcutaneous and has precarious blood supply. Fractures of the distal third tibia have comminution at the fracture site, as it is metaphyseal cancellous bone with a thin shell of cortex , and have associated significant soft tissue injury. Generally, skin condition is not satisfactory due to ecchymosis, blebs, swellings, wounds, etc. All these factors contribute to delayed union, nonunion, and malunion.

The present study is about the ability to maintain a mechanically stable reduction in the distal third tibia with intramedullary nail, when lower 4 cm of tibia not fractured. If associated with fibula fracture (in lower 10 cm), it is always fixed as a rule to give stability to syndesmosis and stability to same-level tibia fracture.

Materials and methods: From January 2013 to March 2015, 60 patients of distal tibia fracture admitted to Government Medical College and Hospital, Latur, were operated and followed up prospectively.

Results: Mean age of patients was 35 years (25-50). Fracture union was seen radiologically within 3 to 4 months, depending on fracture geometry.

Conclusion: We conclude that results of fractures of distal third tibia not extending into lower 4 cm of tibia treated with interlock nailing were found satisfactory. Meticulous planning and placement of nail at the center of a wide metaphysis in the anteroposterior and lateral is mandatory to avoid varus, valgus, and posterior tilt. Polar screw or temporary K-wire during surgery is very helpful. Same-level fibula fracture fixation with a plate or square nail is very effective for stability of reduction.

Keywords: Fibula fixation, Fracture distal third tibia, Interlock tibia nailing.

How to cite this article: Gawali SR, Kukale SB, Nirvane PV, Toshniwal RO. Management of Fractures of Distal third Tibia by Interlock Nailing. J Foot Ankle Surg (Asia-Pacific) 2016;3(1):15-22.

Source of support: Nil

Conflict of interest: None

 
4.  Review Article
Midfoot Charcot Arthropathy: Overview and Surgical Management
Sundararajan Silvampatti, HS Nagaraja, S Rajasekaran
[Year:2016] [Month:July-December] [Volume:3 ] [Number:2] [Pages:56] [Pages No:97-106] [No of Hits : 622]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1056 | FREE

ABSTRACT

Midfoot Charcot arthropathy is a progressive deforming condition characterized by recurrent ulceration leading to high morbidity and amputation with lack of timely intervention. Nonoperative treatment is largely reserved for acute phase disease. Recent trend in management is early surgical interventions which could alter deforming forces and prevent deformity progression, as well as surgeries which provide osseously stable plantigrade foot. However, there are no clear-cut evidencebased guidelines regarding timing of interventions and method of techniques in surgical stabilization. This study discusses about surgical technique in the management of midfoot Charcot.

Keywords: Early surgery, External fixation, Fusion bolts, Internal fixation, Midfoot charcot.

How to cite this article: Silvampatti S, Nagaraja HS, Rajasekaran S. Midfoot Charcot Arthropathy: Overview and Surgical Management. J Foot Ankle Surg (Asia-Pacific) 2016;3(2):97-106.

Source of support: Nil

Conflict of interest: None

 
5.  Original Article
Revision Ankle Syndesmosis Fixation: Functional Outcome after TightRope® Fixation
Senthil Rajagopalan, Pradeep Moonot, Anurag Sangar, Heath Taylor
[Year:2016] [Month:January-June] [Volume:3 ] [Number:1] [Pages:63] [Pages No:23-27] [No of Hits : 558]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1044 | FREE

ABSTRACT

Introduction: Syndesmotic injuries present a challenge to orthopedic surgeons. Malreduction of the syndesmosis has been reported to cause instability and secondary osteoarthritis and is correlated with poor subjective and objective outcomes. There are very few studies that report the outcome after revision fixation of these injuries. Previous studies have reported varying techniques for revision syndesmosis reconstruction, including screw fixation and tendon transfers.

We present the results of the use of the TightRope® suture for revision syndesmosis fixation. This implant has the advantage of maintaining physiological motion whilst allowing for healing of syndesmotic ligaments and prevents the need for further surgery to remove screws in already scarred soft tissues.

Materials and methods: We retrospectively analyzed 124 patients who required syndesmotic stabilization from January 2000 until December 2009. Eight of these 124 patients required surgical revision of their failed syndesmosis fixation, each of which was stabilized with the TightRope® Suture. All eight patients were followed up and their outcomes assessed. Seven of the eight patients in our study had technically sound initial fixation of the syndesmosis. Four of the eight patients had syndesmotic separation after screw removal 10 weeks after primary fixation.

Results: In our study, 6 of the 8 patients had good or satisfactory outcomes based on American Orthopedic Foot and Ankle Society (AOFAS) scores. In spite of accurate revision fixation of the syndesmosis, two patients required further surgery. One patient had conversion to an ankle fusion because of persistent syndesmotic widening and ongoing pain after revision surgery. Another patient required syndesmotic arthrodesis as a result of persistent pain.

Conclusion: TightRope® suture fixation is a good method of syndesmosis stabilization in patients requiring revision surgery. Randomized studies would be required to compare the effectiveness of this method of fixation with screw fixation.

Keywords: Ankle, Fracture, Revision, Syndesmosis, Tight rope.

How to cite this article: Rajagopalan S, Moonot P, Sangar A, Taylor H. Revision Ankle Syndesmosis Fixation: Functional Outcome after TightRope® Fixation. J Foot Ankle Surg (Asia- Pacific) 2016;3(1):23-27.

Source of support: Nil

Conflict of interest: None

 
6.  Original Article
Retrograde Tibial Nailing for Arthrodesis of Ankle and Subtalar Joints
Govind Shivram Kulkarni, Milind Govind Kulkarni, Sunil Govind Kulkarni, Vidisha Sunil Kulkarni, Ruta Milind Kulkarni
[Year:2015] [Month:July-December] [Volume:2 ] [Number:2] [Pages:49] [Pages No:60-70] [No of Hits : 1321]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1031 | FREE

ABSTRACT

Introduction: When ankle and subtalar joints are arthritic and painful they both need fusion. Principles of treatment by fusion are removal of cartilage till bleeding of subchondral bone, keeping the joint surfaces congruous, proper positioning of the foot and ankle and stable fixation.

Materials and methods: During the last 10 years, 16 cases of retrograde nailing were done. Eight cases were post-traumatic, one was tuberculosis, three for Charcot joint and three for osteoarthritis of the ankle joint, and one case of rheumatoid arthritis. All patients had severe pain instability, varying degrees of deformities and antalgic gain. Two cases were treated with supracondylar femoral interlocking nail. Nine cases were treated with antegrade tibial nail as retrograde nail. Nine cases were treated with retrograde tibial nails with posteroanterior calcaneal screws. Two cases were treated with special nails newly designed by Smith and Nephew. Initially, older the calcaneus had two latero-medial screws. Newer designs of nail have two posteroanterior screws, passing from calcaneal tuberosity through the nail-one towards cuboid and the other towards talus. These two screws have increased the stability of the construct and improved the outcome. Mann’s technique of ankle fusion was used. Fibular strut was used as bone graft and fixed by one screws into the tibia and the other into talus. Indian tibia is smaller in diameter with a narrow intramedullary canal. Indian tibia need to have a nail with a smaller diameter.

Results: When supracondylar femoral and antegrade tibial nails were used, 4 out of 5 failed. When newer design nails with posteroanterior calcaneal screws were used, outcome improved 2 out of 11 failed.

Conclusion: Newer design of retrograde tibial nails with two posteroanterior screws have greatly improved the outcome of pantalar arthrodesis.

Keywords: charcot joint, Pantalar arthrodesis, Post-traumatic arthritis, Retrograde tibial nail.

How to cite this article: Kulkarni GS, Kulkarni MG, Kulkarni SG, Kulkarni VS, Kulkarni RM. Retrograde Tibial Nailing for Arthrodesis of Ankle and Subtalar Joints. J Foot Ankle Surg (Asia- Pacific) 2015;2(2):60-70.

Source of support: Nil

Conflict of interest: None

 
7.  Case Report
Os Intermetatarseum Revisited: A Case Report of Rare Variant and Review of Literature
Rajesh Rachha, Anand Gorva
[Year:2015] [Month:January-June] [Volume:2 ] [Number:1] [Pages:50] [Pages No:47-50] [No of Hits : 1040]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1029 | FREE

ABSTRACT

Os intermetatarseum is the rarest accessory bone of the foot. It is usually found between 1st and the 2nd metatarsal bases arising typically from the base of the 2nd metatarsal. Only a few symptomatic cases have been reported in the literature, which were either unilateral or bilateral and radiographically they were of different shapes and sizes. We present a large, bilaterally symmetrical and unusual variant of os intermetatarseum. To our knowledge, such large, bilaterally symmetrical, fully formed os intermetatarseum, fusing to both metatarsals has not been described before. The case report also describes the surgical anatomy during the excision of os intermetatarseum and review of the literature to date.

Keywords: Os intermetatarseum, Accessory bone of the foot, Metatarsal bar, Deep peroneal nerve compression.

How to cite this article: Rachha R, Gorva A. Os Intermetatarseum revisited: A Case Report of Rare Variant and Review of Literature. J Foot Ankle Surg (Asia-Pacific) 2015;2(1): 47-50.

Source of support: Nil

Conflict of interest: None

 
8.  Original Article
Percutaneous Repair for the Treatment of Rupture of the Achilles Tendon: A Study of 20 Cases
Gautam D Salunkhe
[Year:2015] [Month:July-December] [Volume:2 ] [Number:2] [Pages:49] [Pages No:51-59] [No of Hits : 779]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1030 | FREE

ABSTRACT

Background: Despite many techniques used for repair of the ruptured Achilles tendon, uncertainty of healing of the surgical wound remains a problem. This mainly determines the success of the surgery. The long-term results generally result in healing of the rupture, but poor healing of the wound occurs repeatedly. This causes apprehension in advising surgery over a conservative approach.

Objectives: To study the outcome of 20 cases of acute rupture of the Achilles tendon treated by the percutaneous technique.

Materials and methods: From March 2004 to March 2012, 20 cases of acute Achilles tendon rupture were treated by percutaneous repair by the method of Ma and Griffith. Modifications were used in distal end and delayed repairs. Immobilization was used after surgery. Postoperative complications were observed, and results assessed using the Leppilahti score after 6 months. Follow-up was done for 2 years.

Results: Percutaneous repair had significantly good results in 95% cases. There were two cases of sural nerve hypoesthesia, which was a minor problem and in no way hampered the longterm result. There were no re-ruptures. Patient satisfaction was high in terms of final result and cosmesis.

Conclusion: Percutaneous repair is a safe and reliable method for repair of the Achilles tendon rupture. It has a minor complication rate, and is advisable over open surgery.

Keywords: Achilles tendon rupture, Percutaneous repair, Wound healing.

How to cite this article: Salunkhe GD. Percutaneous Repair for the Treatment of Rupture of the Achilles tendon: A Study of 20 Cases. J Foot Ankle Surg (Asia-Pacific) 2015;2(2):51-59.

Source of support: Nil

Conflict of interest: None

 
9.  Original Article
Lateral Wall Decompression for Malunited Calcaneal Fractures
Sanjay Agarwala, Anshul Shyam Sobti
[Year:2015] [Month:July-December] [Volume:2 ] [Number:2] [Pages:49] [Pages No:80-85] [No of Hits : 777]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1035 | FREE

ABSTRACT

Aim: The purpose of this case series is to reintroduce Kashiwagi decompression as a viable treatment option for malunited calcaneal fractures, delineate the operative technique, and discuss its advantages.

Materials and methods: From August 2004 to May 2013, 18 patients with Sanders type I malunited calcaneal fractures with lateral heel pain and impingement were treated with the lateral wall decompression technique. The functional outcome was assessed using the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale.

Results: Eleven patients were males and seven were females, with an average age of 48.4 years. Ten patients had left feet fracture and eight had right feet fracture. Among all the 18 patients with a ‘poor’ score at baseline, 2 (11.11%) scored ‘excellent’, 11 (61.11%) scored ‘good’ and 3 (16.67%) scored ‘fair’ during postoperative evaluation. The average time to return to daily activities was 10.2 weeks (8-12.5 weeks).

Conclusion: Lateral wall osteotomy and decompression effectively addresses the pathology in cases of lateral abutment due to a malunited calcaneal fracture. This technique has advantages of ensuring a reliable resolution with good clinical outcomes and produces fewer postoperative complications.

Clinical significance: Malunion is a common complication with calcaneal fracture. It affects normal function. In malunited calcaneal fractures, the lateral wall of the calcaneum forms a lateral wall exostosis that causes both subfibular impingement and peroneal tendinopathy or displacement. There is need for a viable treatment option for malunions with lateral wall exostosis after calcaneal fractures. This study describes a surgical technique as a solution for the above.

Keywords: Case series, kashiwagi decompression, kashiwagi syndrome, lateral wall exostosis, peroneal tendinopathy or displacement, Sanders type I malunited calcaneal fractures, subfibular impingement.

How to cite this article: Agarwala S, Sobti AS. Lateral Wall Decompression for Malunited Calcaneal Fractures. J Foot Ankle Surg (Asia-Pacific) 2015;2(2):80-85.

Source of support: Nil

Conflict of interest: None

 
10.  Original Article
Correlation of Foot Bimalleolar Angle with Pirani Scoring System in Clinical Evaluation of Congenital Talipes Equinovarus
Abhay Shankar Dube, Manvender Gaur, Avinash Rastogi, Rajat Kapoor
[Year:2015] [Month:January-June] [Volume:2 ] [Number:1] [Pages:50] [Pages No:17-21] [No of Hits : 700]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1022 | FREE

ABSTRACT

The correlation of anteromedial foot bimalleolar angle with Pirani score evaluated prospectively in 120 children (204 feet) with congenital talipes equinovarus (CTEV). The patients were divided into groups I, II and III based on clinical severity before casting, having the Pirani score 0 to 2, 2.5 to 4 and 4.5 to 6 respectively. Mean foot bimalleolar angle 75.75°, 67.62° and 58.28° of groups I, II and III respectively was correlated by standard deviation with their Pirani scores to evaluate the severity difference among the groups before initiation of the casting treatment. The change in clinical severity or Pirani score was further correlated with the change in mean foot bimalleolar angle at the time of completion of casting and before bracing. The foot bimalleolar angle is an objective, quantitative and reproducible method which can be used to classify, prognosticate and to monitor the progress of the treatment.

Background: The prospective observational study on role of foot bimalleolar angle against the Pirani scoring in clinical evaluation of club foot in 120 children (204 feet) with mean age of 5.4 months treated by Ponseti technique of casting.

Keywords: Congenital talipes equinovarus, Foot bimalleolar angle, Pirani scoring and Podogram.

How to cite this article: Dube As, Gaur M, Rastogi A, Kapoor R. Correlation of Foot Bimalleolar Angle with Pirani Scoring System in Clinical Evaluation of Congenital Talipes Equinovarus. J Foot Ankle Surg (Asia-Pacific) 2015;2(1):17-21.

Source of support: Nil

Conflict of interest: None

 
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