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Biomedical subjects

A H Borrelli

Publications and source records attributed to A H Borrelli.

11 recordsLinked to original sources
PubMed1999

Planar dominance. A major determinant in flatfoot stabilization.

For treatment of a symptomatic flat foot in a child or an acquired flatfoot from posterior tibial dysfunction in the adult, an understanding of the biomechanics and function of the foot and leg is essential to achieve an excellent outcome. Evaluation of supramalleolar deformity directly influences the procedure choice and eventual success of the procedure. An understanding of the level of deformity also indicates the procedure to be used. Subtalar and midtarsal joint function, although related, have their own primary source of deformity. Correction through the subtalar and midtarsal joints must be individualized. Augmentation of the primary repair must be performed when overall instability is present, such as an elongated or deformed posterior tibial tendon or medial ligamentous structure. Evaluation of the gross deforming force of the triceps suri also must be evaluated to provide and ensure predicted outcomes.

Adult↗
PubMed1989

Osteochondral fracture of the talofibular joint.

Many accounts have been written concerning osteochondral fracture of the ankle joint. However, many of these pertain only to the talus. The author discusses an osteochondral fracture of the fibular articulating surface of the ankle joint. The etiology of the osteochondral fracture, previously undescribed, is postulated to arise from a plantarflexed inverted foot that undergoes axial rotation. The talus, therefore, fractures the fibular articulating surface. These fractures may be difficult to diagnose and require special radiographic views, such as computed tomography scans or tomograms, to help differentiate the diagnosis. In some cases, ankle arthrography may be helpful in identifying the fracture.

Adult↗
PubMedDate not supplied

Outcomes for surgical correction for stages 2 and 3 tibialis posterior dysfunction.

Between the years 1991 and 1996, 13 patients with stage 2 or 3 tibialis posterior dysfunction were evaluated following surgical reconstruction. Those patients with posterior tibial tendon tendinitis with a progressive flatfoot were categorized as having a stage 2 deformity according to Mueller's developmental stages of tibialis posterior dysfunction. Those patients with increasing severity of symptoms including a forefoot abductus component were classified as stage 3. There were five patients in stage 2, ranging in age from 53 to 80 years old; and there were eight patients in stage 3, ranging in age from 41 to 73 years old. Standard conservative care was utilized prior to surgical intervention in all cases. Follow-up was 12 months to 63 months. Patients in stage 2 underwent a Cobb reconstruction utilizing a split tibialis anterior tenodesis, and patients in stage 3 underwent an Evans lateral column-lengthening procedure combined with a Cobb procedure. Utilizing retrospective radiographic evaluation and patient interviews, results indicated that patients in stage 2 had a better patient satisfaction than those patients in stage 3. Although both patient groups had a 6-point average decrease in pain according to the 0- to 10-point visual analog pain scale, 50% of the patients undergoing a Cobb-Evans procedure felt that the procedure did not meet their expectations. Only one out of the five Cobb procedure patients felt that the procedure did not meet his expectations. The results of this limited study of patients with stage 3 tibialis posterior dysfunction suggest that although the lateral column lengthening with tendon augmentation renders good radiographic correction, many patients develop protracted lateral column pain and felt that surgery did not meet their expectations. Additional calcaneal osteotomies and arthrodesing procedures of the hindfoot may render a more satisfactory outcome.

Adult↗
PubMedDate not supplied

Percutaneous plantar fasciotomy: a minimally invasive procedure for recalcitrant plantar fasciitis.

A retrospective study was done to evaluate patient pain level and satisfaction after a percutaneous plantar fasciotomy. Between 1990 and 1996, 51 patients underwent percutaneous plantar fasciotomy for chronic plantar fasciitis associated with heel pain syndrome. All patients had undergone at least 6 months of conservative therapy. A questionnaire incorporating a visual analog pain scale was used to determine the effectiveness and patient satisfaction of the procedure. Of 35 patients who responded to the questionnaire, 27 were female and eight were male, ranging in age from 31 to 76 years with an average age of 47 years. Follow-up time after surgery ranged from 12 to 57 months, with an average of 34 months. Utilizing a visual analog pain scale, results showed a preoperative pain level of 8.7 (+/- 1.2) with a range of 6-10. Pain level at follow-up was 2.1 (+/- 2.7) with a range of 0-10. Eighty-three percent of the patients stated that the procedure met or exceeded their expectations. Percutaneous plantar fasciotomy is a simple and cost-effective method for surgical intervention of chronic heel pain syndrome. Complications are rare and the results compare favorably with other reported more invasive and costly techniques.

Adult↗
PubMedDate not supplied

Asymptomatic accessory soleus muscle.

The accessory soleus muscle has been infrequently seen and reported clinically. Most of the cases reported have been associated with symptomatology. Yet there are cases in which the patient presents with only asymptomatic swelling. Such a case is presented as well as a review of previously reported cases of the accessory soleus muscle.

Adult↗