K R Biddinger | PubMed Health

PubMed1998

A new modified technique for harvest of calcaneal bone grafts in surgery on the foot and ankle.

Reported sites for retrieval of cancellous bone for grafts include the iliac crest, greater trochanter, proximal tibia, and distal tibia. A new lateral technique for retrieval of cancellous bone from the calcaneus is evaluated through anatomic review, quantitative analysis, and retrospective clinical assessment. Of 22 patients managed with this technique over a 2-year period, 17 returned for an evaluation by questionnaire, physical examination, and radiographic follow-up at an average of 7 months after surgery (range, 4-16 months). Complaints/complications were minor: three had minor incisional symptoms, five had medial heel pain (3 caused by plantar fasciitis), and one had unchanged preoperative heel pain secondary to clubfoot deformity. Compared with more extensive bone-grafting procedures, this procedure offers the advantages of bone harvested under local anesthesia using a readily accessible ipsilateral extremity and producing minor complications.

Adolescent↗

PubMed1996

Results of arthrodesis of the tarsometatarsal joints after traumatic injury.

We retrospectively reviewed the records of thirty-two patients who had had an arthrodesis of the tarsometatarsal joints for intractable pain after a traumatic injury of the midfoot. The arthrodesis was performed at a mean of thirty-five months (range, six to 108 months) after the injury. All of the procedures were performed with use of rigid internal fixation, and twenty-four patients, in whom a defect had been created by debridement of the joints, were managed with an autogenous bone graft. Nine patients had at least one concomitant procedure, including a claw-toe procedure (eight patients), a reconstruction of the posterior tibial tendon (three patients), an excision of an interdigital neuroma (three patients), an arthrodesis of the calcaneocuboid joint (one patient), and an arthrodesis of the ankle (one patient). Complications included neuritis in three patients; metatarsalgia in two; malunion in two; and asymptomatic non-union, wound slough, superficial infection, and reflex sympathetic dystrophy in one each. The patients were evaluated at a mean of fifty months (range, twenty-four to 105 months) after the arthrodesis. The evaluation included a physical examination, radiographs, and use of the rating scale of the American Orthopaedic Foot and Ankle Society for the evaluation of the midfoot. The mean postoperative score of 78 (of a possible 100) points was significantly better than the mean preoperative score of 44 points (p = 0.02). With the numbers available, we could not show that the extent of the arthrodesis, the involvement of other joints in the hindfoot or the forefoot, the mechanism of injury, or whether the injury was work-related significantly affected the functional outcome.

Adult↗

PubMed1994

Dance screen programs and development of dance clinics.

Dance movements can be stressful to the body, and the required extreme positions may place physiologic structures at risk for acute, subacute, or chronic injury. The authors designed a screening program, conducted by a team of physical therapists, orthopedists, and dance instructors, to evaluate dancers for musculoskeletal problems and to make recommendations that would improve movement compensation, strength, endurance, and mobility.

Ankle↗