September 27, 2019
Today’s Top Story

Study Reports Midterm Outcomes Following Single-stage Flexor Digitorum Longus Lateral Transfer

According to a study published in the September issue of Foot & Ankle International, flexor digitorum longus (FDL) tendon transfer to the lateral foot could effectively treat irreparable rupture of the peroneal tendons. Among 25 consecutive patients who underwent FDL transfer to the fifth metatarsal for irreparable peroneal tendon tears, 15 (mean age at surgery, 48.4 years) were available for follow-up after a mean 53.7 months. Assessments included the visual analog scale (VAS) pain score, Foot Function Index (FFI), Short Musculoskeletal Function Assessment (SMFA), and Foot and Ankle Ability Measure (FAAM), as well as testing for range of motion (ROM), peak force, and peak power. Patients reported satisfaction with the surgery. VAS pain decreased by 5.6, mean FFI was 12.8, mean FAAM was 86.4, and mean SMFA function and bothersome indices were 12.4 and 11.5, respectively. Compared to the nonoperative side, patients had an average of 58 percent less eversion and 28 percent less inversion; isometric peak torque and isotonic peak velocity were 38.4 percent and 28.8 percent less, respectively. When comparing power in the two limbs, the operative limb was an average of 56 percent less than the nonoperative limb.

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In Other News

Study: Home-based Physical Therapy Does Not Significantly Improve Mobility Following Hip Fracture in Older Adults

A multicomponent home-based physical therapy intervention did not significantly improve walking ability in older adults with hip fracture compared to usual care, according to a study published in the Sept. 10 issue of JAMA. The parallel, two-group, randomized trial was conducted at three U.S. clinical centers between Sept. 16, 2013, and June 20, 2017. A total of 210 patients (mean age, 80.8 years; 161 were women) were randomized to a training intervention that included aerobic, strength, balance, and functional training (n = 105) or a control cohort that received transcutaneous electrical nerve stimulation and active ROM exercises (n = 105). Both groups received up to three home visits from a physical therapist per week for 16 weeks; nutritional counseling; and daily vitamin D (2,000 IU), calcium (600 mg), and multivitamins. The primary outcome was walking 300 meters or more in six minutes; 22 patients (22.9 percent) in the intervention cohort and 18 (17.8 percent) in the control cohort met this goal. Seventeen patients (16.2 percent) in the intervention cohort and 15 (14.3 percent) in the control group had one or more adverse events, the most common of which were falls (n = 6 versus n = 4), femur/hip fracture (n = 2 for both), pneumonia (n = 2 versus n = 0), urinary tract infection (n = 2 versus n = 0), dehydration (n = 0 versus n = 2), and dyspnea (n = 0 versus n = 2).

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Study: K-wire Treatment Restores Joint Alignment and Stability in Proximal Interphalangeal Joint Injury

Treatment of proximal interphalangeal joint (PIP) with a parabolic dynamic external fixator consisting of two Kirschner wires (K-wires) restored joint alignment and stability, according to a study published online in Archives of Orthopaedic and Trauma Surgery. Researchers retrospectively evaluated 21 patients who sustained a pilonoidal fracture of the PIP joint and were treated with a dynamic external fixator between 2005 and 2014. Mean PIP joint ROM was 76 degrees. Patients reported mild discomfort (mean, 0.7), high satisfaction (mean, 1.9), and a moderate acceptance (mean, 27). The mean Disabilities of the Arm, Shoulder, and Hand Questionnaire score was 11.6, and the mean Buck Gramcko score was 13.0. All patients showed bone healing. One patient suffered a recurrent dislocation, and another suffered a subluxation of the PIP joint while wearing the fixator. Most patients (n = 20, 95 percent) showed a concentric and stable aligned joint.

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Study Evaluates Association Between Shoulder Stiffness and Retear After Rotator Cuff Repair

Passive ROM of the shoulder may be a predictor of retear in patients who undergo arthroscopic rotator cuff repair (RCR), according to a study published in the September/October issue of the Journal of Orthopaedics. The researchers compared pre- and postoperative passive ROM in RCR patients based on those who healed (86.4 percent of shoulders) and those who experienced retear (13.6 percent). There was a significant association between stiffness and retear: Three months postoperatively, the healed group had significantly smaller passive external rotation with the arm compared to retear patients.

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Device-makers Are Struggling in the Face of Ambulatory Surgery Growth

Ambulatory surgery centers (ASCs) have significantly grown over the last few years, and the pace is expected to continue, according to a new report from Bain & Company. Orthopaedics is expected to be one of the fastest-growing specialties in 2020. This change has forced medical technology companies to reconsider their approaches by developing lower-cost service models, simplifying their products, addressing a variety of needs of ASCs, and rethinking their business models.

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Minimally Invasive Surgery Gains Traction Among Foot and Ankle Surgeons

Minimally invasive surgery (MIS) of the foot refers to percutaneous procedures through very small incisions, such as osteotomies using specialized burrs. MIS has been described in the forefoot, midfoot, and hindfoot. Although the approach was out of favor in the United States, interest in Europe remained strong, and several successful series have been reported over the past 15 years. Results have been promising, and acceptance of MIS in the United States has slowly increased.

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AAOS Updates Privacy Policy

AAOS has updated its privacy policy to specify the types of Personal Information that AAOS collects and how the data may be used/processed. These changes were made in response to changes in U.S. and international privacy laws.

For more information, view the privacy policy…


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