Biomechanical Implications of Congenital Conditions of the Foot/Ankle
Segmental foot and ankle models are often used as part of instrumented gait analysis when planning interventions for complex congenital foot conditions. More than 40 models have been used for clinical analysis, and it is important to understand the technical differences among models. These models have been used to improve clinical planning of pediatric foot conditions including clubfoot, planovalgus, and equinovarus. They have also been used to identify clinically relevant subgroups among pediatric populations, quantify postoperative outcomes, and explain variability in healthy populations. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - January 2, 2023 Category: Orthopaedics Authors: Karen M. Kruger, Peter A. Smith, Joseph J. Krzak Source Type: research
Biomechanical Sequelae of Syndesmosis Injury and Repair
This review characterizes fibula mechanics in the context of syndesmosis injury and repair. Through detailed understanding of fibula kinematics (the study of motion) and kinetics (the study of forces that cause motion), the full complexity of fibula motion can be appreciated. Although the magnitudes of fibula rotation and translation are inherently small, even slight alterations of fibula position or movement can substantially impact force propagation through the ankle and hindfoot joints. Accordingly, implications for clinical care are discussed. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - January 2, 2023 Category: Orthopaedics Authors: Jennifer A. Nichols, Chloe Baratta, Christopher W. Reb Source Type: research
Reflections on Presurgical and Postsurgical Gait Mechanics After 50 Years of Total Ankle Arthroplasty and Perspectives on the Next Decade of Advancement
Although not the most prevalent form of lower limb pathology, ankle arthritis is one of the most painful and life-limiting forms of arthritis. Developing from overuse and various traumatic injuries, the effect of ankle arthritis on gait mechanics and effective treatment options for ankle arthritis remain an area of extensive inquiry. Although nonsurgical options are common (physical therapy, limited weight-bearing, and steroidal injections), surgical options are popular with patients. Fusion remains a common approach to stabilize the joint and relieve pain. However, starting in the early 1970s, total ankle arthroplasty was...
Source: Foot and Ankle Clinics - January 2, 2023 Category: Orthopaedics Authors: Robin M. Queen, Daniel Schmitt Source Type: research
Disease-Specific Finite element Analysis of the Foot and Ankle
Finite-element analysis is a computational modeling technique that can be used to quantify parameters that are difficult or impossible to measure externally in a geometrically complex structure such as the foot and ankle. It has been used to improve our understanding of pathomechanics and to evaluate proposed treatments for several disorders, including progressive collapsing foot deformity, ankle arthritis, syndesmotic injury, ankle fracture, plantar fasciitis, diabetic foot ulceration, hallux valgus, and lesser toe deformities. Parameters calculated from finite-element models have been widely used to make predictions abou...
Source: Foot and Ankle Clinics - January 2, 2023 Category: Orthopaedics Authors: Hamed Malakoutikhah, Leonard Daniel Latt Source Type: research
Biomechanical Insights Afforded by Shape Modeling in the Foot and Ankle
Advancements in volumetric imaging makes it possible to generate high-resolution three-dimensional reconstructions of bones in throughout the foot and ankle. The use of weightbearing computed tomography allows for the analysis of joint relationships in a consistent natural position that can be used for statistical shape modeling. Using statistical shape modeling, a population-based statistical model is created that can be used to compare mean bone shape morphology and identify anatomical modes of variation. A review is presented to highlight the current work using statistical shape modeling in the foot and ankle with a fut...
Source: Foot and Ankle Clinics - January 2, 2023 Category: Orthopaedics Authors: Amy L. Lenz, Rich J. Lisonbee Source Type: research
Definitions and Measurements of Hindfoot Alignment and Their Biomechanical and Clinical Implications
This article presents a critical review of the past and the current state of the art in defining and measuring hindfoot, ankle, and subtalar alignment. It describes the transition occurring at present from two-dimensional to three-dimensional (3D) alignment measurements, which accompany the emergence of new, functional, high-resolution imaging modalities such as the weight-bearing cone-beam computerized tomography (CT) imaging. To ease and enhance the transition and acceptability of 3D alignment measurements, new acceptable standards for different clinical application are highly desirable. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - January 2, 2023 Category: Orthopaedics Authors: Sorin Siegler, Luigi Piarulli, Jordan Stolle Source Type: research
Current Challenges in Chronic Ankle Instability
Chronic ankle instability (CAI) is common, disabling, and represents a significant socioeconomic burden. Current treatment options are not adequately efficacious. CAI is multifaceted, yet it is commonly addressed in terms of either mechanical instability or functional impairment. Both are inherently linked. Basic research must be conducted to foster reliable translational research encompassing both mechanical and functional aspects. A review was conducted to identify CAI risk factors for inclusion in future studies, and we offer here opinions and perspectives for future research. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - January 2, 2023 Category: Orthopaedics Authors: Matthieu Lalev ée, Donald D. Anderson, Jason M. Wilken Source Type: research
Diabetic Foot Considerations Related to Plantar Pressures and Shear
Diabetic foot ulcers are a complex, multifaceted, and widespread complication of diabetes mellitus. Although there are a multitude of risk factors contributing to diabetic foot ulcer development, pressure and (more recently) shear stresses are two biomechanical metrics that are gaining popularity for monitoring risk factors predisposing skin breakdown. Other areas of diabetic foot ulcers under research include plantar temperature measuring, as well as monitoring wear-time compliance and machine learning/AI algorithms. Charcot arthropathy is another diabetes complication that has a relationship with diabetic foot ulcer deve...
Source: Foot and Ankle Clinics - January 2, 2023 Category: Orthopaedics Authors: Jessi K. Martin, Brian L. Davis Source Type: research
Role of Robotic Gait Simulators in Elucidating Foot and Ankle Pathomechanics
This article summarizes the clinical applications of dynamic cadaveric gait simulation, including foot bone kinematics and joint function, muscle function, ligament function, orthopaedic foot and ankle pathologies, and total ankle replacements. The literature was reviewed and an in-depth summary was written in each section to highlight one of the more sophisticated simulators. The limitations of dynamic cadaveric simulation were also reviewed. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - January 2, 2023 Category: Orthopaedics Authors: William R. Ledoux Source Type: research
Thermal Injuries Occurring to the Foot
Thermal injuries are one of the most common injuries in both civilian and combat scenarios. The importance of clinical determination of burn and frostbite injuries and treatment involves understanding the pathophysiology and mechanisms of these injuries while continually reviewing literature and studying new treatment modalities. This present review examines the (1) epidemiology, (2) etiology, (3) pathophysiology and classification, and (4) treatment of thermal injuries occurring to the foot. In addition to the paucity of new literature and studies on thermal injury, this is the first review, to the best of our knowledge, ...
Source: Foot and Ankle Clinics - January 2, 2023 Category: Orthopaedics Authors: John M. Tarazi, Adam D. Bitterman Source Type: research
First Metatarsophalangeal Arthrodesis for the Failed Hallux
This article addresses many common yet challenging clinical scenarios, and a few hot topics, related to hallux MTPJ arthrodesis, including matarsus primus elevatus, severe hallux valgus, avascular necrosis, and infections. The article provides a condensed evidence-based discussion on how to manage these challenges using MTPJ arthrodesis. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - November 9, 2022 Category: Orthopaedics Authors: Ahmed Khalil Attia, Keith A. Heier Source Type: research
Lisfranc Arthrodesis in Posttraumatic Chronic Injuries
Chronic injuries at the tarsometatarsal joint represent a wide array of painful malunions ranging from isolated instability to complex three-dimensional deformities with rapid development of posttraumatic arthritis. Deformity correction and arthrodesis of the symptomatic joints leads to significant pain reduction and functional improvement provided that realignment of the anatomic axes is achieved. Arthrodesis should be limited to the first to third tarsometatarsal joints, whereas interposition arthroplasty is preferred for symptomatic arthritis of the fourth to fifth tarsometatarsal joints. For complex deformities and ins...
Source: Foot and Ankle Clinics - November 9, 2022 Category: Orthopaedics Authors: Stefan Rammelt, Pablo Andr és Cárdenas Murillo Source Type: research
Ankle Arthrodesis in Crippled Cases
The current article provides an algorithm of how to approach crippled ankle by ankle arthrodesis. There is no standard pathology or treatment present, which makes the diagnosis but also surgical correction complex. A surgeon who faces this kind of deformities needs to be skilled and well familiar with the full setting of the foot and ankle armamentarium. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - November 9, 2022 Category: Orthopaedics Authors: Norman Espinosa Source Type: research
Management of the Subtalar Joint Following Calcaneal Fracture Malunion
Subtalar joint arthrosis is common following intra-articular calcaneus fractures. The appropriate management of pain secondary to posttraumatic arthritis depends on the status of the remaining posterior facet articular cartilage, the magnitude of any residual joint displacement and distortions in the overall morphology of the calcaneus. In select circumstances, joint-preserving surgical techniques may be considered including lateral wall exostectomy, far lateral posterior facet joint debridement, and intra-articular osteotomies. When the subtalar joint is not salvageable, some form of arthrodesis procedure is pursued. Occa...
Source: Foot and Ankle Clinics - November 9, 2022 Category: Orthopaedics Authors: Benjamin J. Ebben, Mark Myerson Source Type: research
Pantalar Arthrodesis
A triple arthrodesis is comprised of subtalar, talonavicular, and calcaneocuboid joints arthrodesis. A pantalar arthrodesis is triple arthrodesis combined with tibiotalar arthrodesis. The goal of the procedure is to obtain a correction of deformity and achieve a plantigrade, functional, painless, stable, weightbearing foot that can be used to ambulate. This is done by creating an osseous continuity across the ankle, subtalar, and talonavicular, and calcaneocuboid joints. There are several approaches and fixation strategies that result in successful clinical union and should be chosen to match the clinical situation. Modern...
Source: Foot and Ankle Clinics - November 9, 2022 Category: Orthopaedics Authors: Sagar Chawla, Michael Brage Source Type: research
