<b>Introduction:</b> Transfemoral amputation results in a prosthesis<span "=""> </span>which bears weight on the ischium. Gait disturbance,<span "=""> </s...<b>Introduction:</b> Transfemoral amputation results in a prosthesis<span "=""> </span>which bears weight on the ischium. Gait disturbance,<span "=""> </span>lack of an end-bearing<span "=""> </span><span "="">stump and discomfort in the groin from the socket even while sitting, are important issues. <b>Methods:</b> This is a pilot report of an ongoing randomized blind clinical trial of a new intramedullary implant post transfemoral amputation. Here</span>, we describe<span "=""> </span>a single case illustrating the surgical technique and clinical outcome of a dysfunctional post-traumatic transfemoral amputation addressed with this implant.<span "=""> </span>Clinical gait analysis, SF-12 and VAS were assessed pre- and post-intervention <span "="">at 6 months of follow-up. <b>Results:</b> An improved stump control is accomplished by means of myoplasty and myodesis through an end-cap. Stride width improved from 0.21</span><span "=""> </span>m pre-op to<span "=""> </span>0.13<span "=""> </span>m post-op, and more symmetrical stride length (<span style="white-space:nowrap;"><span style="white-space:nowrap;">△</span></span>0.21<span "=""> </span>m pre-op vs. <span style="white-space:nowrap;"><span style="white-space:nowrap;">△</span></span>0.06<span "=""> </span>m post-op) was noted, indicating improved gait quality and stability. Gait velocity increased (0.51 ± 0.04 m/s pre-op<span "=""> </span><span "="">vs. 0.64 ± 0.02 m/s post-op). <b>Conclusion:</b> This technique reveals improvements in gait parameters in</span><span "=""> </span>a transfemoral amputee treated with a new procedure. Improved prosthesis control, sitting comfort, greater hip range of motion, better gait stability, and enhanced walking abilities were noted.展开更多
Introduction: A new electromechanical instrument has been developed to measure relative dorsal mobility of the first ray in an objective and reliable way by simulating ground reaction forces during gait. This device e...Introduction: A new electromechanical instrument has been developed to measure relative dorsal mobility of the first ray in an objective and reliable way by simulating ground reaction forces during gait. This device equally applies a standardized, electronically controlled, and precise force under the first metatarsal head M1 as well as under the heads of the lesser metatarsals M2 to M5. The relative dorsal mobility between these two bearings is then measured. The purpose of this study is to assess the intra- and inter-examiners reliabilities of the measurements obtained with this device. Methods: The protocol included two examiners and 36 feet (18 volunteers with healthy feet and no history of forefoot disorders). A total of nine measurements were performed on each foot separated into three sets of three trials for the assessment of inter-rater and intra-rater reliability. For this purpose, the interclass correlation coefficient (ICC), the error of measurement (SEM) and the Bland and Altman (B&A) graphical analysis were computed. Results: Excellent ICC values (≥0.91) were obtained with the novel device for inter-rater and intra-rater reliability when using the FRRM calculation. The B&A analysis presented a bias between examiners of -0.25 mm ranging from -1.66 to 1.18 mm. Conclusion: This study demonstrated the capability of the developed device to reliably measure the relative dorsal mobility of the first ray of the foot. This is a promising first step for further studies to better understand, qualify and quantify first ray hypermobility.展开更多
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Little is known about the rate and reasons for revision after prim...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Little is known about the rate and reasons for revision after primary Metatarsophalangeal (MTP1) arthrodesis with </span><span style="font-family:Verdana;"><span style="font-family:Verdana;">the </span></span><span style="font-family:Verdana;">latest implants. While it is commonly assumed that nonunion accounts for most reoperations, we hypothesized that malposition is the leading cause of revision. The aim of this study was to determine the rate and reasons for revision after MTP1 arthrodesis using cup- and cone-reamers and </span><span style="font-family:Verdana;"><span style="font-family:Verdana;">the </span></span><span style="font-family:Verdana;">latest locking plate technology. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> Between 2015 and 2017, 120 consecutive MTP1 fusions in 114 patients were performed with a low profile, pre</span><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span><span style="font-family:Verdana;">contoured titanium dorsal locking plate and a plantar metatarsophalangeal screw. The rate and reasons for revision within a minimum one</span><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span><span style="font-family:Verdana;">year follow-up period (</span><span style="font-family:Verdana;">average </span><span style="font-family:Verdana;">16 months</span><span style="font-family:Verdana;"> [12</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">26]</span><span style="font-family:Verdana;">) after index procedure</span><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span><span style="font-family:Verdana;"> were </span><span style="font-family:Verdana;">documented </span><span style="font-family:Verdana;">and analyzed. </span>展开更多
文摘<b>Introduction:</b> Transfemoral amputation results in a prosthesis<span "=""> </span>which bears weight on the ischium. Gait disturbance,<span "=""> </span>lack of an end-bearing<span "=""> </span><span "="">stump and discomfort in the groin from the socket even while sitting, are important issues. <b>Methods:</b> This is a pilot report of an ongoing randomized blind clinical trial of a new intramedullary implant post transfemoral amputation. Here</span>, we describe<span "=""> </span>a single case illustrating the surgical technique and clinical outcome of a dysfunctional post-traumatic transfemoral amputation addressed with this implant.<span "=""> </span>Clinical gait analysis, SF-12 and VAS were assessed pre- and post-intervention <span "="">at 6 months of follow-up. <b>Results:</b> An improved stump control is accomplished by means of myoplasty and myodesis through an end-cap. Stride width improved from 0.21</span><span "=""> </span>m pre-op to<span "=""> </span>0.13<span "=""> </span>m post-op, and more symmetrical stride length (<span style="white-space:nowrap;"><span style="white-space:nowrap;">△</span></span>0.21<span "=""> </span>m pre-op vs. <span style="white-space:nowrap;"><span style="white-space:nowrap;">△</span></span>0.06<span "=""> </span>m post-op) was noted, indicating improved gait quality and stability. Gait velocity increased (0.51 ± 0.04 m/s pre-op<span "=""> </span><span "="">vs. 0.64 ± 0.02 m/s post-op). <b>Conclusion:</b> This technique reveals improvements in gait parameters in</span><span "=""> </span>a transfemoral amputee treated with a new procedure. Improved prosthesis control, sitting comfort, greater hip range of motion, better gait stability, and enhanced walking abilities were noted.
文摘Introduction: A new electromechanical instrument has been developed to measure relative dorsal mobility of the first ray in an objective and reliable way by simulating ground reaction forces during gait. This device equally applies a standardized, electronically controlled, and precise force under the first metatarsal head M1 as well as under the heads of the lesser metatarsals M2 to M5. The relative dorsal mobility between these two bearings is then measured. The purpose of this study is to assess the intra- and inter-examiners reliabilities of the measurements obtained with this device. Methods: The protocol included two examiners and 36 feet (18 volunteers with healthy feet and no history of forefoot disorders). A total of nine measurements were performed on each foot separated into three sets of three trials for the assessment of inter-rater and intra-rater reliability. For this purpose, the interclass correlation coefficient (ICC), the error of measurement (SEM) and the Bland and Altman (B&A) graphical analysis were computed. Results: Excellent ICC values (≥0.91) were obtained with the novel device for inter-rater and intra-rater reliability when using the FRRM calculation. The B&A analysis presented a bias between examiners of -0.25 mm ranging from -1.66 to 1.18 mm. Conclusion: This study demonstrated the capability of the developed device to reliably measure the relative dorsal mobility of the first ray of the foot. This is a promising first step for further studies to better understand, qualify and quantify first ray hypermobility.
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Little is known about the rate and reasons for revision after primary Metatarsophalangeal (MTP1) arthrodesis with </span><span style="font-family:Verdana;"><span style="font-family:Verdana;">the </span></span><span style="font-family:Verdana;">latest implants. While it is commonly assumed that nonunion accounts for most reoperations, we hypothesized that malposition is the leading cause of revision. The aim of this study was to determine the rate and reasons for revision after MTP1 arthrodesis using cup- and cone-reamers and </span><span style="font-family:Verdana;"><span style="font-family:Verdana;">the </span></span><span style="font-family:Verdana;">latest locking plate technology. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> Between 2015 and 2017, 120 consecutive MTP1 fusions in 114 patients were performed with a low profile, pre</span><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span><span style="font-family:Verdana;">contoured titanium dorsal locking plate and a plantar metatarsophalangeal screw. The rate and reasons for revision within a minimum one</span><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span><span style="font-family:Verdana;">year follow-up period (</span><span style="font-family:Verdana;">average </span><span style="font-family:Verdana;">16 months</span><span style="font-family:Verdana;"> [12</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">26]</span><span style="font-family:Verdana;">) after index procedure</span><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span><span style="font-family:Verdana;"> were </span><span style="font-family:Verdana;">documented </span><span style="font-family:Verdana;">and analyzed. </span>
