Search

Symptomatic flatfoot is a prevalent disorder. We undertook a review of 50 feet in 39 patients with flexible flatfoot treated between August 2000 and January 2008 in order to evaluate the modified Kidner-Cobb procedure. Overall clinical results were rated as good in 48 (96%) feet and fair in 2 (4%) feet, and there were no poor results. Average follow-up was 4.6 years, and total recovery time was 5.7 months in older patients and 3.7 months in children. Manual muscle-strength testing revealed no difference in tibialis anterior strength between the operated and contralateral extremity. All patients visually demonstrated postoperative elevation of the medial longitudinal arch height. Complications included 2 feet with wound dehiscence and 1 foot with fractured hardware. The results of this review indicate that the modified Kidner-Cobb procedure is a useful treatment option for patients with symptomatic flexible flatfoot with posterior tibial tendon dysfunction stage 2.

The authors report on the retrospective follow-up of 9 patients (6 women and 3 men) who underwent a mini-arthrotomy ankle arthrodesis by means of small incisions for exposure, cartilage resection, and internal fixation with crossed interfragmental compression screws. Patients were kept non-weight-bearing in a short leg cast for 12 weeks postoperative. At a mean follow-up of 55 months, outcomes were assessed by clinical examination, radiographs, and patient satisfaction questionnaires. Fusion was obtained in all patients, and there were no cases of delayed union, infection, or cutaneous compromise. Modified American Orthopaedic Foot and Ankle Society ankle and hindfoot rating scale scores significantly improved (P.001) from a mean of 38 points preoperatively to 72 points at follow-up. A categorical assessment of functional ability in the postoperative period revealed 6 patients graded as excellent, 2 as good, and 1 as fair. In regard to a categorical assessment of clinical outcome in the postoperative period, 7 patients were graded as excellent and 2 as good. All of the patients stated that they were satisfied with their results and would undergo the procedure again. The mini-arthrotomy ankle arthrodesis with crossed interfragmental compression screw fixation appears to be a useful alternative to traditional open arthrodesis for selected patients with ankle arthritis.

A retrospective analysis was conducted of 32 patients (33 ankles) who had undergone surgical ankle arthroscopy for chronic ankle pain that was recalcitrant to conservative treatment. All patients were examined clinically and completed a written questionnaire. Intraoperative ankle arthroscopy showed hypertrophic synovitis, adhesive bands, chondral bands with synovitis, osteophytes, and abnormalities in the talar dome. Results of treatment after an average follow-up time of 1.4 years (range: 0.33 to 12.5 years) showed ankle scores of 15 excellent, 11 good, 5 fair, and 2 poor. Obesity was significantly related to the outcomes of arthroscopy procedures. Obese patients were more likely to be rated as fair or poor, while nonobese patients were significantly more likely to be rated excellent or good. Those patients who received physical therapy postoperatively for one or more months had significantly better ankle ratings than those who did not elect to have physical therapy.