RxPG News Feed for RxPG News

Medical Research Health Special Topics World
  Home
 
   Health
 Aging
 Asian Health
 Events
 Fitness
 Food & Nutrition
 Happiness
 Men's Health
 Mental Health
 Occupational Health
 Parenting
 Public Health
 Sleep Hygiene
 Women's Health
 
   Healthcare
 Africa
 Australia
 Canada Healthcare
 China Healthcare
 India Healthcare
 New Zealand
 South Africa
 UK
 USA
 World Healthcare
 
 Latest Research
 Aging
 Alternative Medicine
 Anaethesia
 Biochemistry
 Biotechnology
 Cancer
 Cardiology
 Clinical Trials
 Cytology
 Dental
 Dermatology
 Embryology
 Endocrinology
 ENT
 Environment
 Epidemiology
 Gastroenterology
 Genetics
 Gynaecology
 Haematology
 Immunology
 Infectious Diseases
 Medicine
 Metabolism
 Microbiology
 Musculoskeletal
 Nephrology
 Neurosciences
 Obstetrics
 Ophthalmology
 Orthopedics
 Paediatrics
 Pathology
 Pharmacology
 Physiology
 Physiotherapy
 Psychiatry
 Radiology
 Rheumatology
 Sports Medicine
 Surgery
 Toxicology
 Urology
 
   Medical News
 Awards & Prizes
 Epidemics
 Launch
 Opinion
 Professionals
 
   Special Topics
 Ethics
 Euthanasia
 Evolution
 Feature
 Odd Medical News
 Climate

Last Updated: Oct 11, 2012 - 10:22:56 PM
Research Article
Latest Research Channel

subscribe to Latest Research newsletter
Latest Research

   EMAIL   |   PRINT
New surgery improves outcomes for severe flat foot deformity

Jul 8, 2010 - 4:00:00 AM
Patients were asked how far they could walk in blocks or miles and the cohort of patients was able to walk an average of 25 blocks (range 10 to 40), equivalent to 1.25 miles, after surgery. Two patients continued to play golf without significant problems, another exercised regularly on a treadmill, one was involved in circuit training, and the final patient played volleyball, although he did notice some stiffness. All patients reported they were satisfied with the procedure and, given the result, would have the operation again.

 
[RxPG] A surgery developed at Hospital for Special Surgery can improve patient outcomes in individuals with severe adult flat foot deformity, a problem that is increasingly being seen inhospitals across the country. Patients who undergo the new surgery have better long-term outcome and mobility than those who undergo traditional surgery. The paper will be presented at the annual meeting of the American Orthopaedic Foot and Ankle Society (AOFAS, abstract 348) in National Harbor, Md., on July 8.

Before this study, we were not sure whether you could salvage patients with flat foot and ankle deformity and correct their ankle as well as their foot deformity, said Jonathan Deland, M.D., chief of the Department of Foot and Ankle Surgery at Hospital for Special Surgery (HSS). Now we know that with this technique you can save the ankle, and it provides a correction of the deformity even at nine years after surgery. Dr. Deland developed the surgery and is senior author of the study.

Adult acquired flat foot deformity is basically a severe type of flat foot that develops for unknown reasons in individuals who have had flat feet all their life. It is more prevalent in women and those who are overweight, and it usually develops in individuals in their 40s and 50s. In stage I of the deformity, the tendon that runs along the inside of the ankle begins to degenerate. In stage II, the arch starts to fail, and a person develops a more severe case of flat foot. As the arch continues to collapse and the flat foot becomes more pronounced, mobility becomes difficult, and the foot becomes stiff, which is considered stage III.

In the most severe stage, stage IV, the ankle starts tilting and is at risk of developing arthritis as a result of the deformity. These people have tremendous flat foot to the point that their ankle is involved, said Scott Ellis, M.D., foot and ankle orthopedic surgeon at HSS and first author of the study. In these people, the extreme flat foot has injured the deltoid ligament, a strong, flat triangular ligament that is located on the inside of the ankle that provides support to prevent the ankle from over pronating. In stage IV, the deltoid ligament has become stretched and incompetent, which is what allows the ankle to tilt.

If the ankle deformity is severe and symptomatic enough, then surgeons either perform an ankle replacement, which is very difficult, or, more commonly, fuse the ankle. The fusion is not ideal because it takes all the motion away in the ankle in a patient who already has a foot problem, Dr. Ellis said. Imagine walking without motion in your ankle. It changes your gait and it leads to arthritis in the other joints of the foot over time, eight to 10 years down the line, because you start having to use those joints to take up the slack of motion that is not occurring in the ankle.

In the new surgery for stage IV deformity developed at HSS, surgeons not only reconstruct the flat foot deformity, but they also reconstruct the deltoid ligament using a tendon that runs along the outside of the calf called the peroneus longus. A person can function without their peroneus longus. Alternatively, the peroneus longus can be kept and a cadaver tendon used.

In the study presented at the AOFAS meeting, HSS investigators conducted the new surgery in five patients, four men and one woman, and monitored the surgery's success. The mean age was 67 years. Patients underwent X-rays that showed the surgery improved the alignment in the ankle and the effects were long-lasting. The X-rays showed the maintenance of the correction of the tilt. The alignment was still improved nine years later, Dr. Ellis said. Patients had excellent mobility at eight to 10 years following the surgery and none of the patients had arthritis.

Doctors also measured outcomes through several questionnaires including the Foot and Ankle Orthopedic Survey, an outcome scale that assessed 42 items divided among six categories. The average FAOS scores were 61.4 for symptoms, 1.5 for stiffness, 78.3 for pain, 87.9 for function/daily living, 71.7 for function/sports/recreational activities, and 42.1 for quality of life. The FAOS scores were good, Dr. Ellis said.

Patients were asked how far they could walk in blocks or miles and the cohort of patients was able to walk an average of 25 blocks (range 10 to 40), equivalent to 1.25 miles, after surgery. Two patients continued to play golf without significant problems, another exercised regularly on a treadmill, one was involved in circuit training, and the final patient played volleyball, although he did notice some stiffness. All patients reported they were satisfied with the procedure and, given the result, would have the operation again.

Dr. Ellis says he thinks the new surgery may be increasingly useful with stage IV flat foot deformity. No surgeons that the authors know of at other hospitals are currently using the surgery. The procedure is expected to become more popular. I see a lot of this deformity in my office. It's one of the major problems I deal with, Dr. Ellis said, pointing out that it is very prevalent.




Advertise in this space for $10 per month. Contact us today.


Related Latest Research News
Drug activates virus against cancer
Bone loss associated with increased production of ROS
Sound preconditioning prevents ototoxic drug-induced hearing loss in mice
Crystal methamphetamine use by street youth increases risk of injecting drugs
Johns Hopkins-led study shows increased life expectancy among family caregivers
Moderate to severe psoriasis linked to chronic kidney disease, say experts
Licensing deal marks coming of age for University of Washington, University of Alabama-Birmingham
Simple blood or urine test to identify blinding disease
Physician job satisfaction driven by quality of patient care
Book explores undiscovered economics of everyday life

Subscribe to Latest Research Newsletter

Enter your email address:


 Feedback
For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page

 
Contact us

RxPG Online

Nerve

 

    Full Text RSS

© All rights reserved by RxPG Medical Solutions Private Limited (India)