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Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_II | Pages 148 - 148
1 May 2011
De Albornoz PM -Angeler JM Fuentes A Forriol F
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Introduction: Ankle arthrodesis is still a surgical technique, which implies compensations with a higher range of motion from the neighbouring joints (knee-tarsus). The aim of this study is to compare and analyze the functional results of large outcome ankle arthrodesis through both kinetic and kinematical motion study and plantar support study.

Material and Methods: We studied 19 patients (17 males and 2 females) with post-traumatic ankle arthrodesis (15 right side and 4 left side) with a minimum follow up of three years (3–9 years). No other lower extremity pathologies were associated. Average age was 37 years (23–56 y.o) and average weight 84,5 kg (54–117 Kg).

We performed physical (including body mass index, BMI), functional and image examination (X-Rays and CT scan). In order to objectify the results we used SF-36, AOFAS scale (max 90 points) and Mazur scale (max 97 points). Kinetic parameters of motion with two force plates (Kistler, Switzerland) and pedography (Emed, Novel, Munich, Germany) were obtained. Kinematic data were obtained with a 3-D video analysis system (Clima system, STT, San Sebastian, Spain). A statistical descriptive study was performed to know the grade of patients’ satisfaction and to analyze the range of motion (ROM) and reaction force of the limbs. Both sides were compared.

Results: results obtained with Mazur scale were 49,26 points (14 – 83), 49,89 points AOFAS scale (22 – 84), 85,79 points SF-36 (85 – 109). Pain score (VAS) was 4.1 points. BMI over 30 points was found six patients. Image analysis of all patients showed an adequate fracture consolidation and a correct ankle position. Kinematical study expressed a lower ROM in the fusion ankle than in the healthy one, basically due to the neighbouring joints movement compensation. Regarding motion parameters we only found differences at the anterior-posterior force switch direction point (41,67% of the healthy foot step and 50,37% in the fusion foot step). Support time was greater in fusion ankle than in healthy one. Midfoot and centre forefoot pressures resulted greater in fusion feet.

Conclusion: Patients with ankle arthrodesis presented often overweight. They show a good subjective outcome in the quality life scales and few mechanical alterations despite of the low score of the ankle and pain specific rating scales.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_II | Pages 117 - 118
1 May 2011
Moya-Angeler J De Albornoz PM Arroyo J Lopez G Forriol F
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Introduction: Anterior cruciate ligament (ACL) rupture leads to biomechanics disturbances of the knee joint which are reflected also in the plantar supports. Our hypothesis is that a redistribution of the sole bilateral charges will be produced to allows the feet to get a new control system to compensate ACL rupture. The aim of this research is to study the plantar support pressures disturbances in patients with ACL rupture before operation.

Material and Methods: We analyzed the plantar pressure distribution in two populations: Group A: 39 males of 37 years average age (21–49 y.o), previous surgery of isolated ACL rupture, excluding patients with meniscal tear or serious cartilage damage, contralateral lesions and knee previous surgery as well. Group B (control group): 37 healthy males of 31 years average age (21–40 y.o) without any musculoskeletal disorders.

We performed physical examination and walking through a pedography plate (Emed, Novel Munich, Germany). We studied global plantar support (pressure, forces and areas) of each foot and also divided each foot into six parts. Data obtained was compared between group A, patients (healthy leg and ACL rupture leg) and group B (control group). Statistical analysis was performed with a non-parametric Wilcoxon test.

Results: Group A (healthy leg and ACL rupture leg) total support area of both feet were statistically superior than Group B total support area (p< 0,019 and p< 0,005 respectively). Evenly midfoot total support area was superior in Group A that in Group B, as well as midfoot force support (p< 0.089).

Group A midfoot pressure was higher in ACL rupture leg than in healthy leg (p< 0.007) and it was also higher to the one obtained for group B (p< 0.046). Evenly the anterior-external region of Group A, healthy leg got the highest pressure (p< 0.076), followed by Group A, ACL rupture leg (p< 0.022) and finally Group B.

Group B anterior-internal pressure was statistically superior to Group A, ACL rupture leg (p< 0.049) followed by Group A, healthy leg (p=0.022). During foot takeoff, first toe pressures were higher in Group B compared to Group A (p< 0.076).

Conclusion: ACL rupture shows differences in plantar support pressures distribution of both legs (ACL rupture leg and healthy leg) compared with a control population. The injured leg seeks balance decreasing heel support and increasing the contact surfaces between floor, midfoot and forefoot.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_IV | Pages 581 - 581
1 Oct 2010
De Albornoz PM Abad J Delgado P Fuentes A Sanchez R Sanz L
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Objective: The purpose of this study was to determine which factors may influence in the outcome of the surgical treatment of Carpal Tunnel Syndrome (CTS).

Material and Methods: During 2005, 175 patients were treated with the diagnosis of CTS by open carpal release (short palmar incision) without ligament reconstruction. 113 cases were selected: 39 males and 74 females, with an average age of 41 years (21 to 64 years) and a follow-up of 24 months (12–36 months). The dominant hand was treated in 58%. The subcutaneous cellular tissue (SCT) was sutured in 14% and 11% were immobilized with a cast for 2 weeks after surgery.

We considered factors such as: systemic conditions, functional work requirement, preoperative time, surgical technique, and their correlation with complications, clinical outcome and time to return to work and activity level.

Results: Complications: 41% pillar pain, 9% suture dehiscence, 3,5% ulnar neuritis, 1,7% trigger finger, 1,7% reflex sympathetic dystrophy, and 1,8% wound infection. 5 patients were re-operated. Complications rate due to surgery was 3,5% after 12 months of follow-up. The average time out of work was 9 weeks (2–43 weeks) and was higher (13 weeks) in patients with post-operative immobilization. All patients, except one, returned to their previous activity level. History of systemic conditions and dominance had not influence on the final outcome. The suture of the SCT and the postoperative immobilization showed lower wound dehiscence and pillar pain cases.

Conclusions: The surgical treatment of the CTS provides good clinical and labour results. Patients with suture of the SCT and cast immobilization show less post-operative surgical complications.