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Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_2 | Pages 21 - 21
1 Jan 2014
Ribee H Bhalla A Patel A Johnson B Leah J Bailey A Chapman C Bing A Hill S Laing P Makwana N Thomason K Marquis C
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Introduction:

Plantar Fasciitis is an extremely common and challenging problem that presents itself to foot and ankle practitioners. Many different treatment modalities are available for this condition, with little proven benefit. ECSWT was approved for use by the FDA for the treatment of chronic proximal plantar fasciitis in 2002 and NICE published guidance in 2009 recommending its use in refractory cases.

Methods:

Patients who diagnosed with ultrasound scan, and for whom other treatments were unsuccessful, underwent treatment on an outpatient basis. They had three 4–5 minute sessions, once a week. A Spectrum machine was used delivering 10 Hz waves in 500 preset pulses at 2 bar pressure, followed by 2000 preset pulses at 2.5 bar pressure. Pre- and 3 month post-treatment pain levels were recorded using a 10 point Visual Analogue Scale.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_21 | Pages 17 - 17
1 Apr 2013
Stevenson J Tong A Joshi Y Laing P Makwana N
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Introduction

Patients who present with atypical foot pain in a non specific sensory distribution may benefit from having nerve conduction studies (NCS). The aim of this study was to confirm whether NCS is a useful tool.

Methods

Between July 2005 and March 2011, 78 patients had NCS to investigate foot pain. The management following NCS was compared with the initial management plan.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XLIII | Pages 58 - 58
1 Sep 2012
Lever C Bing A Hill S Laing P Makwana N
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Introduction

Forefoot deformities are common in the rheumatoid population and lead to abnormal loading, plantar callosities and metatarsalgia. First MTP joint arthrodesis with lesser toe Stainsby procedures has become a popular method of reconstructing the rheumatoid forefoot but there is little data that reviews the clinical or biomechanical results of combining the two procedures.

Materials & Methods

A prospective observational study was set up to review 10 rheumatoid patients (20 feet) undergoing bilateral first MTP joint arthrodesis via a medial approach with Stainsby procedures to all lesser toes via curved incisions with resection of two thirds of the proximal phalanx, repositioning of plantar fat pad, extensor to flexor interposition and temporary stabilisation with k wires. Clinical scoring and dynamic pedobarograph pressure measurements were taken pre operatively and at one year post surgery.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXII | Pages 63 - 63
1 May 2012
Malhotra A Gallacher P Makwana N Laing P Hill S Bing A
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Background

Salvage procedures on the 1st MTPJ following failed arthroplasty, arthrodesis or hallux valgus surgery are difficult and complicated by bone loss. This results in shortened first ray and transfer metatarsalgia. We present our experience of using tri-cortical interposition grafts to manage this challenging problem.

Methods

Between 2002 and 2009 our department performed 21, 1st MTPJ arthrodeses using a tri-cortical iliac crest interposition graft. Surgical fixation was achieved with a compact foot plate. We performed a retrospective review from the medical notes and radiographs along with American Foot and Ankle scores which were collected prospectively.

We analysed the following parameters: time to radiological, requirement for further surgery, lengthening of 1st ray and any post operative complications.