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Reingrittha P, Kittipibul K, Kulkittaya S, Jitprapaikulsarn S. U-Turn Design Metatarsal Artery Flap: Reliable Solution in Distal Forefoot Defect. Ann Plast Surg 2024; 93:94-99. [PMID: 38864419 DOI: 10.1097/sap.0000000000004012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
BACKGROUND In distal forefoot defect, finding wound closure is challenging because of the distal site and small blood vessels involved. One possible resolution is the utilization of a metatarsal artery flap in a 'U-turn' design. This method offers several advantages, including its long length and a viable option for distal forefoot defect. METHODS Thirty-six patients with forefoot injuries from metatarsophalangeal (MTP) joint to distal interphalangeal (DIP) joint due to trauma were consecutively recruited and completed the study. Outcomes were analyzed descriptively, and risk prediction modeling for edge necrosis was performed. RESULTS The mean ± SD follow-up time was 27.3 months ±1.9. The median (IQR) MTP-to-DIP joint wound width and length were 1.8 (1.4, 3.0) and 3.2 cm (2.9, 6.2), respectively. The median (IQR) width, length, and width-to-length ratio flap dimensions were 3.6 (2.8, 6.0), 4.7 cm (4.3, 9.3), and 1.5 (1.2, 1.7), respectively. The mean ± SD operative time was 32.9 min ± 5.7. The median (IQR) intraoperative blood loss was 5.0 mL (4.0, 5.0). The mean ± SD hospital length of stay postoperatively was 4.0 days ±1.0. The mean ± SD Foot and Ankle Outcome Score and Foot Function Index were 64.1 ± 2.5 and 7.8% ± 3.3, respectively. All patients had good or excellent aesthetic satisfaction. Spontaneously resolving edge necrosis occurred in 13.9%. The mean ± SD time-to-start-ambulation was 1.7 weeks ±0.5. At the 2-year follow-up visit, all patients had reduced U-turn flap pivot point redundancy without shoe size impact, needing reoperation, or donor site morbidity. Edge necrosis was significantly associated with length-to-width ratio ( P = 0.014) but not with Foot and Ankle Outcome Score or Foot Function Index. CONCLUSIONS Metatarsal artery flap of U-turn design was reliable and was associated with a short recovery time, alternative resolution for forefoot area due to short operation time, minimal blood loss, short hospital length of stay, and excellent availability.
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Cervera-Garvi P, Galan-Hurtado MH, Ortega-Avila AB, Marchena-Rodriguez A, Lopezosa-Reca E, Castillo-Dominguez A, Diaz-Miguel S. Measurement properties of the Foot Function Index (FFI) questionnaire: A systematic review. Clin Rehabil 2024:2692155241258299. [PMID: 38856157 DOI: 10.1177/02692155241258299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
OBJECTIVE Large numbers of people are subject to alterations and pathologies in the foot. To quantify how these problems of foot function affect the quality of life, clinicians and researchers have developed measures such as the Foot Function Index (FFI). Our aim is to determine the methodological quality of the FFI including adaptations to other languages. DATA SOURCES The studies considered in this review were extracted from the PubMed, Embase and CINAHL databases. The inclusion criteria were followed: (1) studies of patients with no previous foot or ankle pathology and aged over 18 years; (2) based on English-language patient-reported outcome measures that assess foot function; (3) the patient-reported outcome measures should present measurement properties based on COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria. REVIEW METHODS The systematic review was conducted following the COSMIN criteria to establish the methodological quality of the original FFI, together with its variants and adaptations. The last search was carried out in May 2024. RESULTS Of the 1994 studies obtained in the preliminary search, 20 were eligible for inclusion in the final analysis. These results are the validations and cross-cultural adaptations to the following languages: the original FFI has cross-cultural adaptation in 13 languages and the FFI-Revised Short Form has been adapted and validated for use in 2 languages. CONCLUSION In terms of methodological quality, the FFI-Revised Short Form questionnaire is a valuable instrument for evaluating ankle and foot function and could usefully be expanded to be available in more languages.
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Affiliation(s)
- Pablo Cervera-Garvi
- Department Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Málaga, Spain
| | | | - Ana Belen Ortega-Avila
- Department Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Málaga, Spain
- Instituto de investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Ana Marchena-Rodriguez
- Department Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Málaga, Spain
| | - Eva Lopezosa-Reca
- Department Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Málaga, Spain
| | | | - Salvador Diaz-Miguel
- Department Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Málaga, Spain
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Thammajaree C, Theapthong M, Palee P, Pakpakorn P, Sitti T, Sakulsriprasert P, Bunprajun T, Thong-On S. Effects of radial extracorporeal shockwave therapy versus high intensity laser therapy in individuals with plantar fasciitis: A randomised clinical trial. Lasers Med Sci 2023; 38:127. [PMID: 37219650 DOI: 10.1007/s10103-023-03791-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/18/2023] [Indexed: 05/24/2023]
Abstract
This study aimed to compare the effects of radial extracorporeal shockwave therapy (rESWT) to the effects of high-intensity laser therapy (HILT) in the treatment of individuals with plantar fasciitis. Thirty-two individuals with unilateral plantar fasciitis were randomized into two groups: rESWT and HILT. In each group, the individuals underwent the intervention two sessions per week, for three weeks. Outcome measures included morning pain, resting pain, pain at 80 newtons (N) pressure, skin blood flow and temperature, plantar fascia (PF) and flexor digitorum brevis (FDB) thickness, and Foot Function Index (FFI). There was no significant difference in baseline characteristics of the individuals in both groups. All outcome measures, except skin blood flow and temperature, and FDB thickness, were significantly different (p < 0.05) over time. Skin blood flow was significantly different between groups at the end of the program. Either HILT or rESWT could alleviate pain in individuals with plantar fasciitis significantly. However, HILT was better at reducing FFI (functional limitation domain) rather than rESWT. This study was a randomized clinical trial and was approved by Mahidol University-Central Institutional Review Board (MU-CIRB) following the Declaration of Helsinki, COA no. MU_CIRB 2020/207.0412, the Thai Clinical Trials Registry (TDTR) numbered TCTR2021012500.
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Affiliation(s)
- Chutiporn Thammajaree
- Physical Therapy Center, Faculty of Physical Therapy, Mahidol University, Bangkok, 10700, Thailand
| | - Montartip Theapthong
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Phongsathon Palee
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Phrattaya Pakpakorn
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Tippawan Sitti
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Prasert Sakulsriprasert
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Tipwadee Bunprajun
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Suthasinee Thong-On
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
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Chuckpaiwong B, Reingrittha P, Harnroongroj T, Mawhinney C, Tharmviboonsri T. Sport and Exercise Activity After Isolated Ankle Arthrodesis for Advanced-Stage Ankle Osteoarthritis: A Single-Center Retrospective Analysis. FOOT & ANKLE ORTHOPAEDICS 2023; 8:24730114231177310. [PMID: 37325694 PMCID: PMC10262617 DOI: 10.1177/24730114231177310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
Background Ankle arthrodesis, a recognized operative treatment for advanced-stage ankle osteoarthritis (OA), is recommended when conservative treatment proves unsuccessful. This single-center retrospective analysis examined the change in functional outcomes and the type of sport/exercise activity performed by advanced-stage ankle OA patients after ankle arthrodesis treatment. Methods A total of 61 advanced-stage ankle OA patients (age, 63.1 ± 12.6 years) who had undergone ankle arthrodesis were included in this single-center retrospective study. The patients had functional outcomes evaluated via American Orthopaedic Foot & Ankle Society Score (AOFAS), Foot Function Index (FFI), Tegner Activity Level Scale (TAS), and High-Activity Arthroplasty Score (HAAS) questionnaires. Clinical status was compared across prearthritic, arthritic, and postarthrodesis periods, and satisfaction with return to sport/exercise activity was recorded. Results Patients' tarsal sagittal ROM (mean [95% CI]: 22.7 degrees [21.4-24.0]); time to union (15.7 weeks [11.8-19.6]); time to walk without gait aid (14.4 weeks [11.0-17.7]); time to return to work (17.9 weeks [15.1-20.8]); and time to exercise activity (20.6 weeks [17.9-23.4]) were recorded postarthrodesis. Hindfoot alignment angle toward a neutral position (difference: 11.4 degrees [9.2-13.6], P < .001) and functional outcomes (P < .001) significantly improved after arthrodesis surgery; however, only the TAS questionnaire indicated patients returned to their prearthritic activity level (P > .99). Patients generally reported "good" satisfaction with their recovery from ankle arthrodesis surgery, with 64% of patients returning to high-impact-type activity. Conclusion Advanced-stage ankle OA patients had improved functional outcomes at ~1 year postarthrodesis surgery, enabling the majority of patients to return to high-impact-type activity. Level of Evidence Level III, retrospective cohort study.
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Affiliation(s)
- Bavornrit Chuckpaiwong
- Orthopaedic Surgery and Rehabilitation department, Siriraj Hospital, Bangkok, Thailand
- College of Sports Science and Technology, Mahidol University, Nakhon Pathom, Thailand
| | - Pissanu Reingrittha
- Orthopaedic Surgery and Rehabilitation department, Siriraj Hospital, Bangkok, Thailand
- Orthopedics Department, Buddhachinaraj Hospital, Phitsanulok, Thailand
| | - Thos Harnroongroj
- Orthopaedic Surgery and Rehabilitation department, Siriraj Hospital, Bangkok, Thailand
| | - Chris Mawhinney
- College of Sports Science and Technology, Mahidol University, Nakhon Pathom, Thailand
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Reingrittha P, Benjawongsathien K, Visuthisakchai S. The Efficacy of Posterior Fasciotomy Versus Inserted Vacuum Drainage in Reducing Postoperative Surgical Site Infection in Open Achilles Tendon Repair: A Prospective Cohort Study With Inverse Probability Treatment Weight Propensity Score Analysis. J Foot Ankle Surg 2023; 62:222-227. [PMID: 35918264 DOI: 10.1053/j.jfas.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 02/03/2023]
Abstract
Posterior crural fasciotomy (PF) may reduce postoperative surgical site infection (SSI) rate compared to inserted vacuum suction drainage (VD) in open Achilles tendon repair surgery. Thus, we aimed to compare the postoperative SSI rate between PF and VD in open Achilles's tendon repair surgery. A prospective, single-centered, nonrandomized controlled study of consecutive adult patients undergoing primary open Achilles tendon repair was performed at tertiary referral hospital between January 2017 and January 2020. Patients received either PF or VD from 2 experienced surgeons. Data were collected on demographic, clinical, and intraoperative characteristics along with postoperative SSI and other outcomes. The primary outcome was SSI rate. Secondary outcomes were Achilles tendon total rupture score, functional foot index, and visual analogue scale. A total of 60 patients were eligible and included in the final analysis (PF group n = 30 and VD group n = 30). Two (6.7%) patients in the PF group and 5 (16.7%) patients in the VD group experience postoperative SSI (crude risk ratio 0.40; 95% confidence interval 0.08, 1.90; p = .228). In inverse-probability-treatment-weighted propensity score analysis, the PF group had a significantly lower SSI rate than the VD group (adjusted risk ratio 0.30; 95% confidence interval 0.01, 0.91; p = .033). Inverse-probability-treatment-weighted propensity score analysis of Achilles tendon total rupture score along with crude analysis of total functional foot index and visual analogue scale were also significantly better in the PF group than the VD group (all p < .05). PF during open Achilles repair was associated with a significant reduction in postoperative SSI infection rate compared to VD.
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Amri MI, Alzhrani MM, Alanazi AD, Alqahtani MM, Kashoo FZ. Cross-cultural adaptation and validation of the Arabic version of the foot function index in patients with chronic lateral ankle instability. J Foot Ankle Res 2022; 15:21. [PMID: 35279212 PMCID: PMC8917771 DOI: 10.1186/s13047-022-00527-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The English version of the Foot Function Index (FFI) is a reliable and valid tool for measuring pain and functional instability due to chronic lateral ankle instability (CLAI). However, its use among Arabic speakers with CLAI is limited because of the unavailability of the Arabic version of the FFI (FFI-Arb). This study aimed to translate, cross-culturally adapt and validate the FFI from the original English version into Arabic.
Methods
The FFI questionnaire was translated using the Beaton guidelines. Two-hundred-and-thirty native Arabic-speaking participants with CLAI were recruited from different physiotherapy clinics in Saudi Arabia. The convergent validity of the FFI-Arb was tested using the Spearman correlation with the Arabic version Cumberland ankle instability tool (CAIT-Arab). Test-retest reliability was tested among 92 participants who completed the form again after seven days.
Results
Two-hundred-and-thirty participants were enrolled (mean age = 32.09, Standard deviation (SD) = 8.64 years old). There was excellent internal consistency for the three subscales of FFI: pain (0.95), disability (0.97), and activity limitation (0.86), as for the total score (0.98). Convergent validity was analyzed by Spearman rank correlation between the new translated versions of FFI-Arb and CAIT-Arab. The total FFI-Arb and CAIT-Arab scores were moderately correlated (rho = − 0.569; p < 0.001). Subscales of FFI-Arb, such as pain, disability, and activity limitation, were also moderately correlated with CAIT-Arab (rho = − 0.565, rho = − 0.561, rho = − 0.512; p < 0.001). The construct validity was confirmed by principal component analysis (factor analysis) showing a three-factor structure (eigenvalue 1) of FFI-Arb with a total variance of 77.3%. Test-retest reliability was excellent for the total score of the FFI-Arb and all its subscales (interclass correlation coefficient = 0.984–0.999).
Conclusions
The FFI-Arb is a reliable and valid tool for Arabic-speaking patients with CLAI. The FFI-Arb can be utilized in hospitals and clinics in Arabic speaking countries.
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