Calcaneal Ossoscopy.
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ABSTRACT:
SUBMITTER: Toepfer A
PROVIDER: S-EPMC5021539 | biostudies-literature | 2016 Jun
REPOSITORIES: biostudies-literature
Publications
Calcaneal Ossoscopy.
Toepfer Andreas A Lenze Ulrich U Harrasser Norbert N
Arthroscopy techniques 20160620 3
Both unicameral bone cysts and intraosseous lipoma of the calcaneus are rare entities that are mostly diagnosed because of unspecific heel pain, pathologic fracture, or as incidental finding. Minimally invasive ossoscopy with endoscopic resection of the tumor followed by grafting can potentially minimize risks of open surgery and speed up convalescence. We present our modifications to previously described techniques of endoscopic curettage with a particular focus on intraosseous lipoma and allog ...[more]
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Project description:IntroductionFlexible pes planovalgus in children may be corrected with a calcaneal lengthening osteotomy (CLO).However, CLO surgery may displace the distal calcaneal fragment dorsally and affect the motion in the calcaneal-cuboid joint (CCJ). We used radiostereometric analysis (RSA) to evaluate CCJ motion and CLO stability in children one year after CLO.MethodsTen patients (10 feet) with symptomatic flexible pes planovalgus were investigated one year after CLO. Mean age was 11.5 years (range 8.2-14.2). Standardised RSA measurements of the foot were obtained one year after surgery without and with weight-bearing (single leg stance). Tantalum markers inserted during surgery, were used to described the CCJ motion as cuboid bone motion with respect to the distal calcaneus, and the CLO stability as distal calcaneal migration with respect to the proximal calcaneus.ResultsOne year after surgery the CLO was stable. The motion in the CCJ upon full weight-bearing was mean -1.04 mm (CI95% -1.40; -0.67) joint distraction, mean 2.27 mm (CI95% 1.57; 2.96) cuboid dorsal translation, mean -1.94 mm (CI 95% -2.68; -1.20) cuboid medial translation, and mean 7.43° (CI 95% 3.97; 10.88) adduction.ConclusionThe motion in the CCJ of children with CLO corrections for pes planovalgus is similar to that of adults during stance load with a normal foot posture and the patients were asymptomatic. Marker-based RSA may be used to evaluate causalities of foot symptoms after CLO surgery.
| S-EPMC7670122 | biostudies-literature
Project description:This review article on the current management for calcaneal fractures discusses the advantages and disadvantages of different treatment options including the problems encountered. Controversies are described and the evidence reviewed. The management of some types of displaced intra-articular calcaneal fractures remains contentious; is there a preferred stabilisation method for each type of calcaneal fracture? How constant is the "constant fragment" in an intra-articular calcaneal fracture and what is the evidence for primary arthrodesis and what is its place in these fractures?
| S-EPMC5862705 | biostudies-literature
Project description:BackgroundCalcaneal fractures are associated with numerous complications and a poor prognosis with significant long-term quality-of-life issues, regardless of treatment. Therefore, in-depth research into the underlying mechanism of calcaneal fracture is still of great interest, with the goal of improving treatment for patients suffering from this condition. This study aimed to investigate the relationship between the distribution of calcaneal fracture lines and their determinants, especially those related to the internal structure of the calcaneus. This goal was achieved by fracture maps created by copying and stacking fracture lines as viewed from six surfaces of the calcaneus.MethodsA total of 210 consecutive patients with 226 calcaneal fractures were retrospectively analyzed. Fracture lines were copied from a reduced 3D calcaneal fracture model and stacked on calcaneal templates to generate fracture maps. The stacked images of six calcaneus surfaces were also converted into spectrograms with MATLAB to highlight the fracture frequency at specific locations.ResultsThere were four concentrated bands of fracture lines and two fracture hot spots on the superior surface. Three dense bands of fractures were observed on the medial surface, and four fracture bands were observed lateral to the calcaneus. Vertical fracture lines dominated the anterior calcaneal fracture map. On the posterior surface, the fracture lines appeared to be centered superiorly. All fracture locations coincided with the interfaces between the trabecular groups.ConclusionsThe fracture maps showed fracture patterns and recurrent fracture zones on all calcaneal surfaces. The shape of the talus and calcaneus and the architecture within the calcaneus, especially the arrangement of the trabeculae, are essential factors for calcaneal fractures.
| S-EPMC8780651 | biostudies-literature
Project description:We investigated calcaneal tendon extracellular matrix (ECM) remodeling after gastrocnemius muscle injury using a rat model. Wistar rats were randomly divided into four groups: control group (C; animals that were not exposed to muscle injury) and harvested at different time points post gastrocnemius muscle injury (3, 14 and 28 days) for gene expression analysis. qRT-PCR was performed using TaqMan Universal PCR Master Mix system (Applied Biosystems, CA, USA - Cat. 4304437).
2019-09-30 | GSE131884 | GEO
Project description:Subfibular impingement is a common cause of lateral heel pain after calcaneal fracture. It can be caused by calcaneofibular impingement, peroneal impingement, or a combination thereof. It may not be easy to differentiate bony impingement from soft-tissue impingement. Simultaneous lateral calcaneal ostectomy and peroneal tendon decompression may increase the chance of pain relief. The purpose of this Technical Note was to report the technical details of endoscopic lateral calcaneal ostectomy and peroneal tendon decompression with the patient in the prone position. This technique is indicated for symptomatic subfibular impingement recalcitrant to conservative treatment. It has the advantages of being minimally invasive surgery and allowing early mobilization of the foot and ankle.
| S-EPMC6948115 | biostudies-literature
Project description:Cross-talk between skeletal muscle and tendon is important for tissue homeostasis. Whereas the skeletal muscle response to tendon injury has been well-studied, to the best of our knowledge the tendon response to skeletal muscle injury has been neglected. Thus, we investigated calcaneal tendon extracellular matrix (ECM) remodeling after gastrocnemius muscle injury using a rat model. Wistar rats were randomly divided into four groups: control group (C; animals that were not exposed to muscle injury) and harvested at different time points post gastrocnemius muscle injury (3, 14, and 28 days) for gene expression, morphological, and biomechanical analyses. At 3 days post injury, we observed mRNA-level dysregulation of signaling pathways associated with collagen I accompanied with disrupted biomechanical properties. At 14 days post injury, we found reduced collagen content histologically accompanied by invasion of blood vessels into the tendon proper and an abundance of peritendinous sheath cells. Finally, at 28 days post injury, there were signs of recovery at the gene expression level including upregulation of transcription factors related to ECM synthesis, remodeling, and repair. At this time point, tendons also presented with increased peritendinous sheath cells, decreased adipose cells, higher Young's modulus, and lower strain to failure compared to the uninjured controls and all post injury time points. In summary, we demonstrate that the calcaneal tendon undergoes extensive ECM remodeling in response to gastrocnemius muscle injury leading to altered functional properties in a rat model. Tendon plasticity in response to skeletal muscle injury merits further investigation to understand its physiological relevance and potential clinical implications.
| S-EPMC6733963 | biostudies-literature
Project description:ObjectiveThe aim of this study was to introduce a novel method of simultaneous in situ decompression of lateral calcaneal bulge and subtalar arthrodesis via a single incision for malunion after calcaneal fractures and evaluate the feasibility of this method.MethodsFrom September 2010 to October 2011, six patients (five males and one female) with malunion and delayed heel pain after conservative treatment of displaced intra-articular calcaneal fractures were included in our study. The mean age of the six patients was 32.9?years (range, 25-71?years). Patients were treated with this novel technique at our department and the functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scores during follow-up. Information of the six patients including surgical data and pre/postoperative function scores were retrospectively analyzed using SPSS 19.0 statistical software.ResultsThe average operation time between wire insertion and incision suture was 42.2?±?11.5?min (range, 25-56?min). The blood loss in all patients was all less than 50?ml each. The average fluoroscopy time was 25.7?±?11.6?s (range, 11-43?s). No wound-related and other short-term complications were recorded. Six patients who were included in our study were followed for an average period of 66.2?±?4.7?months (range, 60-73?months). There was no patient lost to follow up. Heel pain was observed to be greatly improved preoperatively in all of the six patients. All patients restored to normal activity of life after surgery. Radiological evidence of fusion was observed in five patients. The average fusion time of these five patients was 3.5?months (range, 2-4?months). The remaining one failed to achieve fusion and the hardware removal was performed due to screw tail irritation. This patient was satisfied with the final outcomes subjectively after removal of hardware. The mean AOFAS scores at 24?months postoperative were 82.0?±?7.0, which was greatly improved compared to preoperative (44.8?±?10.7) (P?<?0.05). The preoperative VAS pain scores were decreased from 5.8?±?1.5 to 2.6?±?1.4 at 24?months postoperative (P?<?0.05) and slightly decreased to 2.0?±?1.7 at 48?months postoperative (P?<?0.05). No surgery-related complications were observed in any of the patients.ConclusionsThe novel technique can effectively relieve the heel pain, prompt functional recovery, decrease the incidence of complications, simplify the surgical procedure, and shorten the learning curve. Therefore, the technique is a feasible and worthwhile alternative in treating malunion after calcaneal fractures.
| S-EPMC7307231 | biostudies-literature
Project description:Background:Operative treatment of calcaneal fractures using the extensile lateral approach is associated with high rates of soft tissue complications. In the past years, there has been a trend toward less invasive surgical approaches. Percutaneous and arthroscopically assisted calcaneal osteosynthesis (PACO) combines the advantages of visualization of the posterior facet of the subtalar joint with a minimally invasive approach.Methods:We conducted a follow-up of 25 patients with 26 calcaneal fractures (Sanders II and III), treated with PACO with a minimum follow-up of 12 months. The median age was 44 years (range, 21-72) and the follow-up period 15 months (12-33). Our clinical outcomes were the Manchester-Oxford Foot Questionnaire (MOxFQ), the Calcaneus Fracture Scoring System (CFSS), the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score, the Short-Form-36 (SF-36), the visual analog scale (VAS) for pain, and the number of complications. Radiographs on follow-up were obtained to evaluate the reduction of the fractures as well as osteoarthritis of the subtalar joint.Results:The median MOxFQ score was 26.6 (0-76.6), the CFSS score 85 (26-100), and the AOFAS score 85 (50-100). The VAS pain score was 0 (0-5.7) at rest and 4.1 (0-8.2) during activity. The Böhler angle improved from a mean (SD) of 3.5 (12.3) degrees preoperatively to 27.7 (10.5) degrees postoperatively. The follow-up radiographs showed subsidence of the fractures and a Böhler angle of 20.3 (12.9) degrees. There were no wound-healing complications. Two patients had additional surgery with screw removal due to prominent hardware.Conclusion:Our results suggest that PACO gives good clinical outcomes and a low risk of complications in selected calcaneal fractures. Prospective long-term studies will be necessary to better document the potential advantages and limitations of this operating technique.Level of evidence:Level IV, retrospective case series.
| S-EPMC7294532 | biostudies-literature
Project description:Processes of development during fetal life profoundly transform tendons from a plastic tissue into a highly differentiated structure, characterised by a very low ability to regenerate after injury in adulthood. Sheep tendon is frequently used as a translational model to investigate cell-based regenerative approaches. However, in contrast to other species, analytical and comparative baseline studies on the normal developmental maturation of sheep tendons from fetal through to adult life are not currently available. Thus, a detailed morphological and biochemical study was designed to characterise tissue maturation during mid- (2?months of pregnancy: 14?cm of length) and late fetal (4?months: 40?cm of length) life, through to adulthood. The results confirm that ovine tendon morphology undergoes profound transformations during this period. Endotenon was more developed in fetal tendons than in adult tissues, and its cell phenotype changed through tendon maturation. Indeed, groups of large rounded cells laying on smaller and more compacted ones expressing osteocalcin, vascular endothelial growth factor (VEGF) and nerve growth factor (NGF) were identified exclusively in fetal mid-stage tissues, and not in late fetal or adult tendons. VEGF, NGF as well as blood vessels and nerve fibers showed decreased expression during tendon development. Moreover, the endotenon of mid- and late fetuses contained identifiable cells that expressed several pluripotent stem cell markers [Telomerase Reverse Transcriptase (TERT), SRY Determining Region Y Box-2 (SOX2), Nanog Homeobox (NANOG) and Octamer Binding Transcription Factor-4A (OCT-4A)]. These cells were not identifiable in adult specimens. Ovine tendon development was also accompanied by morphological modifications to cell nuclei, and a progressive decrease in cellularity, proliferation index and expression of connexins 43 and 32. Tendon maturation was similarly characterised by modulation of several other gene expression profiles, including Collagen type I, Collagen type III, Scleraxis B, Tenomodulin, Trombospondin 4 and Osteocalcin. These gene profiles underwent a dramatic reduction in adult tissues. Transforming growth factor-?~1 expression (involved in collagen synthesis) underwent a similar decrease. In conclusion, these morphological studies carried out on sheep tendons at different stages of development and aging offer normal structural and molecular baseline data to allow accurate evaluation of data from subsequent interventional studies investigating tendon healing and regeneration in ovine experimental models.
| S-EPMC4304568 | biostudies-literature
Project description:Specialized acrobatic leaping has been recognized as a key adaptive trait tied to the origin and subsequent radiation of euprimates based on its observed frequency in extant primates and inferred frequency in extinct early euprimates. Hypothesized skeletal correlates include elongated tarsal elements, which would be expected to aid leaping by allowing for increased rates and durations of propulsive acceleration at takeoff. Alternatively, authors of a recent study argued that pronounced distal calcaneal elongation of euprimates (compared to other mammalian taxa) was related primarily to specialized pedal grasping. Testing for correlations between calcaneal elongation and leaping versus grasping is complicated by body size differences and associated allometric affects. We re-assess allometric constraints on, and the functional significance of, calcaneal elongation using phylogenetic comparative methods, and present an evolutionary hypothesis for the evolution of calcaneal elongation in primates using a Bayesian approach to ancestral state reconstruction (ASR). Results show that among all primates, logged ratios of distal calcaneal length to total calcaneal length are inversely correlated with logged body mass proxies derived from the area of the calcaneal facet for the cuboid. Results from phylogenetic ANOVA on residuals from this allometric line suggest that deviations are explained by degree of leaping specialization in prosimians, but not anthropoids. Results from ASR suggest that non-allometric increases in calcaneal elongation began in the primate stem lineage and continued independently in haplorhines and strepsirrhines. Anthropoid and lorisid lineages show stasis and decreasing elongation, respectively. Initial increases in calcaneal elongation in primate evolution may be related to either development of hallucal-grasping or a combination of grasping and more specialized leaping behaviors. As has been previously suggested, subsequent increases in calcaneal elongation are likely adaptations for more effective acrobatic leaping, highlighting the importance of this behavior in early euprimate evolution.
| S-EPMC3701013 | biostudies-literature