first balkan foot and ankle meeting - e-vip · cavovarus foot reconstruction t. ogut, turkey...
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FIRST BALKANFOOT AND ANKLEMEETING6-8th SEPTEMBER 2018EUROPEAN INTERBALKAN MEDICAL CENTERTHESSALONIKI GREECE
www.gbfootandankle.eu
Under the auspices of the European Foot and Ankle SocietyHellenic Association of Orthopaedic Surgery & TraumatologyOrthopaedic & Traumatologic Association of Macedonia & Thrace
MED CONGRESSEvents OrganizerKalapothaki 3, GR 54624 ThessalonikiT: ++30 231 403 9704 - F: ++30 231 220 6898E: [email protected]
ΕΛΛΗΝΙΚΗ
ΕΤΑ
ΙΡΕ
ΙΑ Χ
ΕΙΡΟ
ΥΡΓΙΚΗΣ ΟΡΘΟΠΑΙΔΙΚΗΣ &
ΤΡΑ
ΥΜ
ΑΤΟ
ΛΟΓΙΑΣ
1947
ΑΘΗΝΑ
Organized by theBulgarian and Hellenic Foot and Ankle Societies
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Dear colleagues,
We welcome you in Thessaloniki to participate in the First Balkan Foot and Ankle Meeting. Objective of the meeting is to comprehensively cover all aspects of modern foot and ankle sur-gery (biomechanics, reconstructive surgery, artrhroscopy and sports injuries, trauma), aiming at an audience of orthopaedic surgeons in training and also specialists with an interest in foot and ankle surgery. Lectures will be delivered by experienced orthopaedic surgeons from the Balkan countries and beyond.
The structure of the meeting has been divided to lectures according to anatomical regions – hindfoot, midfoot, forefoot - and thematic sessions. Free presentations from different regions will also give us an insight of local trends and experience in foot and ankle surgery. Apart from the scientific program, Thessaloniki is a vibrant, cultural city where participants and accompanying members can enjoy sightseeing, shopping, interesting food and nearby beaches in a safe environment. Wishing you all an enjoyable and constructive meeting!
Best regards,
2018 Meeting of the Working Group on Obesity, Diabetes and the High Risk Patient6-8th SEPTEMBER 2018, EUROPEAN INTERBALKAN MEDICAL CENTER
ORGANIZING COMMITTEEAtanas Katsarov
Nikolaos GougouliasDimitris Hatziemmanuil
Evgeni NeshevPanagiotis Symeonidis
SCIENTIFIC COMMITTEEPanagiotis Symeonidis
Atanas KatsarovAthanasios Badekas
Svilen TodorovNikolaos Gougoulias
President of the Organizing Committee
Katsarov Atanas
President of the Scientific Committee
Symeonidis Panagiotis
Thursday September 06
15.00-16.00 REGISTRATIONS
16.00-17.00 FREE PAPERS 1. RECONSTRUCTION Chairmen: N. Gougoulias, Greece - S. Todorov, Bulgaria
FP1. Extensor tendon transfers for Charcot Marie Tooth disease A. Tanrıover, Turkey FP2. Mid-term results following arthroscopic ankle arthrodesis A.Yildirim, Turkey
FP3. Mid-term results of hindfoot salvage arthrodesis with retrograde compression intramedullary nail in charcot neuro arthropathy A. Yildirim, Turkey
FP4. Talectomy for severe nevrogenic equinovarus deformity A. Gerchev, Bulgaria
FP5. Our experience in the application of a nail used for tibio- talo-calcanear arthrodesis N. Tzachev, Bulgaria
FP6. Arthroscopic arthrodesis of the subtalar joint V. Lampridis, Greece
FP7. Tarso-matetarsal joints arthrodesis V. Lampridis, Greece
17.00-18.20 FOOT & ANKLE APPLIED BIOMECHANICS AND DEFORMITIES Chairmen: P. Symeonidis, Greece – R. Kehayov, Bulgaria
Applied Foot & Ankle Biomechanics N. Gougoulias, Greece
Compensation patterns relative to foot misalignment and dys function M. Panagiotidou, Greece
Planovalgus foot reconstruction V. Protsko, Russia
FIRST BALKAN FOOT AND ANKLE MEETING
Cavovarus foot reconstruction T. Ogut, Turkey
18.20-19.00 DIABETIC FOOT CARE. MULTIDISCIPLINARY TEAM APPROACH - MANAGEMENT OF SEPTIC FOOT AND BONE INFECTION Chairman: N. Gougoulias, Greece Lecturer: A. Wee, United Kingdom
19.00 OPENING SESSION - GREETINGS Chairman: N. Gougoulias Speakers: A.Katsarov - A. Drevelegkas -A. Badekas - P. Symeonidis
20.00 WELCOME RECEPTION AT INTERBALKAN MEDICAL CENTER
Friday September 07
09.00-11.00 FOREFOOT Chairmen: T. Badekas, Greece – A. Pettas, Greece
A new simple algorithm for decision making in hallux valgus T. Esemenli, Turkey
Scarf osteotomy K. Buedts, Belgium
Revision hallux valgus surgery L. Makinyan, Russia
ModifiedHelalosteotomyinthetreatmentofsevereforms of metatarsalgia and hammer toe deformities A. Mazalov, Russia
MTPJ instability and the plantar plate D. Bobrov, Russia
MIS forefoot surgery D. Hatziemmanuil, Greece
11.00-11.30 BREAK
11.30-12.30 FREE PAPERS 2. FOREFOOT AND MISCELLANEOUS Chairmen: A. Katsarov, Bulgaria - M. Drobnic, Slovenia
FP8. Arthroscopyofthefirstmetatarsophalangealjoint
2018 Meeting of the Working Group on Obesity, Diabetes and the High Risk Patient6-8th SEPTEMBER 2018, EUROPEAN INTERBALKAN MEDICAL CENTER
D. Dimnjakovic, Croatia FP9. Doessesamoidpositioneffectpatientsatisfactionafter hallux valgus surgery? A study over tangential sesamoid view E. Uygur, Turkey FP10. Evaluation and results of PBS percutaneous correction technique for symptomatic hallux valgus deformity P. Salonikidis, Greece
F11. Innovative approach to improving the method of preoperative planning and performing corrective forefoot osteotomy A. Akulaev, Russia
FP12. Theeffectsofhumanamnioticfluidandmembraneon fracture healing on rat fracture model (experimental study) A. Gultekin, Turkey
12.30-13.30 LIVE SURGERY (MIS HALLUX VALGUS CORRECTION) Performed by D. Hatziemannouil
13.30-14.00 BREAK
14.00-15.30 HIND FOOT Chairmen: A. Eleftheropoulos, Greece - R. Kastelov, Bulgaria
Hindfoot arthritis. Treatment alternatives T. Badekas, Greece
Deformity correction around ankle and hindfoot M. Drobnic, Slovenia
Ankle Arthroplasty K. Buedts, Belgium
Neuropathic diabetic foot reconstruction V. Obolenskiy, Russia
15.30-16.00 BREAK
16.00-17.00 ANKLE TRAUMA Chairmen: S. Todorov, Bulgaria – V. Lampridis, Greece
High ankle sprain. Syndesmotic involvement A. Katsarov, Bulgaria
FIRST BALKAN FOOT AND ANKLE MEETING
Ankle Fractures A. Eleftheropoulos, Greece
PilonFractures.Whyweleftearlysurgery? R. Kastelov, Bulgaria
20.00 DINNER AT NIKOPOLIS HOTEL
Saturday September 08
08.30-09.30 FREE PAPERS 3. TRAUMA AND SOFT TISSUE Chairmen: A. Katsarov, Bulgaria – N. Tzachev, Bulgaria
FP13. Two crossed Schanz pins versus calcaneal plate in the treatment of intraarticular calcaneal fractures? A comparison of functional and radiological outcomes A. Duramaz/E. Baca, Turkey
F14. Effectsofankletapingondynamicposturalcontrolin patients with ankle instability K. Sidiropoulos, Greece
FP15. Posteriormalleolusfixationforsyndesmosis E. Baca, Turkey
FP16. Translation and cross-cultural adaptation of the Turkish version of the foot health status questionnaire S. Karaborklu/E. Baca, Turkey
FP17. Retrospective study of Lisfranc fracture dislocations treatedwithfusionandinternalfixation K. Surchev, Bulgaria
FP18. Thefirst55peronealtendoscopiesofonesurgeon: analysisofintraoperativefindingsandperformedconcomitant procedures D. Dimnjakovic, Croatia
FP19. Proximal medial gastrocnemius release in the treatment of recalcitrant plantar fasciitis V. Lampridis, Greece
FP20. Salvagefibularlengtheningbyexternalfixatorafter incorrect lower leg lengthening. A two cases report. M. Zhivkov, Bulgaria
2018 Meeting of the Working Group on Obesity, Diabetes and the High Risk Patient6-8th SEPTEMBER 2018, EUROPEAN INTERBALKAN MEDICAL CENTER
FP21. Long term results of percutaneous radiofrequency nerve ablation for chronic plantar heel pain associated with plantar fasciitis Y. Erken, Turkey
09.30-11.00 ARTHROSCOPY - SPORTS INJURIES Chairmen: T. Ogut, Turkey - D. Hatziemmanuil, Greece
Chronicpainafterananklesprain-howtosetananatomic diagnosis M. Drobnic, Slovenia
Arthroscopy:Techniqueandindications N. Gougoulias, Greece
Talus Osteochondral lesions K. Irgit, Turkey
Endoscopic treatment of chronic Achillobursitis S. Tamoev, Russia
11.00-11.15 BREAK
11.15-12.30 FOOT FRACTURES; ACHILLES’ TENDON RUPTURES Chairmen: A. Katsarov, Bulgaria – A. Konstantinidis, Greece
Acute & Chronic Achilles tendon ruptures K. Irgit, Turkey
Calcaneal fractures E. Neshev, Bulgaria
Talus fractures S. Assiov / A. Iliev, Bulgaria
Lisfranc’s injuries P. Symeonidis, Greece
FIRST BALKAN FOOT AND ANKLE MEETING
2018 Meeting of the Working Group on Obesity, Diabetes and the High Risk Patient6-8th SEPTEMBER 2018, EUROPEAN INTERBALKAN MEDICAL CENTER
FREE PAPERS PRESENTATION FREE PAPERS 1. “RECONSTRUCTION”Thursday 6th of September 2018Chairmen: N. Gougoulias – S. Todorov FP1. EXTENSOR TENDON TRANSFERS FOR CHARCOT MARIE TOOTH DISEASEA. Tanrıöver
FP2. MID-TERM RESULTS FOLLOWING ARTHROSCOPIC ANKLE ARTHRODESISA. Yildirim
FP3. MID-TERM RESULTS OF HINDFOOT SALVAGE ARTHRODESIS WITH RETRO-GRADE COMPRESSION INTRAMEDULLARY NAIL IN CHARCOT NEURO ARTHROPATHYA. Yildirim - Ali Gulec
FP4. TALECTOMY FOR SEVERE NEVROGENIC EQUINOVARUS DEFORMITYA. Gerchev
FP5. OUR EXPERIENCE IN THE APPLICATION OF A NAIL USED FOR TIBIOTALO-CAL-CANEAR ARTHRODESISN. Tzachev - N. Ivanov - D.Liljanov - N.Hariskov
FP6. ARTHROSCOPIC ARTHRODESIS OF THE SUBTALAR JOINTV. Lampridis - G. Kiziridis - N. Gougoulias FP7. TARSO-MATETARSAL JOINTS ARTHRODESISV. Lampridis - G. Kiziridis - N. Gougoulias
FREE PAPERS 2. “FOREFOOT AND MISCELLANEOUS”Friday 7th of September 2018Chairmen: A. Katsarov - M. Drobnic
FP8. ARTHROSCOPY OF THE FIRST METATARSOPHALANGEAL JOINTD. Dimnjakovic - T. Smoljanovic - I. Bojanic
FP9. DOES SESAMOID POSITION EFFECT PATIENT SATISFACTION AFTER HALLUX VALGUS SURGERY? A STUDY OVER TANGENTIAL SESAMOID VIEWE. Uygur
FP10. EVALUATION AND RESULTS OF PBS PERCUTANEOUS CORRECTION TECH-NIQUE FOR SYMPTOMATIC HALLUX VALGUS DEFORMITYP. Salonikidis
FP11. INNOVATIVE APPROACH TO IMPROVING THE METHOD OF PREOPERATIVE PLANNING AND PERFORMING CORRECTIVE FOREFOOT OSTEOTOMYA. Akulaev - A. Filippova - V. Protsko
FIRST BALKAN FOOT AND ANKLE MEETING
FP12. THE EFFECTS OF HUMAN AMNIOTIC FLUID AND MEMBRANE ON FRACTURE HEALING ON RAT FRACTURE MODEL (EXPERIMENTAL STUDY)A. Gultekin - A. Meric Unal - M. Unlu - I. Safa Satoglou
FREE PAPERS 3. “TRAUMA AND SOFT TISSUE”Saturday 8th of September 2018Chairmen: A. Katsarov - N. Tzachev
FP13. TWO CROSSED SCHANZ PINS VERSUS CALCANEAL PLATE IN THE TREATMENT OF INTRAARTICULAR CALCANEAL FRACTURES? A COMPARISON OF FUNCTIONAL AND RADIOLOGICAL OUTCOMESE. Baca - A. Duramaz
FP14. EFFECTS OF ANKLE TAPING ON DYNAMIC POSTURAL CONTROL IN PATIENTS WITH ANKLE INSTABILITYK. Sidiropoulos - K. G. Tsikopoulos - D. Kitridis - P. Gkivisis
FP15. POSTERIOR MALLEOLUS FIXATION FOR SYNDESMOSISE. Baca - N. Ziroglou
FP16. TRANSLATION AND CROSS-CULTURAL ADAPTATION OF THE TURKISH VERSION OF THE FOOT HEALTH STATUS QUESTIONNAIREE. Baca - S. Karaborklu Argut - P. Tiryaki - O. Coban
FP17. RETROSPECTIVE STUDY OF LISFRANC FRACTURE DISLOCATIONS TREATED WITH FUSION AND INTERNAL FIXATIONK. Surchev - M. Rashkov FP18. THE FIRST 55 PERONEAL TENDOSCOPIES OF ONE SURGEON: ANALYSIS OF IN-TRAOPERATIVE FINDINGS AND PERFORMED CONCOMITANT PROCEDURESD. Dimnjakovic - T. Smoljanovic - I. Bojanic
FP19. PROXIMAL MEDIAL GASTROCNEMIUS RELEASE IN THE TREATMENT OF RECAL-CITRANT PLANTAR FASCIITISV. Lampridis - G. Kiziridis - A. Wee - N. Gougoulias
FP20. SALVAGE FIBULAR LENGTHENING BY EXTERNAL FIXATOR AFTER INCORRECT LOWER LEG LENGTHENING. A TWO CASES REPORTM. Zhivkov Lyubomirov
FP21. LONG TERM RESULTS OF PERCUTANEOUS RADIOFREQUENCY NERVE ABLATION FOR CHRONIC PLANTAR HEEL PAIN ASSOCIATED WITH PLANTAR FASCIITISY. Erken
2018 Meeting of the Working Group on Obesity, Diabetes and the High Risk Patient6-8th SEPTEMBER 2018, EUROPEAN INTERBALKAN MEDICAL CENTER
FACULTY
S. Assiov, MD, PhD, Associate Professor, Head of Clinic of Orthopaedics and Traumatolo-gy, University Multiprofile Hospital “St. Anna”, Sofia, BulgariaT. Badekas, MD, Director 3rd Orthopaedic Clinic Henry Dunant Hospital. Athens, Greece,Past President Greek Foot and Ankle Society Council Member EFASD. Bobrov, MD, PhD, Associate Professor Sechenov University, The Department of Trauma-tology, Orthopaedics and Disaster Surgery, Botkin Hospital, RussiaK. Buedts, Consultant Orthopaedic and Trauma surgeon, Head of Foot and Ankle Unit, Ortho-paedic Department ZNA Middelheim, Belgium, EFAS Council Member, Ass.Editor Foot Ankle Surgery journal Editorial Board Foot Ankle International journalA.Drevelegkas, President of Interbalkan Medical Center Scientific Committee M. Drobnic, MD, PhD, Consultant orthopaedic surgeon Department of Orthopaedic Surgery, University medical centre Ljubljana, SloveniaA. Eleftheropoulos, Orthopaedic Foot and Ankle Surgeon, Clinical Director Orthopaedic Dept., Naousa General Hospital, GreeceT. Esemenli, Professor of Orthopaedics and Traumatology, Istanbul Kent UniversityIstanbul Academic Hospital, TurkeyA. Iliev, Deputy chief of Clinic of Orthopaedics and Traumatology, University Multiprofile Hospital “St. Anna”, Sofia, BulgariaN. Gougoulias, MD, PhD, Consultant Orthopaedic Foot and Ankle Surgeon, Frimley Park Hos-pital, UK, Private Practice, Greece, Member of EFAS Education CommitteeD. Hatziemmanuil, MD, Foot and Ankle Surgeon, Interbalkan Medical Center Thessaloniki, Greece K. Irgit, Assoc. Professor Marmara School of Medicine, Istanbul, Orthopaedics and Trauma-tology, Chief of Foot and Ankle Division, President of Turkish Foot and Ankle SurgeryR. Kastelov, M.D., Ph.D. Prof., Head Orthopaedics and Trauma Department Medical Insti-tute, Ministry of Interior Sofia, BulgariaA. Katsarov, MD, PhD, Assoc. Prof., President of BFAS, President of the Organizing Commit-tee, BulgariaR. Kehayov, M.D., Orthopaedic Surgery, Foot Surgery, Pediatric Surgery, BulgariaA. Konstantinidis, Attending Orthopaedic surgeon, GreeceV. Lampridis, MD, MSc , FEBOT, FRCS (Tr&Orth), Consultant Orthopaedic Surgeon, Military Hospital Thessaloniki, GreeceL. Makinyan, MD, PhD, Docent Senior lecturer at the chair of Traumatology and Orthopae-dics, PFUR, RussiaA. Mazalov, MD, Orthopaedic, Clinical Scientific Center, City Clinical Hospital Yudin S.S., Moscow, Russia, Vice President of the Russian Association of Foot and Ankle SurgeonsE. Neshev, MD, Orthopaedic trauma surgeon, specialized in the treatment of general orthopaedic trauma and Foot and ankle trauma, Chief of the Or-thopaedic and trauma department in St. Anna hospital – Sofia, Bulgaria V. Obolenskiy, PhD, Head of the Septic Surgery Unit, City Clinical Hospital, Moscow, Russia T. Ogut, M.D. Professor of Orthopaedics and Traumatology, Istanbul, Turkey M. Panagiotidou, Osteopath and Physiotherapist, Euromedica - Arogi Physiotherapy Centre, Thessaloniki, GreeceA. Pettas, Orthopaedic surgeon, GreeceV. Protsko, MD, PhD, Docent Russian, University of Peoples’ Friendship, City Clinical Hospi-tal, Yudin S.S., Moscow RussiaP. Symeonidis, MD,PhD, Orthopaedic Foot and Ankle Surgeon St’ Luke’s Hospital, Thessalon-
iki, GreeceS. Tamoev, MD, PhD, Orthopaedic Foot and Ankle Surgeon, Dept. of Foot Surgery of Sergey Yudin City Hospital Moscow, RussiaS. Todorov, MD, PhD, Assoc. Prof. Orthopaedic and trauma surgeon, BulgariaN. Tzachev, MD, PhD, Prof., Orthopaedic and trauma surgeon, Military Medical Academy So-fia, BulgariaA. Wee, FRCS (Tr&Orth), Consultant Orthopaedic Foot and Ankle SurgeonFrimley Park Hospital, UK, Surrey Foot & Ankle Clinic, United Kingdom
FREE PAPERS PRESENTERSA. Akulaev, Orthopaedic and trauma specialist, RussiaE. Baca, foot and ankle surgeon in Department of Orthopedic and Traumatology of Istanbul Bakırkoy Dr Sadi Konuk Education and Research Hospital, TurkeyD. Dimnjakovic, MD, PhD, Orthopaedic and Trauma Surgeon, Department of Orthopaedic Surgery University Hospital Center Zagreb, CroatiaA. Duramaz, foot and ankle surgeon in Department of Orthopedic and Traumatology of Istanbul Bakırkoy Dr Sadi Konuk Education and Research Hospital, TurkeyY. Erken, MD, Assoc. Prof., Istanbul Okan University Faculty of Medicine, Department of Ortho-paedics and Traumatology, TurkeyA. Gerchev, Orthopaedic and trauma specialist, BulgariaA. Gultekin, MD, Orthopaedic surgeon, TurkeyS. Karaborklu, MsC, PT, Research Assistant Istanbul University - Cerrahpasa, Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Turkey V. Lampridis, MD, MSc , FEBOT, FRCS (Tr&Orth), Consultant Orthopaedic Surgeon, Military Hospital Thessaloniki, GreeceP. Salonikidis, MD, foot and ankle surgeon, Director of the orthopaedic department of Olympi-on General Hospital Patras, PBS surgeon in Italy, and PBS representative in GreeceK. Sidiropoulos, MD, Orthopaedic surgeon, GreeceK. Surchev, MD, Resident in Orthopedic Surgery and Trauma, BulgariaA. Tanriover, Orthopedic Surgeon, Foot and Ankle specialist in Cankaya Hospital , Ankara, TurkeyN. Tzachev, MD, PhD, Prof., Orthopaedic and trauma surgeon, Military Medical Academy Sofia, BulgariaE. Uygur, M.D., Assistant Prof. Orthopaedics and Traumatology Department Istanbul Medeni-yet University Goztepe Training and Research Hospital, İstanbul, TurkeyA. Yildirim, MD, Asst. Prof. Selcuk University School of Medicine Orthopaedics and Traumatol-ogy Dep. Konya, Turkey M. Zhinkov, Paediatric orthopaedic, Bulgaria
FIRST BALKAN FOOT AND ANKLE MEETING
2018 Meeting of the Working Group on Obesity, Diabetes and the High Risk Patient6-8th SEPTEMBER 2018, EUROPEAN INTERBALKAN MEDICAL CENTER
GENERAL INFORMATION
PLACE AND DATES: Thessaloniki, Greece, 6 – 8/09/2018
VENUE: European Interbalkan Medical Center, Thessaloniki, Greece - Asklipiou 10-Avenue of Agricultural School, Pylaia, Thessaloniki, Greece
ACCOMMODATION: There would be rooms available in the nearby hotels
REGISTRATION FEES:Trainees / residents: 50 Euros
Orthopaedic Surgeons: 70 Euros
SCIENTIFIC PROGRAM: Lectures, round tables and free anouncements have been devided according to regions and pathology (hindfoot, midfoot, forefoot, applied boimachan-ics,deformities, arthroscopy and trauma).The eminent key note specialists invited as lecturers and the skilled, experienced instructors encourage the active participation of the delegates.
The whole course will be accredited. Please confirm yourattendance at the sessions with your barcode on your badge.
medical pq 2.pdf 9/19/11 11:57:35 AM
The organizing committee wishes to thank the following companies – sponsors for their help in accomplishing the First Balkan Foot
and Ankle Meeting
FREE PAPERS
FP1. EXTEN
SOR
TEND
ON
TRA
NSFER
S FOR
CHA
RC
OT M
AR
IE TOO
TH D
ISEASE
Altuğ Tanrıöver
Orthopaedic Surgeon
Private Cankaya Hospital
Ankara Turkey
Introduction:Charcot M
arie Tooth (CMT) disease is one of the m
ost comm
on inherited neurological condition, affecting m
yelin sheaths of nerves. It causes mus-
cles weakness in feet and arm
s.M
uscle imbalance usually appear at adolescent age as peroneal w
eakness, cavovarus feet, gastrosoleus contractures and lateral instability.G
old standard in treating flexible cavovarus foot is deformity correction and balancing m
uscle forces and sparing joints. Calcaneal osteotomies,
tibialis posterior and peroneal tendon transfers are comm
only applied. Extensor hallucis longus tendon transfer to first metatarsal head w
ith inter-phalangeal arthrodesis is defined for first ray elevation and ham
mer toe.
Purpose:In this study, extensor tendon transfers to all five m
etatarsals with concom
itant interphalangeal arthrodesis for semiflexible cavus foot and m
eta-tarsus adductus and plantar ulcers, is perform
ed instead of midfoot and m
etatarsal osteotomies and arthrodesis. Clinical and radiologic results and
wound healing is follow
ed.M
ethod:Four feet of tw
o patients having CMT disease and plantar ulcers under m
etatarsal heads. Both patients (ages 20 and 40, m
ale) underwent sam
e procedures, and feet are operated separately w
ith six months interval. G
astrorecession, calcaneal sliding osteotomy, tibialis posterior to lateral cu-
neiform transfer, plantar fascia release, peroneus longus to brevis transfer w
ere performed. Clinical and radiologic data w
ere collected and wound
healing is checked.R
esults:Throughout follow
up period both patients with four feet had plantigrade feet w
ithout ulcers. Conclusion:A
lthough midfoot osteotom
ies and/or metatarsal osteotom
ies are recomm
ended for midfoot and forefoot deform
ities, long extensor tendon trans-fer w
ith interphalangeal arthrodesis is a viable option for treating both metatarsus adductus and cavus w
ith hamm
ertoes and metatarsal plantar
ulcers. Extensor tendon transfer spares joints and bones, and less invasive and technically easier to perform w
ithout need for C-arm and special
implants.
FP2. MID
-TERM
RESU
LTS FOLLO
WIN
G A
RTH
RO
SCO
PIC A
NK
LE AR
THR
OD
ESIS
Ahm
et Yildirim, A
sst.Prof 1
1 Departm
ent of Orthopedics and Traum
atology, Medical Faculty of Selcuk U
niversity, Konya, Turkey
Corresponding Author: A
hmet YILD
IRIM
, Asst. Prof., D
epartment of O
rthopedics and Traumatology, M
edical Faculty of Selcuk University, 42100
Konya, Turkey
We review
ed 26 patients who underw
ent arthroscopic ankle arthrodeses. The mean age of these patients w
as 54,2 months (30 to 88 years). The
indications for operation were post-traum
atic osteoarthritis, primary osteoarthritis, inflam
matory arthropathy and rheum
otid arthritis. The mean
follow-up w
as 15 months (9 to 24). The patients w
ere assessed by clinical visit and telephone interview. The operation w
as did with the help of
fluoroscopy and through arthroscopic procedure with at least 2 lateral fixation and 1 m
edial fixation of 6,5 cannulated screw. The m
ean time to
union was 13 w
eeks (9 to 24). Nonunion occurred in 3 cases (11 %
). Other com
plications included superficial infections, 1 deep vein thromboses,
one revision of fixation, one stress fracture. Preoperative mean A
OFA
S score was 18 and postoperative A
OFA
s score was 80; as w
e see the results are good and excellent for the ankle arthritis aft
er arthroscopic arthrodesis.
FP3. MİD
-TERM
RESU
LTS OF H
İND
FOO
T SALV
AG
E AR
THR
OD
ESİS WİTH
RETR
OG
RA
DE C
OM
PRESSİO
N IN
TRA
MED
ULLA
RY
NA
İL İN CH
AR
-C
OT N
EUR
OA
RTH
RO
PATH
Y
Ahm
et Yildirim; A
sst.Prof 1, Ali G
ulec; Asst.Prof 1
1 Departm
ent of Orthopedics and Traum
atology, Medical Faculty of Selcuk U
niversity, Konya, Turkey
Corresponding Author: A
hmet YILD
IRIM
, Asst. Prof., D
epartment of O
rthopedics and Traumatology, M
edical Faculty of Selcuk University, 42100
Konya, Turkey
Introduction: Charcot arthropathy of the hindfoot and ankle is a hard issue mostly seen as diabetes m
ellitus complication. H
indfoot arthrodesis with
retrograde intramedullary nailing is a slight new
method to reconstruct deform
ities of the ankle and hindfoot in patients with Charcot arthropathy.
Obtaining a plantigrade foot and ankle, reducing the risk of ulceration and decreasing pain is the m
ain purpose.
Purpose: Our study is about to analyze the m
idterm results of hindfoot arthrodesis w
ith intramedullary nail to treat Charcot osteo-neuroarthropa-
thy.
Material and M
ethods: We perform
ed a retrospective analysis of 11 consecutive patients with Charcot arthropathy w
ho underwent a hindfoot and
midfoot arthrodesis using tw
o different types of retrograde intram
edullary compression nail. Patients w
ere three men and eight w
omen w
ith a m
ean age of 71.13 years (48.5 to 81.8). We describe the rate of lim
b salvage, complications requiring additional surgery, and fusion rate in both
groups. The mean duration of follow
-up was 16.24 m
onths (11 to 25).
Results: The transtibial am
putation procedure was required for one patient, lim
b salvage rate was ten. Com
plications including infection, implant
removal, nonunion, calcaneus and talus fracture aft
er mobilization and persistent ulcers requiring further intervention w
ere also seen. Mean A
OFA
S scores w
ere increased from 14 to 58 aft
er 12 months from
surgery.
Conclusions: Due to m
idterm results; use of retrograde intram
edullary compression nail show
s good results when used for hindfoot reconstruction
in patients with Charcot arthropathy.
FP4. TALEC
TOM
Y FO
R SEV
ERE N
EVR
OG
ENIC
EQU
INO
VA
RU
S DEFO
RM
ITY
Gerchev A
. , Bulgaria
Objective: R
epresent the effectiveness of Talectom
y in treatment for Equinovarus paralytic’s feet. The aim
of the orthopaedics treatment is correc-
tion of the deformity and restoration of the w
alking ability M
aterial and methods: W
e prospectively reviewed in this report, tw
o young patients brother and sister ( ♂10 y. and ♂12 y.) affected by a H
MSN
type I, w
ith rigid severe pes equinovarus (PEV) deformities that underw
ent single-stage corrective surgery. The patients were treated and follow
ed for the period 2013 - 2018 Children’s Clinic of U
SBA
LO ,, Professor. B
. Boychev “
Hereditary m
otor and sensory neuropathy (HM
SN) also know
n as Charcot-Marie-Tooth disease is the m
ost comm
on inherited neuromuscular dis-
ease which includes a group of clinically and genetically heterogeneous disorders of the peripheral nervous system
. Foot deformities are com
monly
present in children with H
MSN
. Our single stage surgery consisted of talectom
y. Complete excision of the talus is perform
ed and fixed in the cor-rected position w
ith two K
-wires through the calcaneus to the distal tibia.
Results: B
oth patients were assessed preoperatively and postoperatively both clinically and radiologically by anteroposterior and lateral radio-
graphs. The mean follow
-up was 34 m
onths (±18.3).Our tibio-calcaneal angle im
proved by 40%. B
oth patients could walk w
ithout assistive devices.Conclusion : O
ur results suggest that, with proper indications, talectom
y, despite of its palliative nature, has its place in pediatric orthopaedic sur-gery. This operation m
ay be a method of choice as a “lim
b-saving procedure” in neurogenic neglected PEV, as well as in adolescents w
ith untreated severe idiopathic congenital PEV in order to obtain a stable plantigrade foot and it’s a good alternative of a pantalar arthrodesis procedure.
FP5. OU
R EX
PERIEN
CE IN
THE A
PPLICA
TION
OF A
NA
IL USED
FOR
TIBIO
-TALO
-CA
LCA
NEA
R A
RTH
RO
DESIS.
N.Ivanov, D
.Liljanov, N.H
ariskov, N.Tzachev
Military M
edical Academ
y, Sofia, Bulgaria
Introduction: Back in 1868 Jean M
artin Charkot described an unusual hypertrofic destruction of the ankle joint. The unstability in the medial tibial
part passes through three phases of progressive collapse and arthrosis of the posterior plantar part. The final phase of the neuropatic osteoarthro-patic of Charcot features the pantalar arthrodesis. The surgical m
ethods of treatment are triple arthrodesis, tibio-talo-calcanear arthrodesis and
pantalar arthrodesis. In 1911, Lorthior is the first who uses pantalar arthrodesis aft
er poliomielit. The arthrodesis is alternative of Sym
es amputa-
tion. A
im: This presentation aim
s to share our experience in the application of a nail for tibio-talo-calcanear arthrodesis. In 1999 at the 15-th Annual
Summ
er Meeting of A
merican O
rthopaedic Foot and Ankle Society the tibio-talo-calcanear arthrodesis w
ith intramedullary nail w
as presented for the first tim
e. The indications for TTK arthrodesis are prim
al and posttraumatic arthrosis of the ankle joint, neuro-m
uscle deformation, avascular
necrosis of the talus, neuroarthropatia of Charkot, rheumatic arthrit, osteoarthrit, ankilosis and m
ultiple contractures in ankle joint. The pre-opera-tive planning includes “X”-ray in A
P and lateral position with loading and B
roden position for subtalar joint. Clinical research of the evolution of the pain is needed, the condition of the tissues, neurological and vessel status. W
e used lateral and transfibular approach. M
aterials and Method: For a period of ten years (2007-2017) w
e operated on 21 patients in our clinic, we have done 21 TTK
arthrodesis with
intramedullary nail. W
e have used Stryker nail T2AA
N in all of the cases.
Results: In all of our clinical cases w
e have reached fusion and stable painless ankle joint. We have had one case of an error in the proxim
al locking and one case of jatrogenic fractures of the m
edial malleus. B
ecause of a deep infection in one of the patients it was necessary to rem
ove the nail, w
hich did not have a negative effect on the arthrodesis.
Conclusion: The pantalar and TTK arthrodesis have a good functional result and is preferred to am
putation. The arthrodesis with IM
nail reaches better rigidity and stability in com
parison to the cross screw fixation.
FP6. AR
THR
OSC
OPIC
AR
THR
OD
ESIS OF SU
BTA
LAR
JOIN
TVasileios Lam
pridis1,2, Georgios K
iziridis1, Nikolaos G
ougoulias1.1.Frim
ley Park Hospital N
HS Trust, U
K, 2. 424 M
ilitary Hospital Thessaloniki
Introduction: Subtalar joint (STJ) arthrodesis can be performed either in isolation or in com
bination with arthrodesis of other joints for the treat-
ment of several conditions, like arthritis, tarsal coalition and posterior tibial tendon dysfunction. A
rthroscopic procedures are an alternative to conventional open techniques, in order to decrease soft
tissue damage and increase union rates w
hilst reducing complications.
Purpose: We w
anted to evaluate and present the results of arthroscopic STJ arthrodesis regarding union rate, time to union and com
plications.M
aterial-Methods: This is a retrospective review
of 15 patients (16 feet) that underwent arthroscopic STJ arthrodesis, w
ith the technique of two
arthroscopic portals through the sinus tarsi, between 2014 and 2017. A
ll procedures were perform
ed by the senior author or under his direct supervision. M
ean patients’ age was 57 years (range 32-76). In addition, arthroscopic arthrodesis of the talo-navicular joint w
as performed in five
patients, of the calcaneo-cuboid joint in one patient and of the ankle joint in six patients. 6.5 or 8 mm
screws w
ere used for the arthrodesis, but in tw
o cases that included the ankle joint a tibio-talo-calcaneal nail was used. G
astrocnemius slide, or A
chilles tendon release was perform
ed in three patients for flatfoot correction.R
esults: Union rate for STJ arthrodesis w
as 94% (15 from
16 feet). One patient w
ho developed non-union had concomitant ankle joint arthrodesis.
He subsequently had revision surgery. O
ne diabetic patient with pre-existing neuropathy, that underw
ent also ankle joint arthrodesis, developed CR
PS. Mean union tim
e was 14 w
eeks (range 6-40).Conclusions: A
rthroscopic STJ arthrodesis revealed high union and low com
plication rates, performed either in isolation or in com
bination with
other joints, for the treatment of arthritis and/or deform
ity correction.
FP7. TAR
SO-M
ATETA
RSA
L JOIN
TS AR
THR
OD
ESISVasileios Lam
pridis1,2, Georgios K
iziridis1, Nikolaos G
ougoulias1.1.Frim
ley Park Hospital N
HS Trust, U
K, 2. 424 M
ilitary Hospital Thessaloniki
Introduction: Arthrodesis of the tarso-m
etatarsal joints (TMTJs) is com
monly perform
ed in patients with painful osteoarthritis or for correction
of foot deformities. It is also frequently perform
ed in conjunction with other procedures in the m
idfoot or forefoot. In the literature there are few
original studies reporting on outcomes aft
er these operations.Purpose: W
e wanted to evaluate and present the results of a cohort from
a fellowship trained orthopaedic foot and ankle surgeon, regarding union
rate, time to union and com
plications.M
aterial-Methods: This is a retrospective review
of 62 patients (68 feet) that underwent TM
TJs arthrodesis between 2010 and 2017. A
ll procedures w
ere performed by the senior author or under his direct supervision. The m
ean patients’ age was 60 years (range 26-80). In addition, talonavicular
joint arthrodesis was perform
ed in seven patients, subtalar arthrodesis in four patients, naviculo-cuneiform arthrodesis in 22 patients and forefoot
procedures for correction of hallux valgus in nine patients. Gastrocnem
ius slide, or Achilles tendon release w
as performed in seven patients. M
ean duration of surgery w
as 105 mins and m
ean hospital stay was 1 day.
Results: U
nion rate for TMTJs w
as 94,1% (64 out of 68 feet). Tw
o of the patients who developed non-union w
ere smokers and one w
as diabetic. All
four were successfully treated w
ith revision arthrodesis. One patient developed a post-operative infection and w
as treated initially with antibiotics
and removal of the m
etalwork. M
ean union time w
as eight weeks (range 6-12).
Conclusions: TMTJs arthrodesis is oft
en part of a major and technically dem
anding foot reconstructive procedure. Complications are uncom
mon,
and fusion rates and time to union can be sim
ilar to other foot fusion procedures.
FP8. AR
THR
OSC
OPY
OF TH
E FIRST M
ETATA
RSO
PHA
LAN
GEA
L JOIN
TD
amjan D
imnjaković1, Tom
islav Smoljanović2, Ivan B
ojanić2 1- D
epartment of O
rthopaedic Surgery, University H
ospital Centre Zagreb, Zagreb, Croatia5- D
epartment of O
rthopaedic Surgery, University H
ospital Centre Zagreb, University of Zagreb School of M
edicine, Zagreb, Croatia IntroductionA
rthroscopy of the first metatarsophalangeal joint (M
TP-1) in comparison to classical open surgery, allow
s an excellent view of intra-articular
structures and thus a detailed overview of the entire joint. Furtherm
ore, morbidity is significantly sm
aller, rehabilitation is faster, and return to dai-ly activities is also faster. B
ut, on the other hand, this procedure is only a part of the treatment of hallux disorders and should be considered w
ithin the m
anagement algorithm
.Purpose The aim
of this study is to present 18 patients who underw
ent arthroscopy of the MTP-1 in a 3-year period in our D
epartment.
Material and m
ethods18 consecutive patients underw
ent arthroscopy of the MTP-1 in our institution from
1st July 2014 until 1st July 2017 and were follow
ed up for a m
inimum
of 6 months. A
ll arthroscopies were done by the senior author (IB
). R
esultsThere w
ere 12 men and 6 w
omen w
ith a mean age of 39.5 (range, 16 to 62) years. The m
ost comm
on indication for arthroscopy in our series was
hallux rigidus (15 cases). Other diagnoses included arthrofibrosis, nonunion of sesam
oid fracture in and osteochondral lesion of metatarsal head in
a single case each. A 2.7-m
m 30° arthroscope and sm
all joint instruments w
ere used in all cases as well as m
anual longitudinal noninvasive distrac-tion to the great toe.ConclusionThe M
TP-1 joint arthroscopy should be performed in selected cases of hallux disorders, and is not for the occasional arthroscopist. It is recom
-m
ended for early stages of hallux rigidus, osteochondral lesions of the metatarsal head, sesam
oid bone pathology and MTP-1 arthrofibrosis. G
ood preoperative planning as w
ell as great experience in arthroscopy of small joints is necessary for good perform
ance and optimal result.
FP9. DO
ES SESAM
OİD
POSİTİO
N EFFEC
T PATİEN
T SATİSFA
CTİO
N A
FTER H
ALLU
X V
ALG
US SU
RG
ERY
? A STU
DY
OV
ER TA
NG
ENTİA
L SESA-
MO
İD V
İEWE. U
ygur, Turkey Introduction:To evaluate sesam
oid position,standard sesamoid tangential view
is taken while the foot is laying over the cassette w
ithout weight-bearing.To
simulate the ground forces better, w
e produced a special semi-rigid cushion for x-ray im
agining.By this cushion 30 degree of m
etatarso-phalangeal angle occurs in sagittal (lateral) plane w
hich simulates push off
phase while w
alking and which perm
its evaluating the position of the sesamoids
while bearing w
eight.
Purpose:In this study,w
e aimed to investigate the correlation of patient satisfaction and sesam
oid positions using weight-bearing tangential view
.We
hypothesized that i) sesamoid positions in tangential view
would be related w
ith anteroposterior (AP) view
s and ii) sesamoid positions w
ould be related w
ith patient satisfaction.
Patients and Methods:
Patients who w
ere undergone hallux valgus surgery with 6 m
onths of follow-up,w
ere included into the study.W
eight-bearing tangential radiographs were taken w
hile the patient was standing on both feet w
ith the knees in full extention.X-ray beam w
hich w
as centered at third metatarsal head w
as sent parallel to the ground.Patient outcom
es were assessed by M
anchester satisfaction score which has been translated and validated into patients’ language.
Results:
24patients were evaluated retrospectively.A
ll of them w
ere female.The average age of them
were 44(24-67).D
istal chevron osteotomy w
as per-form
ed in 18patients and proximal osteotom
y in 6patients.Pearson(one-tailed) correlation test w
as utilized for the analyses.A significant correlation w
as detected between sesam
oid positions in tangential view
and AP view
(r=0.04).On the other hand there w
as no significant correlation between sesam
oid position and AO
FAS scores(r=0.136) nor sesa-
moid position and patient satisfaction(r=0.183).
Conclusions:In this study w
hile AP and tangential view
s were detected to be correlated,our second hypothesis (correlation betw
een tangential view and patient
satisfaction) was not supported.The reason of this result m
ay be because of the diversity of factors effecting the patient satisfaction or because of
our small cohort w
hich is a limitation of this study.
FP10. EVA
LUA
TION
AN
D R
ESULTS O
F PBS PER
CU
TAN
EOU
S CO
RR
ECTIO
N TECH
NIQ
UE FO
R SY
MPTO
MA
TIC H
ALLU
X V
ALG
US D
EFOR
MITY
P.Salonikidis, Greece
Abstract
Background
Many procedures and diff
erent osteotomies have been described for percutaneous hallux valgus correction. Percutaneous techniques m
ay lead to reduced m
orbidity, operation and recovery time. A
im of this study is to evaluate the clinical and radiological outcom
e of a new percutaneous proce-
dure (PBS-Percutaneous B
ianchi System).
Methods
One hundred tw
elve (112) patients have been treated with Percutaneous B
ianchi System for correction of their m
ild, moderate or severe hallux
valgus deformity. A
ll patients were clinically assessed preoperatively and during the last follow
-up examination, by w
eight-bearing x-rays, AO
FAS
score, VAS scale and patient satisfaction.
Results
AO
FAS scores im
proved from preoperative 29.9 to 91 at last follow
-up. VAS pain score im
proved from 6.6 before surgery to 0.5 at last follow
-up. M
ean HVA
, IMA
and DM
AA
were significantly decreased from
preoperatively to last follow-up.
ConclusionPB
S technique is a safe, reliable and effective procedure for correction of sym
ptomatic m
ild to-severe hallux valgus deformity.
FP11. INN
OV
ATIV
E APPR
OA
CH TO
IMPR
OV
ING
THE M
ETHO
D O
F PREO
PERA
TIVE PLA
NN
ING
AN
D PER
FOR
MIN
G C
OR
REC
TIVE FO
REFO
OT
OSTEO
TOM
Y.
Anton A
kulaev, Anastasia Filippova, Victor Protsko
St Peterburg State University. The Pirogov Clinic of A
dvanced Medical Technologies.
Introduction. At the current level of developm
ent of visualization technologies, the use of conventional routine planning methods seem
s inad-equate, since overlapping projections and im
age distortions result in inaccuracies when planning, w
hich undoubtedly limits the predictability of
results.
The purpose of this study is to improve the technique of preoperative planning and perform
ing corrective osteotomy in patients w
ith forefoot deform
ities (Valgus deformity of the great toe of the foot) by developing a new
preoperative planning protocol - 3D m
odeling - and performing
corrective osteotomy using individually custom
ized high polygonal directional templates.
Materials and m
ethods. In this study 36 patients aged 30 to 70 years were exam
ined. The study was conducted on a com
puter tomograph
“Toshiba Aquilion 64” using specifically developed protocols. U
sing a set of our own custom
ized 3D soft
ware , w
e carried out individual 3D m
odeling and prototyping on 3D
printers “Picaso 250 Pro”, “Objet Eden 260”. For com
parison, the second group of patients underwent classical m
easure-m
ents with the help of radiographs.
Results. The analysis of the results of planning and perform
ing corrective osteotomy of the forefoot in 36 patients show
ed that in 100% of
cases the average difference in the m
easurement of angular param
eters was 6˚ ± 2˚ (р <0,05). The expected results of 3D
modeling w
ere exactly the sam
e as the results obtained.
Conclusion. This technique will be very useful not only for a professional, but also for a beginner specialist, allow
ing them to accurately plan,
predict the result of surgical treatment and, m
ost importantly, to accurately im
plement it all in the operating room
using individual high polygonal directional tem
plates.
FP12. THE EFFEC
TS OF H
UM
AN
AM
NİO
TİC FLU
İD A
ND
MEM
BR
AN
E ON
FRA
CTU
RE H
EALİN
G O
N R
AT FR
AC
TUR
E MO
DEL(EX
PERİM
ENTA
L STU
DY
)A
lper GU
LTEKIN
(1), A.M
eric UN
AL(2), M
ehtat UN
LU(3), I.Safa SATO
GLU
(4)1-SB
U K
ocaeli Derince Training and R
esearch Hospital O
rthopaedıcs and Traumatology
2-Suleyman D
emirel U
niversity Hospital Sports M
edicine3-D
okuz Eylul Unıversıty H
ospıtal Pathology4-D
okuz Eylul Unıversıty H
ospıtal Orthopaedics and Traum
atology
Introduction and Purpose: Hum
an amniotic fluid contains several grow
th factors and hyaluronic acid. It has positive effect in healing the tendon,
nerve and bone injuries. Hum
an amniotic m
embrane has positive eff
ects on tendon, nerve healing and is also used for skin healing in burns and com
plex wounds. W
e hypothesized that human am
niotic fluid and human am
niotic mem
brane have positive stimulating eff
ects on fracture healing. The aim
of this study is to investigate the effects of hum
an amniotic fluid and hum
an amniotic m
embrane on bone healing in rat tibial bone frac-
ture model.
Materials and M
ethods: A 72 open fracture m
odel was created for both tibial bones of 36 m
ale Wistar rats. They w
ere divided into three groups. G
roup-1 was the control group. In G
roup-2, human am
niotic fluid which w
as taken from am
niocentesis of seronegative pregnants in their second trim
ester was injected to the fracture site. In group-3, hum
an amniotic m
embrane w
hich was taken from
normal seronegative term
pregnants after
their caesarean sections was w
rapped around fracture site and then human am
niotic fluid was injected to the fracture site. R
adiological fracture union patterns and histopathological evaluations w
ith Modified Lane-Sandhu classification w
ere performed w
ith Modified Lane-Sandhu classifica-
tion at the end of third and sixth weeks.
Results: A
t third week, G
roup-2 and Group-3 had better histopathological results than G
roup-1. At sixth w
eek, Group-2 had significantly better
results than Group-1. G
roup-3 had also better results than Group-1 although there w
as no statistical significance. At third and sixth w
eeks, histo-pathological scores of G
roup-2 were significantly better than G
roup-3(p=0.021, p=0.019).
Conclusion: Our data suggested that hum
an amniotic fluid had positive eff
ect while hum
an amniotic m
embrane had no positive eff
ect on bone healing. W
ith its low im
munity and easy delivery, hum
an amniotic m
embrane can also be used to stim
ulate bone healing in combination w
ith human
amniotic fluid w
ith different application techniques.
Keyw
ords: Tibia fracture model, hum
an amniotic fluid, hum
an amniotic m
embrane, anim
al study, fracture healing
FP13. TWO
CR
OSSED
SCHA
NZ PİN
S VER
SUS C
ALC
AN
EAL PLA
TE İN TH
E TREA
TMEN
T OF İN
TRA
AR
TİCU
LAR
CA
LCA
NEA
L FRA
CTU
RES? A
C
OM
PAR
İSON
OF FU
NC
TİON
AL A
ND
RA
DİO
LOG
İCA
L OU
TCO
MES
Altuğ D
UR
AM
AZ, M
.D., B
akırköy Dr Sadi K
onuk Education and Research H
ospitalEm
re BA
CA, M
.D., B
akırköy Dr Sadi K
onuk Education and Research H
ospital
Introduction: Many surgical techniques have been tried in the treatm
ent of of intraarticular calcaneus fractures and they have been changed over tim
e.
Purpose: The aim of this study w
as to compare the functional and radiological results of the anatom
ic calcaneus plate (ACP) and tw
o crossed schanz pins (CSP) in the treatm
ent of intraarticular calcaneal fractures.
Material: B
etween M
arch 2010 and Novem
ber 2014, thirty-four patients who underw
ent surgery using CSP and 31 patients who underw
ent surgery using A
CP for isolated closed unilateral calcaneus fracture were included in the study.
Methods: The fractures w
ere typed according to the Sanders classification. Trauma type, preoperative and postoperative period, com
plications, postoperative functional and radiological results w
ere evaluated. AO
FAS hind foot score and ankle function w
ere evaluated at final postoperative control of the patients. The tw
o surgical methods w
ere compared in term
s of functional and radiological outcomes.
Results: The duration of surgery w
as significantly longer in ACP than CSP (p <0,001). Fluoroscopy exposure w
as significantly less in ACP than CSP (p
<0.001). Postoperative Böhler and G
issane angles was significantly higher in A
CP than in CSP (p <0,001 and p <0,001). AO
FAS score w
as signifi-cantly higher in A
CP (88,4±4,1) than in CSP (81,7±4,9) (p <0,001).
Conclusions: Although CSP shortens the operation tim
e in the the treatment of intraarticular calcaneal fractures, it has disadvantages com
pared to A
CP due to increased floroscopy exposure, low functional and radiological results. There are no significant diff
erences between the tw
o surgical m
ethods in terms of com
plications. ACP is better technique than percutaneous CSP in the treatm
ent of intraarticular calcaneal fractures.
FP14. EFFECTS O
F AN
KLE TA
PING
ON
DY
NA
MIC
POSTU
RA
L CO
NTR
OL IN
PATIEN
TS WITH
AN
KLE IN
STAB
ILITY 1.K
onstantinos Sidiropoulos, MD
, Orthopedic Surgeon 2nd O
rthopaedic Departm
ent, Papageorgiou Hospital Thessaloniki
2.Konstantinos G
. Tsikopoulos, MD
, MSc, PhD
Candidate 2nd Orthopaedic D
epartment Papageorgiou H
ospital Thessaloniki3.D
imitrios K
itridis, MD
, MSc, PhD
Candidate 1st Orthopaedic D
epartment Papanikolaou H
ospital Thessaloniki,Greece
4.Panagiotis Gkivisis, M
D, M
Sc, PhD Professor of 1st O
rthopaedic Departm
ent Papanikolaou Hospital Thessaloniki, G
reece A
bstract Introduction: Prim
ary managem
ent of chronic lateral ankle instability consists of non-operative treatments, how
ever there is no specific protocol show
ing the most eff
ective method. R
ehabilitation has been shown to be eff
ective at decreasing symptom
s, although methods of increasing its
effectiveness, such as passive restraints, m
ust be evaluated.
Purpose: To conduct a meta-analysis to assess the im
pact of ankle taping on dynamic postural control in patients w
ith ankle instability.
Material: R
andom-eff
ects network m
eta-analysis.
Methods: W
e searched PubMed, Scopus, and CEN
TRA
L up to the 1/6/2018 for completed studies. R
andomized trials assessing the results of real
taping, wait-and-see protocols, and sham
taping for the primary m
anagement of chronic lateral ankle instability w
ere considered in the quantita-tive synthesis. W
e assessed dynamic balance in term
s of the star-excursion balance test in the posteromedial direction, the m
ost representative. W
e also judged the quality of the trials using the Cochrane risk of bias tool and the quality of evidence using the (GR
AD
E) approach.
Results: W
e enrolled seven trials in this systematic review
. There were no statistically significant diff
erences in favor of real taping over watch-and-
wait policy or placebo (standardized m
ean difference w
as -0.11 [95% CIs -0.72 to 0.5], and -0.27 [95%
CIs -0.17 to 0.71], respectively).
Conclusions: The network m
eta-analysis showed that real taping w
as ineffective in im
proving dynamic postural control in patients w
ith ankle insta-bility. There w
as also no evidence of a placebo effect in participants treated w
ith sham taping.
FP15. POSTER
İOR
MA
LLEOLU
S FİXA
TİON
FOR
SYN
DESM
OSİS
1.Nezih ZIR
OG
LU M
D B
akirkoy Dr Sadi K
onuk Training and Research
Hospital ISTA
NB
UL
2.Emre B
ACA
MD
Bakirkoy D
r Sadi Konuk Training and R
esearch Hospi-
tal ISTAN
BU
L - IntroductionD
oes isolated posterior malleolus fixation provide suffi
cient proper syn-desm
osis reduction on the posterior malleolus fracture cases associated
with syndesm
otic injury? PurposeSyndesm
otic ligament is a com
plex structure consisting of a combina-
tion of anterior inferior talofibular ligament (A
ITFL), posterior inferior talofibular ligam
ent (PITFL), interosseous ligament (IO
L) and transvers inferior talofibular ligam
ent (TITFL). Stability contributions of each parts are A
İTFL %35, İO
L %22 and PİTFL %
42.A
single screw is usually perform
ed from lateral plan to provide tibiofib-
ular covering, at the treatment of the m
ost ankle sprain cases associat-ing w
ith syndesmotic injury.
PITFL avultion fractures which is the highest contribution to syndes-
motic ligam
ent cause syndesmotic instability at the posterior m
alleolus fracture cases associating w
ith syndesmotic injury.
We aim
ed to explore syndesmotic ligam
ent reduction status at the pa-tients w
ho’ve had posterior malleolus fixation surgery w
ithout perform-
ing screw fixation from
lateral plan according to our hypothesis.M
aterial – Methods
A total of 41 patients, 27 fem
ales and 14 males, w
ho were follow
ed up at B
akırkoy Dr Sadi K
onuk Training and Research H
ospital in our study w
ere evaluated.In the evaluated patients, posterior m
alleolus injury accompanying syn-
desmosis injury w
as absolute, and some of the patients had m
edial and / or lateral m
alleolus fracture. All of the patients w
ho were underw
ent lateral screw
ing were excluded from
the study.B
y the way all patients w
ho underwent posterior approach w
ere used one of these diff
erent implants like cannulated screw
s, malleolus screw
and plate screw
systems.
We assessed the reduction status of the syndesm
otic ligament by eval-
uating our patients’ radiographs and tomographies (CT). The evaluation
was carried out according to evaluation criteria m
ade by the mea-
surements described by Futum
ara et al in their study in 2017 from the
transverse CT section taken 1 cm proxim
al to the ankle joint. R
esultsA
t the procedures which posterior m
alleolus had fixated , it was thought
that the syndesmotic ligam
ent would be reducted and it w
ould not be necessary to perform
an extra syndesmosis screw
from the lateral side.
Forty-one patients who had at least one year follow
-up, post-op x-ray and CT scans w
ere identified. While the youngest of the patients is 15
years old and the oldest one is 75 years old. The average age is 42.65. The aff
ected extremity is right in 24 patients and left
in 17 patients. The follow
-up period of patients is at least one year and average is 19.2 m
onths.It w
as seen that isolated posterior fixation reduced syndesmotic liga-
ment in 38 of the patients. W
hen 3 patients without adequate reduction
were exam
ined, it was seen that 1 had com
plicated ankle heterotrophic ossification due to ankle arthrosis and the related syndesm
otic interval w
as open. In another patient, it was found that the syndesm
osis liga-m
ent due to posterior malleolus m
alreduction was not reduced. In the
third patient, it was observed that the screw
applied to the posterior m
alleolus reduction gradually moved to the tibiofibular region and pre-
vented the reduction of the syndesmosis ligam
ent. ConclusionsFixation posterior m
alleolus fracture associated with syndesm
otic injury (isolated orw
ith medial and / or lateral m
allolus fracture) is eliminating neccessity
of appliying an extra syndesmotic screw
from lateral plan and achiving
an anatomic reduction of syndesm
otic ligament. The m
ost important
issue is the appropriate anatomical reduction of the fracture and rigid
fixation. When the patients w
ith inadequate reduction of syndesmosis
ligament w
ere examined, insuffi
cent reduction and malfixation w
as show
ned.
FP16. TRA
NSLA
TION
AN
D C
RO
SS-CU
LTUR
AL A
DA
PTATIO
N O
F THE TU
RK
ISH V
ERSIO
N O
F THE FO
OT H
EALTH
STATU
S QU
ESTION
NA
IRE
Sezen KA
RA
BO
RK
LU A
RG
UT1, Pelin TIRYA
KI2, O
zge COB
AN
3, Emre B
ACA
4 1Istanbul U
niversity-Cerrahpasa, Faculty of Health Science, D
epartment of Physiotherapy and R
ehabilitation, Istanbul, Turkey2 Istanbul G
elisim U
niversity, School of Health Sciences, D
epartment of Physiotherapy and R
ehabilitation, Istanbul, Turkey3Yıldırım
Beyazıt U
niversity, Faculty of Health Science, D
ivision of Physiotherapy and Rehabilitation, A
nkara, Turkey4B
akirköy Dr. Sadi K
onuk Education and Research H
ospital, Departm
ent of Orthopedics and Traum
atology, Istanbul, Turkey. Introduction: The Foot H
ealth Status Questionnaire(FH
SQ) w
as originally developed in English for evaluating foot health and problems. It has not
yet been translated or culturally adapted for Turkish-speaking individuals.
Purpose: The purpose of this study was to translate and culturally adapt the FH
SQ into Turkish.
Material&
Methods:The FH
SQ w
as translated into Turkish, consistent with published m
ethodological guidelines. In the first stage, 2 Turkish individ-uals w
ith a good comm
and of English were responsible for the translation of the questionnaire(T1,T2). The translations w
ere completed inde-
pendently. Then, both translations were com
pared and reviewed by a bilingual individual w
ho highlighted any conceptual errors or inconsistencies in the translations to establish the first Turkish translation(T12). In the third stage, aft
er the first Turkish translation was agreed upon, 2 native En-
glish speakers with a good com
mand of Turkish separately translated it back into English(B
1,B2). B
oth translators were unaw
are of the purpose of the study and the original English version. In the fourth stage, the back-translated version w
as compared to the initial English version. A
comm
ittee evaluated the 4 translations and com
pared the discrepancies. Aft
er that, the comm
ittee finalized the Turkish version of the FHSQ
. Thirty patients w
ith foot disorders were enrolled for the pilot test. The questions that w
ere difficult to understand and their recom
mendations w
ere noted.
Results: FH
SQ w
as generally found easy to understand by patients(n=30, 43.6±12.8 years;30.1±4.1kg/m2,20fem
ales).For cultural adaptation purposes, the term
of “podiatrist’’ had to be changed to “clinician” due to podiatrist was not a profession in Turkey. The questions 25 and 28 w
ere about health insurance system
in that country where the FH
SQ w
as developed. Therefore, these questions were revised by considering health insur-
ance system in Turkey.
Conclusions: The translation and cultural adaptation of the FHSQ
were com
pleted. Reliability and validity of the Turkish FH
SQ has been studying.
Keyw
ords: Foot pain, Outcom
e, FHSQ
.
FP17. RETR
OSPEC
TIVE STU
DY
OF LISFR
AN
C FR
AC
TUR
E DISLO
CA
TION
S TREA
TED W
ITH FU
SION
AN
D IN
TERN
AL FIX
ATIO
N K
iril Surchev, Mihail R
ashkov 3rd Clinic of O
rthopedics and Trauma, U
MPH
ATT “N. I. Pirogov”, Sofia, B
ulgaria Fracture dislocations of the tarsom
etatarsal (Lisfranc) joint are relatively rare injuries that still pose a lot of questions in terms of choosing proper
treatment strategy according to the preoperative diagnostics. The aim
of the study was to evaluate and com
pare internal fixation sparing the tarsom
etatarsal joints versus primary arthrodesis in the operative treatm
ent of Lisfranc fracture dislocations. Furthermore, the current study tries
to derive a relationship between the type of fracture and operation and the long-term
outcome.
This is a retrospective study encompassing 40 patients treated in the hospital over a 5 year period. X-rays, CT-scans, patient records, clinical data,
Am
erican Orthopedic Foot and A
nkle (AO
FAS) scores and dynam
ic and static plantograms w
ere analyzed and compared.
The results show that prim
ary arthrodesis was chosen as a m
ethod of treatment for com
plex fractures involving more than one tarsom
etatarsal joints. The recovery period aft
er surgery was slightly faster for the fused patients w
ith them reporting less pain and daily hindrances at 1 year
after surgery. M
ore than 80% of the patients treated w
ith joint sparing internal fixation manifested posttraum
atic arthritis after the second year,
both clinically and on X-rays. Clinical symptom
s of posttraumatic arthritis w
ere marginally less expressed aft
er arthrodesis. Plantograms dem
on-strated less loss of foot arches in the fused patients, although som
e of them w
ere hyper corrected.The results of this study suggest that prim
ary arthrodesis is a viable method of treatm
ent for Lisfranc fracture dislocations leading to fewer com
-plications in the long term
follow up, but care should be taken to choose suitable cases for prim
ary fusion.
F18. THE FIR
ST 55 PERO
NEA
L TEND
OSC
OPIES O
F ON
E SUR
GEO
N: A
NA
LYSIS O
F INTR
AO
PERA
TIVE FIN
DIN
GS A
ND
PERFO
RM
ED C
ON
CO
M-
ITAN
T PRO
CED
UR
ESD
amjan D
imnjaković1, Tosm
islav Smoljanović2, Ivan B
ojanić2 1- D
epartment of O
rthopaedic Surgery, University H
ospital Centre Zagreb, Zagreb, Croatia2- D
epartment of O
rthopaedic Surgery, University H
ospital Centre Zagreb, University of Zagreb School of M
edicine, Zagreb, Croatia IntroductionPeroneal tendons disorders oft
en occur combined w
ith other symptom
s derived by intra- or extra-articular pathology of the ankle needing the com-
bined single-step procedure of peroneal tendoscopy with arthroscopic or open procedures of the ankle.
PurposeThis study analyses the intraoperative findings of the first 55 peroneal tendoscopies done by a single surgeon and show
s which concom
itant proce-dures w
ere performed.
Materials and m
ethodsFrom
January 2013 to July 2017, 55 consecutive peroneal tendoscopies were perform
ed in our Departm
ent. Peroneal tendoscopy was perform
ed before any other arthroscopic or open procedure in all patients w
ith a 4.5-mm
30°- arthroscope in a standard fashion. Postoperative managem
ent w
as performed depending on specific type of pathology that w
as treated. R
esultsPeroneal tendoscopy w
as performed in 14 m
ale and 40 female patients (m
ean age, 46 years; range, 13-60 years) who w
ere followed-up for a m
ini-m
um of 6 m
onths (clinical or telephone). None of the patients underw
ent open or tendoscopic procedure on peroneal tendons prior to surgery in our departm
ent. We have perform
ed peroneal tendoscopy as a solitary procedure in 23, while in the rem
aining 32 cases it was perform
ed together with
ankle arthroscopy (28 cases), subtalar arthroscopy (1 case) and excision of the os peroneum (3 cases). The m
ost comm
on pathology was low
-lying peroneus brevis m
uscle belly (28 cases), followed by partial longitudinal rupture of the peroneus brevis tendon (20 cases), isolated tenosynovitis (5
cases) and an accessory peroneus quartus tendon (2 cases). Due to persistent posterolateral pain tw
o patients were reoperated (one in our institu-
tion) six months aft
er the initial operation. All the other patients w
ere symptom
-free at a minim
um of six m
onths follow-up.
ConclusionPeroneal tendoscopy is an eff
ective minim
ally invasive procedure to treat miscellaneous peroneal tendon disorders w
ith low m
orbidity and excellent functional results.
FP19. PRO
XIM
AL M
EDIA
L GA
STRO
CNEM
IUS R
ELEASE IN
THE TR
EATM
ENT O
F REC
ALCITR
AN
T PLAN
TAR
FASCIITIS
Vasileios Lampridis1,2, G
eorgios Kiziridis1, A
lex Wee1, N
ikolaos Gougoulias1.
1.Frimley Park H
ospital NH
S Trust, UK
, 2. 424 Military H
ospital Thessaloniki Introduction: Isolated gastrocnem
ius contracture has been implicated as the cause of a num
ber of foot and ankle pathologies, due to altered foot biom
echanics. Plantar fasciitis (PF) is the comm
onest of these conditions. Chronic PF can affect the quality of life of the patients and its treatm
ent can be challenging.
Purpose: We report our results w
ith an isolated release of the proximal m
edial head of gastrocnemius (PM
GR
) for the treatment of recalcitrant PF.
Material-M
ethods: This is a retrospective review of 64 patients (70 legs), w
ith mean age of 49 years (range 32-74) that underw
ent PMG
R betw
een 2009 and 2017. PF w
as diagnosed clinically and confirmed radiologically (ultrasound or M
RI) in all cases. In this cohort w
e included patients that had at least 1 year of conservative treatm
ent and an isolated gastrocnemius contracture w
as confirmed clinically using Silfverskiold’s test preop-
eratively. Outcom
e measures included a 5-point Likert scale as w
ell as subjective and objective calf weakness assessm
ents. Final follow up w
as on average 47 m
onths (range 12 to 94) after the surgery.
Results: 51 patients (55 heels) (79%
) reported total or significant pain relief following the surgery and none reported w
orsening of their symptom
s. 30 patients im
proved within eight w
eeks and the rest within 3-6 m
onths. No patient had subjective or objective evidence of calf w
eakness. One
patient developed a superficial wound infection and w
as treated with a course of antibiotics. Three patients (6%
) developed DVT and w
ere treated w
ith LMW
H.
Conclusions: PMG
R is a sim
ple way of treating a patient w
ith recalcitrant PF who has failed to respond to conservative m
anagement. In our series,
the results were favourable, the recovery w
as fast and the complication rate low
.
FP20. SALV
AG
E FIBU
LAR
LENG
THEN
ING
BY
EXTER
NA
L FIXA
TOR
AFTER
INC
OR
REC
T LOW
ER LEG
LENG
THEN
ING
. A TW
O C
ASES R
EPOR
T. M
IRO
SLAV ZH
IVKO
V LYUB
OM
IRO
VU
NIV. H
OSPITA
L “SAIN
T AN
NA” , VA
RN
A , B
ULG
AR
IA R
elative shortening of the fibula may occur aft
er improper low
er leg lengthening when the fibula is not fixed to the external fixator. Patients com
-plain of pain and restriction of their daily and sporting activities. Clinically, there is valgus of the ankle and hind foot due to abduction and lateral rotation of the talus. Lim
b lengthening is performed usually in childhood age if the fibula is not fixed and lengthened together w
ith tibia leads to incongruence of the ankle joint and early degenerative changes .
The purpose of this article is to present our two case experience to restore congruency of ankle joint by lengthening of the fibula by rail m
ini fixa-tor.
Betw
een 2014 and 2018 , two patients w
ere treated by fibular lengthening. Both w
ere female w
ith the average age 7y (5 and 9y)
The average shortening of the fibula was 15m
m w
ith valgus of the ankle and painful gait. The interval between artificial shortening of the fibula
and correction was 1 m
onths in first case and 6 years in second case.
We perform
ed lengthening of the fibula by mini B
iomed or m
ini rail fixator with 4 or 6 H
A 3m
m pins. O
steotomy of the fibula w
as transverse , 3-4 cm
above syndesmosis . D
istraction rate was 0.75m
m/day and fixator tim
e was 3 m
onths.
Restoration of length of fibula and correction of ankle valgus w
as achieved in all two cases. There w
as no pain during walking and norm
al sport activities.
Early results of so-called salvage ex-fix fibular lengthening is save and successfully restores normal length of the fibula and ankle congruency. Thus
prevent early degenerative changes and restores plantigrade walking.
FP21. LON
G TER
M R
ESULTS O
F PERC
UTA
NEO
US R
AD
IOFR
EQU
ENC
Y N
ERV
E AB
LATIO
N FO
R CH
RO
NIC
PLAN
TAR
HEEL PA
IN A
SSOCIA
TED
WITH
PLAN
TAR
FASCIITIS
H. Yener Erken1
1: Istanbul Okan U
niversity Faculty of Medicine D
epartment of O
rthopaedic Surgery, Istanbul, Turkey A
bstractIntroductionChronic plantar heel pain is one of the m
ost painful foot conditions and is generally associated with plantar fasciitis.
PurposeThis study reports long term
followup results of radiofrequency radiofrequency nerve ablation (R
FNA
) of the calcaneal branches of the inferior calcaneal nerve in patients w
ho did not respond to conservative treatments.
Material and M
ethodsW
e prospectively evaluated the results of the RFN
A of the calcaneal branches of the inferior calcaneal nerve on 68 feet in 58 patients w
ith plantar heel pain betw
een 2008 and 2013. All of the patients w
ho were treated had been com
plaining of heel pain for over six months and had been re-
sistant to conservative treatments. Patients included in the study w
ere evaluated (quantitatively) using the average 10-point Visual Analog Scale
(VAS) before the treatm
ent, as well as at their one m
onth followup, one year follow
up, two years follow
up, and last followup aft
er the procedure, respectively.R
esultsThe m
ean last followup w
as 62 months (range, 47-110 m
onths). The average VAS score of the feet w
as 9.54 + 1.66 before treatment, 0.75 +1.24
one month aft
er the procedure, and 1.59+ 2.23 at one year followup, 1.72 + 1.88 at tw
o years followup, and 2.34+ 0.92 at last follow
up(p<0.001). In the evaluation of the patients’ feet, 81 %
of the patients rated their treatment as very successful or successful at the last follow
up.ConclusionsThese findings suggest that R
adiofrequency nerve ablation (RFN
A) of the calcaneal branches of the inferior calcaneal nerve provide a long term
eff
ective treatment for chronic heel pain associated w
ith plantar fasciitis.
NOT P
RESE
NTED
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