Evaluación radiológica pre y posoperatoria de la osteotomía de Austin y uso de AutoCAD® / Preoperative and Postoperative Radiological Evaluation of Austin Osteotomy and Use of Autocad®

Introducción: Se han descrito más de 300 técnicas quirúrgicas para la corrección del hallux valgus. Una de ellas es la técnica de Austin, la cual constituye una osteotomía capital en V con una angulación de 60º utilizada en el tratamiento quirúrgico del hallux valgus leve-moderado. Objetivos: Analizar el grado de corrección que tiene la osteotomía de Austin sobre diferentes parámetros radiológicos y describir la frecuencia con la que se utilizan técnicas complementarias sobre la falange proximal. Métodos: Se realizó un estudio descriptivo, transversal, observacional y retrospectivo. Se seleccionó una muestra de 29 pies intervenidos mediante la técnica de Austin, a los que se les realizaron varias mediciones sobre sus radiografías pre y posoperatorias con AutoCAD®. Resultados: Se obtuvieron diferencias estadísticamente significativas en todos los parámetros evaluados. Conclusiones: Esta técnica corrige significativamente todos los parámetros analizados. Se demuestra que el uso de técnicas quirúrgicas complementarias sobre la falange proximal es bastante frecuente al realizar esta osteotomía(AU)

Introduction: More than 300 surgical techniques have been described for the correction of hallux valgus. One of them is the Austin technique, which constitutes a capital V osteotomy with an angulation of 60º used in the surgical treatment of mild-moderate hallux valgus. Objectives: To analyze the degree of correction that Austin osteotomy has on different radiological parameters and to describe the frequency with which complementary techniques are used on the proximal phalanx. Methods: A descriptive, cross-sectional, observational and retrospective study was carried out in a sample of 29 feet operated on using the Austin technique. Several measurements were made on their pre- and postoperative radiographs with AutoCAD®. Results: Statistically significant differences were obtained in all the parameters evaluated. Conclusions: This technique significantly corrects all the parameters analyzed. It is shown that the use of complementary surgical techniques on the proximal phalanx is quite frequent when performing this osteotomy(AU)

Use of Plantar Pressure Sensors to Take Weight-Bearing Foot Casts.

Techniques of taking casts mainly rely not on the objectivity of the procedure, but on the experience and skill of the technician. The aim of this study was to demonstrate the efficiency of a technique of taking standing foot casts controlled via pressure sensors. In this way, we mean to objectivize the degree of correction. The study was carried out through 150 procedures on 50 feet of 29 patients. The value of the "Heel Symmetry Index" was calculated on three casts in three different situations of the same foot: A first cast in which the subject did not control the position of his/her foot; a second cast where manipulations corrected the foot's pronator position; and a third cast with pressure sensors placed in the subject's heel. This enabled the control and quantification of the pressure during the manipulation when taking the cast. The comparison of the "Heel Symmetry Index" in the different groups showed significant p-values of 0.05. Conclusion: The technique of taking casts controlled by pressure sensors achieved more equilibrated casts with a better symmetry index of the heel's outline.

Medium-Term Outcomes of Chevron Osteotomy for Hallux Valgus Correction in a Spanish Population: Radiologic and Clinical Parameters and Patient Satisfaction.

BACKGROUND: Chevron osteotomy for mild and moderate hallux valgus obtains good effects. It is suitable for a variety of cases, allowing for a significant degree of correction. This study aimed to investigate chevron osteotomy for the correction of hallux valgus in the medium-term by podiatric surgeons. It considers clinical and radiologic findings and patient perspectives and level of satisfaction. METHODS: Forty-five patients (50 feet) were assessed preoperatively, postoperatively, and at final follow-up. Mean patient age was 59.43 years (range, 32-80 years). The protocols include medical record review, clinical examination, and radiologic assessment. Anteroposterior weightbearing radiographs were analyzed preoperatively and at final follow-up. Clinical effects were analyzed with visual analog scale and American Orthopaedic Foot and Ankle Society (AOFAS) scores. RESULTS: Interobserver and intraobserver reliability were evaluated. Mean ± SD hallux valgus angle decreased at final follow-up (25.30° ± 7.21° versus 17.25° ± 10.32°; P = .041). There was no significant reduction in mean ± SD intermetatarsal angle at final follow-up (13.13° ± 3.03° versus 7.65° ± 3.47°; P = .078). Final AOFAS score was 82.08 ± 17.66. This study showed the relevance of magnet therapy, nail surgery, and other procedures. No patient was dissatisfied with the aesthetic scarring. CONCLUSIONS: The radiologic results at final follow-up were not compatible with relapse of the deformity. The definitive clinical results and the degree of patient satisfaction achieved with this technique were favorable from the patients' point of view.

Terapias complementarias en cirugía podológica

Este artículo presenta una serie de terapias complementarias, como son la homeopatía, la fitoterapia y la oligoterapia, en relación con la cirugía del pie. Éstas terapias nos serán de gran ayuda como coadyuvantes en las terapias prequirúrgicas y posquirúrgicas, así como en el mismo transcurso de la cirugía (AU)