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Reliability Study of a New Electromechanical Device Designed to Measure the Relative Dorsal Mobility of the First Ray of the Foot

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Open Journal of Orthopedics 2022年第10期12卷 383-392页

作者： Nils Reymond Quentin Praz Spyridon Schoinas Navindravadhanam Sockalingam Antoine Acker Victor Dubois-Ferrière Philippe Passeraub mathieu assal Centre assal for Foot and Ankle Surgery Clinique La Colline Geneva Switzerland Institute of Industrial Technologies and Sciences University of Applied Sciences and Arts Western Switzerland (HES-SO Geneva/HEPIA) Geneva Switzerland

Introduction: A new electromechanical instrument has been developed to measure relative dorsal mobility of the first ray in an objective and reliable way by simulating ground reaction forces during gait. This device equally applies a standardized, electronically controlled, and precise force under the first metatarsal head M1 as well as under the heads of the lesser metatarsals M2 to M5. The relative dorsal mobility between these two bearings is then measured. The purpose of this study is to assess the intra- and inter-examiners reliabilities of the measurements obtained with this device. Methods: The protocol included two examiners and 36 feet (18 volunteers with healthy feet and no history of forefoot disorders). A total of nine measurements were performed on each foot separated into three sets of three trials for the assessment of inter-rater and intra-rater reliability. For this purpose, the interclass correlation coefficient (ICC), the error of measurement (SEM) and the Bland and Altman (B&A) graphical analysis were computed. Results: Excellent ICC values (≥0.91) were obtained with the novel device for inter-rater and intra-rater reliability when using the FRRM calculation. The B&A analysis presented a bias between examiners of -0.25 mm ranging from -1.66 to 1.18 mm. Conclusion: This study demonstrated the capability of the developed device to reliably measure the relative dorsal mobility of the first ray of the foot. This is a promising first step for further studies to better understand, qualify and quantify first ray hypermobility.

关键词： First Ray Dorsal Mobility Instability Hypermobility Medical Device Reliability Study Foot

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Why and How Often Is Revision Surgery Necessary after First Metatarsophalangeal Joint Arthrodeses? A Cohort of 120 Consecutive Cases

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Open Journal of Orthopedics 2021年第8期11卷 221-232页

作者： Lisca Drittenbass Halah Kutaish Leow Voon Chin Richard Stern mathieu assal Centre for Surgery of the Foot & Ankle Hirslanden Clinique La Colline Geneva Switzerland Faculty of Medicine Geneva University Geneva Switzerland

Background: Little is known about the rate and reasons for revision after primary Metatarsophalangeal (MTP1) arthrodesis with the latest implants. While it is commonly assumed that nonunion accounts for most reoperations, we hypothesized that malposition is the leading cause of revision. The aim of this study was to determine the rate and reasons for revision after MTP1 arthrodesis using cup- and cone-reamers and the latest locking plate technology. Method: Between 2015 and 2017, 120 consecutive MTP1 fusions in 114 patients were performed with a low profile, pre-contoured titanium dorsal locking plate and a plantar metatarsophalangeal screw. The rate and reasons for revision within a minimum one-year follow-up period (average 16 months [12 - 26]) after index procedures were documented

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A New Implant for Transfemoral Amputation: Improved Gait and Comfort

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Open Journal of Orthopedics 2021年第6期11卷 199-205页

作者： mathieu assal Halah Kutaish Richard Stern Alice Bonnefoy-Mazure Antoine Acker Axel Gamulin Stephane Stephane Gorki Carmona Alain Lacraz Foot & Ankle Surgery Center Centre Assal Hirslanden Clinique La Colline Geneva Switzerland Faculty of Medicine Geneva University Geneva Switzerland Willy Taillard Laboratory of Kinesiology Geneva University Hospitals and Geneva University Geneva Switzerland Division of Orthopaedic Surgery and Traumatology University Hospitals of Geneva Geneva Switzerland

Introduction: Transfemoral amputation results in a prosthesis which bears weight on the ischium. Gait disturbance, lack of an end-bearing stump and discomfort in the groin from the socket even while sitting, are important issues. Methods: This is a pilot report of an ongoing randomized blind clinical trial of a new intramedullary implant post transfemoral amputation. Here, we describe a single case illustrating the surgical technique and clinical outcome of a dysfunctional post-traumatic transfemoral amputation addressed with this implant. Clinical gait analysis, SF-12 and VAS were assessed pre- and post-intervention at 6 months of follow-up. Results: An improved stump control is accomplished by means of myoplasty and myodesis through an end-cap. Stride width improved from 0.21 m pre-op to 0.13 m post-op, and more symmetrical stride length (△0.21 m pre-op vs. △0.06 m post-op) was noted, indicating improved gait quality and stability. Gait velocity increased (0.51 ± 0.04 m/s pre-op vs. 0.64 ± 0.02 m/s post-op). Conclusion: This technique reveals improvements in gait parameters in a transfemoral amputee treated with a new procedure. Improved prosthesis control, sitting comfort, greater hip range of motion, better gait stability, and enhanced walking abilities were noted.

关键词： Above Knee Amputation Transfemoral Amputation Gritti-Stokes Weight-Bearing End-Cap

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