Full text publication rates of papers presented at the British Foot and Ankle Society

Background

Techniques in foot and ankle surgery have expanded rapidly in recent years, often presented at national society meetings. It is important that research is published to guide evidence based practice. Many abstracts however do not go on to full text publication.

Epidemiology and referral patterns of burns admitted to the Burns Centre at Inkosi Albert Luthuli Central Hospital,Durban

Rationale

The epidemiology, referral patterns and outcome of patients admitted to a tertiary burns unit in southern Africa were reviewed.

Materials and methods

The charts of all patients with thermal injury presenting to the Burns Centre at Inkosi Albert Luthuli Central Hospital (IALCH) between 1 January 2008 and 31 December 2010 were reviewed. Information collected included age, gender, past medical history, cause of burn, size of burn, presence of inhalation injury, time before admission, time to excision, length of hospital stay, complications and mortality.

Findings

Four hundred and sixty two patients were admitted, 296 (58%) children and 193 (42%) adults. The female–male ratio was 1:1.13. The mean total body surface area (TBSA) burned was 12% (interquartile range 8–25%) for children and 18% (interquartile range 10–35%) for adults. Common causes for the burns were in children: hot liquids (71%) and open flame (24%). Major causes in adults were: open fire (68%) and hot liquids (25%). Epilepsy was a contributing factor in 12.7%. Inhalation injury was seen in 13.6% of adults and 14.3% of children with a flame burn.Forty-four percent of referrals from general surgical units were for burns <30% in adults, and 30% for burns <10% in children. More than one in four patients was referred between 1 and 6 weeks post-injury.Overall mortality was 9.1% (5.7% in children and 15.1% in adults). Complications occurred in 21.6% of children and 36.7% in adults, the most common being lung complications such as ARDS and infection, severe sepsis, skin graft failure and contractures. The length of stay was 1 day/% TBSA burn for all burns in children and for burns between 10 and 49% in adults.

Conclusions

The epidemiology and outcome of severe burns referred to the Burns Centre at IALCH is similar to those in other units in Africa. The management and referral of burns patients by other hospitals are inappropriate in a significant number of patients.     

Reliability and Validity of the Turkish Version of Foot and Ankle Ability Measure for Patients With Chronic Ankle Disability

The Foot and Ankle Ability Measure is a valid, reliable, and widely used self-reported questionnaire for the foot. It has been adapted and validated for a Turkish-speaking population. The purpose of this study was to provide evidence for validity and reliability of the Turkish version of the Foot and Ankle Measure (FAAM-T) in patients with chronic ankle instability (CAI). A total of 316 patients with CAI were enrolled. The internal consistency and test–retest reliability were evaluated. Validity was examined using correlations with the Short Form Health Survey version 2.0 (SF-36v2) questionnaire. Cronbach's alpha scores were 0.94 and 0.96 for the the FAAM-T ADL (Activities of Daily Living) and FAAM-T Sports subscales, respectively, indicating high internal consistency. For the second administration, Cronbach's alpha was found to be 0.96 for both subscales of the FAAM-T. The test–retest reliability of the FAAM-T was very high for both subscales with an intraclass correlation coefficient of 0.97 and 0.94, respectively (p < .001). The standard error of the mean and minimal detectable change were determined to be 2.5 and 6.7 for the FAAM-T ADL and 6.9 and 18.5 for the FAAM-T Sport. The FAAM-T ADL and Sport subscales were strongly correlated with the SF-36v2 PF (physical functioning; r?=?0.51, r?=?0.40, respectively; p?=?.001) and SF-36v2 PCS (physical component scale; r?=?0.64, r?=?0.55, respectively; p?=?.001). The weakest associations between the FAAM-T ADL and Sport and the SF-36v2 were noted for the mental health subscale (r?=?0.08 and r?=?0.03) and the SF-36v2 MCS (mental component scale; r?=?.05 and r?=?.006, respectively). This study provides evidence for validity, internal consistency, and test–retest reliability for the FAAM-T to evaluate patients with CAI.     

Role of anti-oxidant (vitamin-C) in post-operative pain relief in foot and ankle trauma surgery: A prospective randomized trial

BackgroundPost-operative pain may adversely affect a patient’s quality of life. Studies have shown that vitamin C, being an anti-oxidant and neuro-modulating agent, can help to reduce pain in a variety of clinical settings. The objective of this randomized controlled trial was to assess the effectiveness of vitamin C in reducing post-operative pain, analgesia requirements and improving functional outcome.MethodsPatients with isolated foot and ankle trauma, who had undergone surgery, were randomly assigned to receive either vitamin C 500 mg or a placebo tablet twice a day. VAS score, analgesia requirement and functional outcome were assessed during their regular follow up. Results were compared and analyzed at the end of 3 months.ResultsThe group which received vitamin C, showed improvement in VAS score at the end of second and sixth week of follow up, reduced analgesia requirements and improved functional outcome as compared to the placebo group.ConclusionsThis study shows that the supplementation of vitamin C in patients undergoing surgery for foot and ankle trauma helps to reduce analgesic requirements, improve VAS scores and achieve better functional outcome.     

The use of three-dimensional biometric Foot and Ankle Offset to predict additional realignment procedures in total ankle replacement

BackgroundDecision to perform associated corrective alignment procedures in patients undergoing total ankle replacement (TAR) is commonly made intraoperatively. The Foot and Ankle Offset (FAO) can evaluate multiplanar deformity and be an effective instrument in surgical planning. This study objective was to assess the ability of this tool to predict the need for additional realignment procedures at the time of TAR.MethodsIn this retrospective study, we enrolled 21 patients who underwent TAR and had preoperative WBCT studies. Two independent and blinded observers calculated the preoperative FAO using dedicated software. FAO measurements were compared between the different alignment groups (physiological alignment, valgus and varus). A multivariate regression analysis was used to assess the correlation between performed realignment procedures and FAO values.ResultsMean preoperative FAO was 4.4% (95%CI = 1.4–7.5). The number of osseous realignment procedures needed was found to correlate positively and significantly with FAO (p = .001). The number of osseus procedures needed was significantly higher in patients with valgus malalignment (p = .009). Patients with valgus malalignment needing a medial column procedure had a relative risk of 6.3 when compared to varus malalignment patients (p = .02).ConclusionThe number of additional bony realignment procedures performed at the time of TAR significantly correlated with preoperative FAO and that the number of osseus procedures needed was significantly higher in patients with valgus malalignment. Such biometric tools may enhance the preoperative assessment and surgical planning for patients undergoing TAR, with the potential to optimize surgical outcomes.