High Rates of Psychiatric Disorders and Below Normal Mental Capacity Associated With Spastic Peroneal Flatfoot: A New Relationship

Spastic peroneal flatfoot (SPFF) is a rare hindfoot pathology usually seen in the adolescent age group that is characterized by painful spasms in the peroneal muscles. We have clinically observed that patients with SPFF also have some behavioral and emotional difficulties and problems in their academic achievements. Because of these observations, we investigated the prevalence and patterns of psychiatric disorders and intellectual disability among young subjects with SPFF. Our cohort consisted of 16 patients with SPFF. Their mean age at presentation was 21 (range 13 to 31) years. Only 6 patients had a tarsal coalition as an underlying condition. The psychometric evaluation was conducted using validated instruments (Wechsler Intelligence Scale for Children–revised form, Stanford Binet intelligence quotient [IQ] test, and Cattell IQ test). Psychiatric disorders were assessed using a semistructured diagnostic instrument (Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version). The testers and psychiatrists were unaware of the orthopedic condition and the preliminary psychiatric diagnoses. The ethical committee approved the study protocol. The mean follow-up period was 41 (range 12 to 97) months. The mean IQ score of the patients was 75.1?±?17.9 (range 52 to 107). Compared with the general population, the rate of intellectual disability was significantly greater (p?=?.0001) and the rate of normal intelligence significantly lower (p?=?.0015) in our patient group. Furthermore, according to the community schooling ratio, our cohort also had lower junior high and secondary education rates compared with the general population. The rate of most psychiatric disorders diagnosed in the SPFF patients was greater than that in the normal population. The most commonly identified psychiatric disorders were social phobia and attention deficit and hyperactivity disorder (75%). Timely interventions of the psychosocial and academic problems of patients with SPFF might increase their compliance with orthopedic treatment and help with their psychological well-being and academic achievement. In addition, this relationship might be a clue for uncovering the etiology of this disease, which has not yet been clarified.     

Superficial Peroneal Nerve to Deep Peroneal Nerve Transfer With Allograft Conduit for Neuroma in Continuity

The anterior approach to the ankle for surgery can result in injury to the superficial peroneal nerve, resulting in a painful neuroma and significant patient morbidity. A paucity of data is available evaluating the role of the superficial peroneal nerve to deep peroneal nerve transfer as a method of treatment of neuromas in continuity after ankle arthrodesis. We describe 11 patients who underwent nerve transfer with nerve allograft and conduit repair to treat recalcitrant painful neuromas after ankle arthrodesis. At a mean follow-up period of 31 months, the mean visual analog pain scale score had improved from 7.9 preoperatively to 2.45 postoperatively (p?<?.0001). These data suggest that nerve transfer with a nerve allograft can provide significant clinical improvement for painful neuromas of the peripheral nerves at the ankle.     

The lateral malleolar bony fleck classified by size and pathoanatomy: The IOFAS classification

Background

This study analyzes position of the peroneal tendons and status of the superior peroneal retinaculum (SPR) whenever a lateral malleolar bony flake fracture occurs.

Common peroneal nerve rupture with multiple ligament knee injury: A case report

In peroneal nerve palsy with closed knee injury, most of the case improves by follow‐up. We present a case of peroneal nerve rupture with closed multiple ligament knee injury, requiring nerve transplantation. In multiple ligament knee injury, it is necessary to consider the possibility of peroneal nerve rupture.     

Assessment of quality of life after soft tissue resection of head and neck carcinoma and reconstruction with double-paddle peroneal artery perforator free flap

We aimed to assess the quality of life for head and neck carcinoma (HNC) patients who underwent soft tissue resection and reconstruction with double-paddle peroneal artery perforator (DPAP) free flap. The quality of life was assessed by means of the University of Washington quality of life (UW-QOL) and the 14-item Oral Health Impact Profile (OHIP-14) questionnaires at 12 months postoperatively. Data from 57 patients were retrospectively analysed. Out of these, 51 patients were at TNM stage III or IV. Finally, 48 patients finished and returned the two questionnaires. In the UW-QOL questionnaire, the mean (SD) higher scores were pain 76.5 (6.4), shoulder 74.3 (9.6), and activity 71.6 (6.1), whereas the lower scores were chewing 49.7 (5.2), taste 51.1 (7.7), and saliva (56.7 (7.4). In the OHIP-14 questionnaire, the higher-scoring domains were psychological discomfort (69.3 (9.6) and psychological disability 65.2 (5.8), whereas the lower-scoring domains were handicap 28.7 (4.3) and physical pain 30.4 (8.1). The DPAP free flap significantly improved appearance, activity, shoulder, mood, psychological discomfort, and handicap compared with pedicled pectoralis major myocutaneous flap reconstruction. In conclusion, DPAP free flap for reconstruction of tissue defects after soft tissue resection of HNC significantly improved the patients' QOL compared to pedicled pectoralis major myocutaneous flap reconstruction.     

3D-CTA辅助下采用游离腓动脉穿支皮瓣修复前足皮肤软组织缺损创面的临床疗效

探讨对前足皮肤软组织缺损创面在3D-CTA辅助下采用游离腓动脉穿支皮瓣修复的效 果。方法 选择2021年2月-2022年6月山东大学附属威海市立医院收治的48例前足皮肤软组织缺损患者为研 究对照，以随机数字表法分为对照组和观察组，每组24例。对照组接受蒂皮瓣修补法治疗，观察组接受 3D-CTA辅助下游离腓动脉穿支皮瓣修复法治疗，比较两组临床疗效、疼痛程度及足功能。结果 观察组 治疗总有效率为95.83%，高于对照组的75.00%（P＜0.05）；观察组治疗后AOFAS评分高于对照组，VAS评 分低于对照组（P ＜0.05）。结论 对前足皮肤软组织缺损创面在3D-CTA辅助下采用游离腓动脉穿支皮瓣 修复的效果良好，可促进患者皮瓣感觉功能恢复，减轻术后疼痛，有利于改善患者的足功能，促进恢复。 【关键词】3D-CTA；腓动脉穿支皮瓣；皮肤软组织缺损；足功能