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1.
Foot (Edinb) ; 57: 102060, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37922633

RESUMO

INTRODUCTION: Hallux valgus (HV) is a common condition with impact on pain, function and HrQoL. International consensus does not exist on operative treatment of HV and population-level data regarding surgical treatment of HV is lacking. In this study we aimed to present base-line data from surgically treated HV patients reported to the Swedish register for foot and ankle surgery (Swefoot) during the period 2014-2021. MATERIAL AND METHODS: In total, 7543 feet in 6770 patients were analyzed regarding patient characteristics, grading of HV, surgical procedures and pre-operative PROMs Euroqol-5 Dimension-3 L (EQ-5D-3 L) and Self-reported Foot and Ankle Score (SEFAS). RESULTS: Median age was 55 years (range 15-91) and 87% were women. The surgeon classified 63% of the cases as moderate HV, 15% as mild and 22% as severe. The Chevron osteotomy was the preferred surgical method and was used in 74% of all cases. Out of these, 58% were fixated with a screw. The Offset-V osteotomy was the most performed shaft osteotomy. Proximal osteotomies and lateral releases were less common. The pre-operative mean EQ-5D-3 L index and SEFAS summary score were low and HV patients with overweight and rheumatoid arthritis had significantly lower scores. CONCLUSION: This is the first report from Swefoot describing surgeon- and patient reported pre-operative data in patients with surgical treated HV.


Assuntos
Hallux Valgus , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Masculino , Hallux Valgus/cirurgia , Tornozelo , Resultado do Tratamento , Suécia , Extremidade Inferior
2.
Foot Ankle Surg ; 28(8): 1404-1410, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35933290

RESUMO

BACKGROUND: Population-based register data could be used to improve our knowledge of patients surgically treated for foot and ankle disorders. The quality register Swefoot was recently created to collect surgical and patient-reported data of foot and ankle surgery. This manuscript aims to describe the development and current use of the register. METHODS: The development of Swefoot started in 2014 and currently, data on 16 different diagnoses are collected in 49 units performing foot and ankle surgery. Registrations are performed by the surgeon and the patient. RESULTS: Between 2014 and 2020 approximately 20,000 surgical procedures have been registered. 75.1% of the registered patients were women, 9.3% were smokers, 9.3% had a concomitant rheumatoid disease, and 18.4% a BMI larger than 30 kg/m2. CONCLUSIONS: The Swefoot is a unique national register for foot and ankle surgery. It is by now possible to present demographic, surgical, and outcome parameters based on Swefoot.


Assuntos
Extremidade Inferior , Humanos , Feminino , Masculino , Autorrelato , Sistema de Registros , Suécia/epidemiologia
3.
Foot Ankle Int ; 43(6): 762-771, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35184581

RESUMO

BACKGROUND: Several studies probe the association between prolonged time to surgery and postoperative complications in ankle fractures, but little is known about how a longer wait time affects clinical outcomes. The present study aims to assess the association between time from injury to surgery and patient-reported outcomes after operative treatment of severe ankle fractures. METHOD: Patients treated operatively for low-energy ankle fractures that also involve the posterior malleolus from 2014 to 2016 were included. Patient charts were reviewed for patient demographics, type of trauma, fracture characteristics, treatment given, and complications. Ankle function was evaluated on a follow-up visit by clinical examination, radiographs, and patient-reported outcome measures (Self-Reported Foot and Ankle Score [SEFAS], RAND-36, visual analog scale [VAS] of Pain, VAS of Satisfaction). We compared patients treated within 1 week to those treated later than a week from injury for analyses. RESULTS: Follow-up visits of 130 patients were performed at mean 26 (SD 9) months after surgery. Patient demographics and fracture characteristics were similar between groups. Mean SEFAS was 34 (SD 10) in patients treated later than a week from injury vs 38 (SD 9) in those treated earlier (P = .012). Patients operated on later than 7 days from injury reported more pain (P = .008) and lower satisfaction than those treated earlier (P = .016). CONCLUSION: In this retrospective patient series of low-energy ankle fractures with posterior malleolar fragments, we found that waiting >7 days for definitive surgery was associated with poorer clinical outcomes and more pain compared with those who had surgery earlier. LEVEL OF EVIDENCE: Level III, retrospective comparative study.


Assuntos
Fraturas do Tornozelo , Fraturas do Tornozelo/cirurgia , Fixação Interna de Fraturas , Humanos , Dor , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos , Resultado do Tratamento
4.
Foot Ankle Surg ; 27(5): 521-527, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32980265

RESUMO

BACKGROUND: The Self-reported Foot and Ankle Score (SEFAS) is a patient-reported outcome measure used to evaluate foot and ankle disorders. The purpose of this study was to translate, cross-culturally adapt and validate the Danish language version of the SEFAS in patients with ankle-related fractures. METHODS: Forward-backward translation, cross-cultural adaption and validation were performed. In total, 125 patients completed the SEFAS-DK and the Danish version of American Orthopaedic Foot and Ankle Score (AOFAS-DK) at three time points after the date of fracture. The evaluation was performed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. RESULTS: The intra-class correlation coefficient (ICC) level of the SEFAS-DK total score was 0.93 (95% confidence interval [CI]: 0.88-0.96). Cronbach's alpha (CA) for the SEFAS-DK was 0.93, while the floor and ceiling effect at week 6 post-injury was 22.4%. Construct validity was correlated with the AOFAS, and >75% of the pre-defined hypotheses could be confirmed. Responsiveness was analysed using longitudinal data. The minimal clinical important change (MCIC) showed that the SEFAS-DK detects changes in physical function over time. CONCLUSION: The Danish version of the SEFAS showed overall good reliability, validity and responsiveness. SEFAS-DK can be used to evaluate physical function in patients with ankle-related fractures. LEVEL OF EVIDENCE: level II, prospective cohort study.


Assuntos
Fraturas do Tornozelo/cirurgia , Articulação do Tornozelo/cirurgia , Tornozelo/cirurgia , Procedimentos Ortopédicos , Projetos de Pesquisa , Autorrelato , Traduções , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Consenso , Dinamarca , Feminino , Seguimentos , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Estudos Prospectivos , Psicometria/métodos , Reprodutibilidade dos Testes , Resultado do Tratamento , Adulto Jovem
5.
Foot Ankle Int ; 42(4): 389-399, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33203272

RESUMO

BACKGROUND: In the past, posterior malleolus fragments (PMFs) commonly have been indirectly reduced and fixed when fragments involve 25% or more of the tibial articular surface, while smaller fragments were left unfixed. The posterior approach has become increasingly popular and allows fixation of even smaller fragments. This study compares clinical outcome for the 2 treatment strategies. METHODS: Patients with ankle fractures involving a PMF treated from 2014 to 2016 were eligible for inclusion. Patients were allocated to group A (treated with a posterior approach) or group B (treated with the traditional approach) according to the treatment given. A one-to-one matching of patients from each group based on the size of the PMF was performed. Patient charts were reviewed, and outcome evaluation was performed clinically, radiographically, and by patient-reported outcome measures (PROMs; Self-Reported Foot and Ankle Score, RAND-36, visual analog scale [VAS] of pain, and VAS of satisfaction). Forty-three patients from each group were matched. Median follow-up was 26 (interquartile range [IQR], 19-35) months postoperatively. RESULTS: The median PMF size was 17% (IQR, 12-24) in both groups, and they reported similar results in terms of PROMs. Fixation of the PMF was performed in 42 of 43 (98%) patients in group A and 7 of 43 (16%) patients in group B (P < .001). The former group more frequently got temporary external fixation (56% vs 12%, P < .01) and less frequently had syndesmotic fixation (14% vs 49%, P < .01), and they had less mechanical irritation and hardware removal but more noninfectious skin problems (28% vs 5%, P < .01). Median time from injury to definitive surgery (8 vs 0 days, P < .001) and median length of stay (12 vs 3 days, P < .001) were longer in group A. CONCLUSION: Comparison of treatment strategies for ankle fractures involving the posterior malleolus showed similar results between patients treated with a traditional approach and a posterior approach. LEVEL OF EVIDENCE: Level III, retrospective comparative study.


Assuntos
Fraturas do Tornozelo , Fraturas do Tornozelo/diagnóstico por imagem , Fraturas do Tornozelo/cirurgia , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/cirurgia , Fixação Interna de Fraturas , Humanos , Estudos Retrospectivos , Resultado do Tratamento
6.
Foot Ankle Surg ; 25(4): 478-481, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30321964

RESUMO

BACKGROUND: Patients with hallux valgus deformity may require surgery but prospective patient-reported data is scarce. METHODS: We evaluated 53 patients with a mean age of 55.3years (SD 14.1, 50 women), who underwent surgery due to hallux valgus. They completed the PROMs SEFAS, EQ-5D and SF-36 before and 6, 12 and 24 months after surgery. RESULTS: All patient-reported outcomes improved at 6, 12 and 24months compared with the preoperative status. The greatest improvement occurred at 6months: SEFAS Δ 10.0 (95% confidence interval 7.8-12.2), EQ-5D Δ 0.22 (0.15-0.29), EQ-VAS Δ 8.4 (4.4-12.4), PF SF-36 Δ 22.0 (14.6-29.3) and BP SF-36 Δ 30.6 (23.1-38.1). CONCLUSIONS: Hallux valgus surgery considerably reduced pain and improved function already within 6months after surgery. The improvement between 6 and 24months' follow-up was minimal measured with PROMs. LEVEL OF CLINICAL EVIDENCE: III - prospective observational cohort study.


Assuntos
Hallux Valgus/cirurgia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Dor , Medição da Dor , Medidas de Resultados Relatados pelo Paciente , Estudos Prospectivos , Amplitude de Movimento Articular , Resultado do Tratamento
7.
Foot Ankle Surg ; 25(3): 361-365, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30321978

RESUMO

BACKGROUND: Patient-reported outcome measures are a critical tool in evaluating the efficacy of orthopedic procedures. The intention of this study was to compare the psychometric properties of the Manchester-Oxford Foot Questionnaire (MOXFQ) and the Self-Reported Foot and Ankle Outcome Score (SEFAS) in patients with foot or ankle surgery. METHODS: 177 patients completed both scores and FAOS, Foot and Ankle Outcome Score (FAOS), Short Form 36 (SF-36) and numeric scales for pain and disability (NRS) before and after surgery. Test-Retest reliability, internal consistency, floor and ceiling effects, construct validity, responsiveness and minimal important change were analyzed. RESULTS: The MOXFQ and SEFAS demonstrated excellent test-retest reliability with interclass correlation coefficient values >0.9 Cronbach's alpha (α) values demonstrated strong internal consistency. No floor or ceiling effects were observed for both questionnaires. As hypothesized MOXFQ subscales correlated strongly with corresponding SEFAS, FAOS and SF-36 domains. MOXFQ subscales showed excellent responsiveness between preoperative assessment and postoperative follow-up, whereas SEFAS demonstrated moderate responsiveness. CONCLUSIONS: The MOXFQ and SEFAS demonstrated good psychometric properties and proofed to be valid and reliable instruments for use in foot and ankle patients. MOXFQ showed better outcomes in responsiveness.


Assuntos
Tornozelo/cirurgia , Pé/cirurgia , Medidas de Resultados Relatados pelo Paciente , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Autorrelato , Adulto Jovem
8.
Foot Ankle Int ; 39(11): 1328-1334, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30035614

RESUMO

BACKGROUND: The Self-Reported Foot and Ankle Score (SEFAS) is a foot- and ankle-specific patient-reported outcome measurement (PROM) score that has been validated with good results for a variety of foot and ankle disorders. SEFAS is sensitive detecting improvement or deterioration after surgery. However, normative values, required to put a specific patient's summary score into perspective, are lacking. METHODS: In this report, we included 396 population-based men and 383 women (43% of the invited individuals), age 20-89 years, who had completed the SEFAS questionnaire and questions regarding anthropometrics and health. We used Mann-Whitney U test to test gender differences and Spearman correlation coefficients to determine any association between SEFAS score and age. We present gender-specific median SEFAS scores with range and 5th to 95th percentiles and mean with standard deviation. RESULTS: The SEFAS normative values were median 48 in men (range 11-48), 5th to 95th percentiles 31 to 48 and mean 45 ± 6, and in women, median 47 (range 6-48), 5th to 95th percentiles 23 to 48 and mean 43 ± 8 (gender comparison P < .001). SEFAS normative values correlated inversely with age (r = -0.12, P < .001). CONCLUSION: In the general population, older age was associated with lower SEFAS value, and men had higher values than women. The population-based normative SEFAS values provided in this study can facilitate quantification of disability related to foot and ankle with and without surgery in the foot and ankle. LEVEL OF EVIDENCE: Level II, prospective comparative study.


Assuntos
, Medidas de Resultados Relatados pelo Paciente , Autorrelato , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Reprodutibilidade dos Testes , Fatores Sexuais , Adulto Jovem
9.
Foot Ankle Surg ; 23(4): 311-316, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29202994

RESUMO

BACKGROUND: To compare the functional outcomes between patients with and without postoperative surgical-site infection (SSI) after surgical treatment in closed ankle fractures. METHODS: Retrospective cohort study with prospective follow-up. Of 1011 treated patients, 959 were eligible for inclusion in a postal survey. Functional outcomes were assessed using three self-reported questionnaires. RESULTS: In total 567 patients responded a median of 4.3 years (range 3.1-6.2 years) after surgery. In total 29/567 had an SSI. The mean Olerud and Molander Ankle Score was 19.8 points lower for patients with a deep SSI (p=0.02), the Lower Extremity Functional Scale score was 10.2 points lower (p<0.01) and the Self-Reported Foot & Ankle Questionnaire score was 5.0 points higher (p=0.10) than for those without an SSI, after adjusting for age, sex, smoking status, diabetes, physical status, fracture classification and duration of surgery. CONCLUSIONS: Patients with a deep SSI had worse long-term functional outcomes than those without an SSI.


Assuntos
Fraturas do Tornozelo/cirurgia , Fixação Interna de Fraturas/efeitos adversos , Infecção da Ferida Cirúrgica/reabilitação , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Estudos Retrospectivos , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/terapia , Inquéritos e Questionários , Resultado do Tratamento
10.
BMC Musculoskelet Disord ; 18(1): 409, 2017 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-29017475

RESUMO

BACKGROUND: Patient-reported outcome measures are a critical tool in evaluating the efficacy of orthopedic procedures and are increasingly used in clinical trials to assess outcomes of health care. The intention of this study was to develop and culturally adapt a German version of the Self-reported Foot and Ankle Score (SEFAS) and to evaluate reliability, validity and responsiveness. METHODS: According to Cross Cultural Adaptation of Self-Reported Measure guidelines forward and backward translation has been performed. The German SEFAS was investigated in 177 consecutive patients. 177 Patients completed the German SEFAS, Foot and Ankle Outcome Score (FAOS), Short-Form 36 and numeric scales for pain and disability (NRS) before and 118 patients 6 months after foot or ankle surgery. Test-Retest reliability, internal consistency, floor and ceiling effects, construct validity and minimal important change were analyzed. RESULTS: The German SEFAS demonstrated excellent test-retest reliability with ICC values of 0.97. Cronbach's alpha (α) value of 0.89 demonstrated strong internal consistency. No floor or ceiling effects were observed for the German version of the SEFAS. As hypothesized SEFAS correlated strongly with FAOS and SF-36 domains. It showed moderate (ES/SRM > 0.5) responsiveness between preoperative assessment and postoperative follow-up. CONCLUSION: The German version of the SEFAS demonstrated good psychometric properties. It proofed to be a valid and reliable instrument for use in foot and ankle patients. TRIAL REGISTRATION: DRKS00007585.


Assuntos
Artroplastia de Substituição do Tornozelo , Articulações do Pé/cirurgia , Pé/cirurgia , Medidas de Resultados Relatados pelo Paciente , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto Jovem
11.
Foot Ankle Surg ; 21(4): 286-9, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26564733

RESUMO

BACKGROUND: Patients with adult acquired flatfoot deformity (AAFD) due to posterior tibial tendon dysfunction (PTTD) may require surgery but few reports have evaluated the outcome. METHODS: We evaluated 21 patients with a median age of 60 (range 37-72) years who underwent different surgical reconstructions due to stage II AAFD before and 6 and 24 months after surgery by the validated Self-Reported Foot and Ankle Score (SEFAS), Short Form 36 (SF-36) and Euroquol 5 Dimensions (EQ-5D). RESULTS: The improvement from before to 24 months after surgery was in SEFAS mean 12 (95% confidence interval 8-15), SF-36 physical function 21 (10-22), SF-36 bodily pain 28 (17-38), EQ-5D 0.2 (0.1-0.3) and EQ-VAS 11 (2-21). CONCLUSION: Surgery for AFFD due to PTTD results in reduced pain and improved function and health related quality of life. The outcome scores have been demonstrated as useful. It has also been shown, since there is a further improvement between 6 and 24 months after surgery, that a minimum follow-up of 2 years is needed. LEVEL OF CLINICAL EVIDENCE: III - prospective observational cohort study.


Assuntos
Pé Chato/cirurgia , Disfunção do Tendão Tibial Posterior/cirurgia , Adulto , Idoso , Calcâneo/cirurgia , Feminino , Pé Chato/complicações , Humanos , Ligamentos Articulares/cirurgia , Masculino , Pessoa de Meia-Idade , Osteotomia , Dor/etiologia , Dor/cirurgia , Avaliação de Resultados da Assistência ao Paciente , Disfunção do Tendão Tibial Posterior/complicações , Estudos Prospectivos , Qualidade de Vida , Recuperação de Função Fisiológica , Transferência Tendinosa
12.
Foot Ankle Surg ; 21(1): 11-5, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25682400

RESUMO

BACKGROUND: Up to a third of patients may be dissatisfied with the outcome of hallux valgus surgery. This stresses the importance of uniform and relevant outcome measures. The purpose of the current systematic review is to identify and rate available patient-reported outcome measures (PROMs) in hallux valgus surgery. METHODS: We performed a systematic literature search for outcome measures directed at hallux valgus. We searched electronic databases for relevant content according to the PRISMA standard. Eligible articles were used to give an overview of available PROMs, with qualitative evaluation of their properties. RESULTS: Twenty-eight eligible studies were included. Most adapted general health assessment tools, in studies on hallux valgus surgery, were the EQ5D and the SF-36 score. The visual analogue scale (VAS) was most cited as pain score. Three disease-specific outcome scores were identified: the Manchester-Oxford foot questionnaire (MOXFQ), the foot and ankle outcome score (FAOS) and the self-reported foot and ankle score (SEFAS). The MOXFQ showed the best psychometric properties. CONCLUSIONS: The MOXFQ scores best on positively rated qualities based on our criteria. The SEFAS may be a good alternative, however it contains less items which are regarded as important by patients with foot/ankle complaints. A relative drawback of the MOXFQ consists of the copyright licence. The VAS is the best pain score and the SF36 the best general health assessment tool. Availability in native languages and future research should lead to uniformity in application of these tools.


Assuntos
Hallux Valgus/cirurgia , Hallux Valgus/complicações , Humanos , Dor Musculoesquelética/etiologia , Avaliação de Resultados da Assistência ao Paciente , Qualidade de Vida
13.
Foot Ankle Int ; 35(10): 1031-6, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25015390

RESUMO

BACKGROUND: The Self-reported Foot and Ankle Score (SEFAS) is a patient-reported outcome measure, while the American Orthopedic Foot and Ankle Society Score (AOFAS) is a clinician-based score, both used for evaluation of foot and ankle disorders. The purpose of this study was to compare the psychometric properties of these 2 scoring systems. METHODS: A total of 95 patients with great toe disorders and 111 patients with ankle or hindfoot disorders completed the 2 scores before and after surgery. We evaluated time to complete the scores in seconds, correlations between scores with Spearman's correlation coefficient (r s), floor and ceiling effects by proportion of individuals who reached the minimum or maximum values, test-retest reliability and interobserver reliability by intraclass correlation coefficient (ICC), internal consistency by Cronbach's coefficient alpha (CA), and responsiveness by effect size (ES). Data are provided as correlation coefficients, means, and standard deviations. RESULTS: SEFAS was completed 3 times faster than AOFAS. The scores correlated with an r s of .49 for great toe disorders and .67 for ankle/hindfoot disorders (both P < .001). None of the scores had any floor or ceiling effect. SEFAS test-retest ICC values measured 1 week apart were .89 for great toe and .92 for ankle/hindfoot disorders, while the corresponding ICC values for AOFAS were .57 and .75. AOFAS interobserver reliability ICC values were .70 for great toe and .81 for ankle/hindfoot disorders. SEFAS CA values were .85 for great toe and .86 for ankle/hindfoot disorders, while the corresponding CA values for AOFAS were .15 and .42. SEFAS ES values were 1.15 for great toe and 1.39 for ankle/hindfoot disorders, while the corresponding ES values for AOFAS were 1.05 and 1.73. CONCLUSION: As SEFAS showed similar or better outcome in our tests and was completed 3 times faster than AOFAS, we recommend SEFAS for evaluation of patients with foot and ankle disorders. LEVEL OF EVIDENCE: Level II, prospective comparative study.


Assuntos
Doenças do Pé/cirurgia , Avaliação de Resultados da Assistência ao Paciente , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Psicometria , Reprodutibilidade dos Testes , Autorrelato , Adulto Jovem
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