Tibiotalocalcaneal arthrodesis (TTCA) is an increasingly used method of stiffening the ankle and subtalar joints in advanced degenerative deformities. The study group consisted of 19 men who were subjected to intramedullary and intraosseous arthrodesis using an intramedullary nail. The average age of patients was 46 (range 19-68) years. The main indication for surgical treatment was post-traumatic arthrosis 11 (58%). In the studied group, clinical condition was assessed using the American Orthopedic Foot and Ankle Score (AOFAS) classification, quality of life using the SF-12 scale, and assessment of pain intensity using the visual-analog scale (VAS) scale. The above parameters were evaluated before surgery (under 2 years), intermediate (from 2 to 5 years), and late (over 5 years) postoperative period. The clinical condition on the AOFAS scale improved from an average of 20.6 points before tibiotalocalcaneal arthrodesis to 63.5 after the procedure. The result was statistically significant (p < .0001). Analyzing the results using the SF-12 scale, a statistically significant increase was found. In the physical sphere of Physical Health Component Score-12 (p = .0004) and in the mental sphere of Mental Health Component Score-12 (p = .030). The intensity of pain assessed in the VAS scale, decreased in all three periods-p < .05. The strongest analgesic effect was observed in the early postoperative follow-up period. Tibiotalocalcaneal arthrodesis using an intramedullary nail causes a significant improvement in the clinical condition according to the AOFAS classification, enabling most patients to move independently, a significant improvement quality of life assessed in the SF-12 scale and a significant reduction of pain ailments assessed in the VAS scale, especially in the early postoperative period.

• MeSH
• Arthrodesis MeSH
• Adult MeSH
• Ankle Joint diagnostic imaging   surgery   MeSH
• Bone Nails MeSH
• Ankle MeSH
• Quality of Life MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Osteoarthritis * diagnostic imaging   surgery   MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Subtalar Joint * diagnostic imaging   surgery   MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Publication type
• Case Reports MeSH

OBJECTIVE: To evaluate the intraobserver and interobserver reliability of the ultrasonographic (US) assessment of subtalar joint (STJ) synovitis in patients with rheumatoid arthritis (RA). METHODS: Following a Delphi process, 12 sonographers conducted an US reliability exercise on 10 RA patients with hindfoot pain. The anteromedial, posteromedial, and posterolateral STJ was assessed using B-mode and power Doppler (PD) techniques according to an agreed US protocol and using a 4-grade semiquantitative grading score for synovitis [synovial hypertrophy (SH) and signal] and a dichotomous score for the presence of joint effusion (JE). Intraobserver and interobserver reliability were computed by Cohen's and Light's κ. Weighted κ coefficients with absolute weighting were computed for B-mode and PD signal. RESULTS: Mean weighted Cohen's κ for SH, PD, and JE were 0.80 (95% CI 0.62-0.98), 0.61 (95% CI 0.48-0.73), and 0.52 (95% CI 0.36-0.67), respectively. Weighted Cohen's κ for SH, PD, and JE in the anteromedial, posteromedial, and posterolateral STJ were -0.04 to 0.79, 0.42-0.95, and 0.28-0.77; 0.31-1, -0.05 to 0.65, and -0.2 to 0.69; 0.66-1, 0.52-1, and 0.42-0.88, respectively. Weighted Light's κ for SH was 0.67 (95% CI 0.58-0.74), 0.46 (95% CI 0.35-0.59) for PD, and 0.16 (95% CI 0.08-0.27) for JE. Weighted Light's κ for SH, PD, and JE were 0.63 (95% CI 0.45-0.82), 0.33 (95% CI 0.19-0.42), and 0.09 (95% CI -0.01 to 0.19), for the anteromedial; 0.49 (95% CI 0.27-0.64), 0.35 (95% CI 0.27-0.4), and 0.04 (95% CI -0.06 to 0.1) for posteromedial; and 0.82 (95% CI 0.75-0.89), 0.66 (95% CI 0.56-0.8), and 0.18 (95% CI 0.04-0.34) for posterolateral STJ, respectively. CONCLUSION: Using a multisite assessment, US appears to be a reliable tool for assessing synovitis of STJ in RA.

• MeSH
• Delphi Technique MeSH
• Adult MeSH
• Incidence MeSH
• Consensus MeSH
• Middle Aged MeSH
• Humans MeSH
• Reproducibility of Results MeSH
• Arthritis, Rheumatoid pathology   MeSH
• Subtalar Joint diagnostic imaging   pathology   MeSH
• Synovitis diagnostic imaging   epidemiology   MeSH
• Ultrasonography, Doppler methods   standards   MeSH
• Research Design MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Evaluation Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Systematic Review MeSH

UNLABELLED: PURPOSE OF THE STUDY The aim of the study was to evaluate, on the basis of radiographic findings and AOFAS scores, the results of the Grice extra-articular subtalar arthrodesis for treatment of planovalgus foot deformity in cerebral palsy patients. MATERIAL AND METHODS A total of 38 patients (50 feet) with cerebral palsy indicated to the Grice procedure for planovalgus foot deformity between 2006 and 2010 were assessed. The group comprised 18 girls and 20 boys, of whom 10 had spastic quadriparesis (four undergoing bilateral surgery), three had triparesis, four had hemiparesis and 21 had diparesis (treated on both sides in eight). The average age at surgery was 12 years (range, 7 years and 2 months to 17 years and 8 months). All patients were evaluated based on the AOFAS scoring system and radiographic findings before and after surgery. RESULTS The average follow-up was 4.5 years. The average AOFAS score increased from 54.9 points pre-operatively to 76.6 points post-operatively. The pre- and post-operative average values for the talocalcaneal angle were 49.8° and 25°, respectively; for the calcaneal inclination angle they were 8.6° and 13.4°, respectively. DISCUSSION The Grice procedure has long been considered a primary surgical treatment for planovalgus foot deformity in patients with cerebral palsy. Recently, calcaneal osteotomy has been used more frequently, but with no evidence of provably better results. CONSLUSIONS The mid-term results of the Grice extra-articular arthrodesis in our group of cerebral palsy children were very good in terms of both radiographic and AOFAS score evaluation; the latter includes objective assessment as well as the patient's subjective evaluation. KEY WORDS: Grice procedure, extra-articular subtalar arthrodesis, cerebral palsy, planovalgus foot deformity.

• MeSH
• Arthrodesis methods   MeSH
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Cerebral Palsy complications   MeSH
• Calcaneus surgery   MeSH
• Subtalar Joint diagnostic imaging   surgery   MeSH
• Treatment Outcome MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH