Abstract M-dwarf stars provide us with an ideal opportunity to study nearby small planets. The HUnting for M Dwarf Rocky planets Using MAROON-X (HUMDRUM) survey uses the MAROON-X spectrograph, which ...is ideally suited to studying these stars, to measure precise masses of a volume-limited (<30 pc) sample of transiting M-dwarf planets. TOI-1450 is a nearby (22.5 pc) binary system containing a M3 dwarf with a roughly 3000 K companion. Its primary star, TOI-1450A, was identified by the Transiting Exoplanet Survey Satellite (TESS) to have a 2.04 days transit signal, and is included in the HUMDRUM sample. In this paper, we present MAROON-X radial velocities (RVs) which confirm the planetary nature of this signal and measure its mass at nearly 10% precision. The 2.04 days planet, TOI-1450A b, has R b = 1.13 ± 0.04 R ⊕ and M b = 1.26 ± 0.13 M ⊕ . It is the second-lowest-mass transiting planet with a high-precision RV mass measurement. With this mass and radius, the planet’s mean density is compatible with an Earth-like composition. Given its short orbital period and slightly sub-Earth density, it may be amenable to JWST follow-up to test whether the planet has retained an atmosphere despite extreme heating from the nearby star. We also discover a nontransiting planet in the system with a period of 5.07 days and a M sin i c = 1.53 ± 0.18 M ⊕ . We also find a 2.01 days signal present in the systems’s TESS photometry that likely corresponds to the rotation period of TOI-1450A’s binary companion, TOI-1450B. TOI-1450A, meanwhile, appears to have a rotation period of approximately 40 days, which is in line with our expectations for a mid-M dwarf.
Venous thromboembolism (VTE) is among the most feared complications by orthopedists both for due to its potentially lethal outcome and the uncertainties related to its prevention. Despite the vast ...literature on VTE prevention in major orthopedic surgeries, little is known about it in ankle and foot procedures. In orthopedics, adequate thromboprophylaxis requires a careful assessment of the thrombotic and hemorrhagic risks based on the procedure to be performed, as well as and knowledge on anticoagulant agents. The presentis review has the goal of assessing the risk of developingdiscusses VTE risk assessment, the modalities of thromboprophylaxis modalities, and the drugs used, with an emphasis on foot and ankle surgeries.
Category:
Bunion
Introduction/Purpose:
The minimally invasive Chevron Akin (MICA) osteotomy have been widely used treating hallux valgus (HV). The purpose of this study was to present a case series ...of patients with severe HV undergoing surgical treatment using the MICA procedure, and to evaluate the clinical and radiographic outcomes
Methods:
Sixty consecutive feet (52 patients) undergoing MICA for severe HV were included. Patients were assessed pre and postoperatively. Clinically evaluation was realized by visual analogue pain scale (VAS) and American Orthopaedic Foot & Ankle Society Score (AOFAS). Radiographic assessments included measurement of hallux valgus angle (HVA), intermetatarsal angle (IMA), metatarsal (MT) length and plantar offset of MT head.
Results:
The mean age was 59.9 years and follow-up were 18.5 months. The average AOFAS increased from 41.2 to 90.9 points and the VAS decreased from 8.1 to 1.3 at the last follow up. Average HVA decreased from 41.2° to 11.6° and IMA reduced from 17.1° to 6.8°. Average shortening of the first metatarsal and the plantar offset of MT head was 3.9 mm and 2.8 mm respectively. There was significant improvement (p<0.001) in all clinical and radiographic parameters (p<0.001). The most observed complication was hardware discomfort, observed in four feet (6.6%).
Conclusion:
The MICA technique is a safe and reproducible method to treat severe HV.
Peroneal disorders are a common cause of ankle pain and lateral instability and have been described in as much as 77% of patients with lateral ankle instability. Clicking, swelling, pain, and ...tenderness in the peroneal tendons track are frequent symptoms, but they can be confused with other causes of lateral ankle pain. The management of peroneal disorders can be conservative or surgical. When the conservative treatment fails, surgery is indicated, and open or tendoscopic synovectomy, tubularization, tenodesis or tendon transfers can be performed. The authors present a surgical technique of tendoscopy associated to minimally invasive tenodesis for the treatment of peroneal tendon tears, as well as the preliminary results of patients submitted to this procedure.
Four patients with chronic lateral ankle pain who were diagnosed with peroneal brevis pathology were treated between 2020 and 2022 with tendoscopic-assisted minimally invasive synovectomy and tenodesis. Using a 2.7 mm 30° arthroscope and a 3.0 mm shaver blade, the entire length of the peroneus brevis tendon and most parts of the peroneus longus tendon can be assessed within Sammarco's zones 1 and 2. After the inspection and synovectomy, a minimally invasive tenodesis is performed.
All patients were evaluated at least six months after surgery. All of them reported improvement in daily activities and in the Foot Function Index (FFI) questionnaire (pre-surgery mean FFI = 23.86%; post-surgery mean FFI = 6.15%), with no soft tissue complications or sural nerve complaints.
The tendoscopy of the peroneal tendons allows the surgeon to assess their integrity, confirm the extent of the lesion, perform synovectomy, prepare the tendon for tenodesis, and perform it in a safe and minimally invasive way, reducing the risks inherent to the open procedure.
Introduction. Baropodometry is used to measure the load distribution on feet during rest and walking. The aim of this study was to evaluate changes in plantar foot pressures distribution due to ...period of working and due to stretching exercises of the posterior muscular chain. Methods. In this transversal study, all participants were submitted to baropodometric evaluation at two different times: before and after the working period and before and after stretching the muscles of the posterior chain. Results. We analyzed a total of 54 feet of 27 participants. After the working period, there was an average increase in the forefoot pressure of 0.16 Kgf/cm2 and an average decrease in the hindfoot pressure of 0.17 Kgf/cm2. After stretching the posterior muscular chain, the average increase in the forefoot pressure was 0.56 Kgf/cm2 and the hindfoot average pressure decrease was 0.56 Kgf/cm2. These changes were not statistically significant. Discussion. It was reported that the strength of the Achilles tendon generates greater forefoot load transferred from the hindfoot. In our study, no significant variation in the distribution of plantar pressure was observed. It can be inferred that baropodometry was a reliable instrument to determine the plantar pressure, regardless of the tension of the posterior chain muscles.
Background
Pressure injuries (PIs) are a major problem for healthcare providers, impacting both care costs and patients' quality of life, although they are predominately preventable. These injuries ...are especially present in Intensive Care Units (ICUs) as a result of the severity of the clinical conditions of patients in this unit.
Aim
To develop a simplified version of the Braden scale by removing two of the most subjective subscores—Nutrition and Sensory Perception—in an attempt to reduce the chance of errors by the nursing team during the application of the scale.
Study Design
A cross‐sectional study was conducted on data collected from patients admitted to the ICU of a private Brazilian tertiary hospital. The resulting data consisted of 5194 patients, 6353 hospital admissions, and 6974 ICU stays. The overall prevalence of PI was 1.09%.
Results
The T‐test showed that both the Braden and the simplified Braden scores were significantly different between patients with and without PI (p < .001). Patients who developed PIs scored lower than those who did not. The area under the Receiver Operating Characteristic curve of the Braden Scale was 74.21% (95% CI: 68.61%–79.8%) and of the simplified scale was 72.54% (95% CI: 66.87%–78.22%). The Positive Predictive Value of the Braden Scale was 3.17% when interpolated at the same sensitivity as the simplified scale (47.37%), which achieved 3.26%.
Conclusions
By removing two of the six subscores of the Braden scale we propose a new tool for identifying patients at risk of developing PI in a more objective and fast way. Our results show that classification performance had little negative impact.
Relevance to clinical practice
A simplified, less subjective scale allows for more precise and less time‐consuming risk classification.
There are no specific criteria that define the level of amputation in diabetic patients. The objective of this study was to assess the influence of clinical and laboratory parameters in determining ...the level of amputation and the wound healing time.
One hundred and thirty-nine diabetic patients were retrospectively assessed. They underwent surgical procedures due to infection and/or ischemic necrosis. Type of surgery, antibiotic use, laboratory parameters and length of hospital stay were evaluated in this study.
The most common amputation level was transmetatarsal, occurring in 26 patients (28.9%). The wound healing time increased with statistical significance in individuals undergoing debridement, who did not receive preoperative antibiotics and did not undergo vascular intervention. Higher levels of amputation were statistically related to limb ischemia, previous amputation and non-use of preoperative antibiotics.
Patients with minor amputations undergo stump revision surgery more often, but the act of always targeting the most distal stump possible decreases energy expenditure while walking, allowing patients to achieve better quality of life. Risk factors for major amputations were ischemia and previous amputations. A protective factor was preoperative antibiotic therapy.
Category:
Hindfoot
Introduction/Purpose:
Objective: To evaluate and quantify the loss of ankle mobility in patients undergoing subtalar arthrodesis compared to the contralateral side, through ...physical examination.
Methods:
A total of 12 patients who had only the subtalar arthrodesis procedure from various causes in one foot were selected. The same foot and ankle surgeon performed all measurements of bilateral tibiotarsal range of motion, with loaded closed-chain and unloaded open-chain tests. Then, to assess whether there was a difference between the operated and the non-operated side, statistical analysis was performed with the Mann-Whitney test (Hollander and Wolfe 1999).
Results:
On the loaded closed-chain test, the operated side had a significantly lower range of motion than the contralateral side, with a mean difference of 5.4 degrees for dorsal flexion and 7.6 degrees for plantar flexion. The open-chain tests showed non- significant differences of 3 degrees for dorsal flexion and 5.3 degrees for plantar flexion.
Conclusion:
Subtalar joint arthrodesis was shown to cause a loss of mobility in the ipsilateral ankle, which is greater in plantar flexion movement.
Category:
Complications
Introduction/Purpose:
Venous thromboembolism (VTE) is the leading cause of preventable hospital death. There are several risk factors for VTE of which orthopedic surgery is an ...important one. VTE risk is highest following major orthopedic surgery and therefore some form of prophylactic therapy is usually recommended here. In contrast, the risk for VTE following foot and ankle surgery is less clear and so are guidelines on VTE prophylaxis in these patients. The purpose is to estimate the risk of VTE and the duration of the increased risk period after foot and ankle surgery.
Methods:
Data from a large population-based case–control study (the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis MEGA study) on the etiology of venous thrombosis were used (5129 cases; 5882 controls). Odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for age, sex and body mass index (ORadj) were calculated for patients undergoing any foot or ankle intervention before the index date (VTE date or control date).
Results:
286 cases and 96 controls underwent any orthopedic intervention in the year before the index date for an ORadj of 3.7 (95%CI 2.9-4.8) The ORadj in the first 90-days was 11.4 (95%CI 7.3-17.7). 57 cases and 20 controls had a foot or ankle intervention in the year before the index date, resulting in a three-fold increased risk for VTE (OR 3.3, 95% CI 1,9-5.5). VTE risk was highest in the first 30 (ORadj 10.2,95%CI 3.0-33.9) and 90-days following surgery (ORadj 12.4, 95% CI 4.4-34.8). In 34 patients the surgery was trauma related while 43 patients underwent elective surgery. Traumatic surgery was associated with a higher risk compared with elective surgery for an OR of 13.9 (95%CI 1.8-108.4) and 8.3 (95%CI 1.9-36.9), respectively at 30-days.
Conclusion:
Foot and ankle procedures were associated with an increased VTE risk which was highest in the first 90-days following surgery. Trauma related surgery was associated with a higher VTE risk than elective surgery. These results are important to decide on thromboprophylactic measures following foot and ankle surgery.
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