FIRST BALKAN FOOT AND ANKLE MEETING - E-VIP · Cavovarus foot reconstruction T. Ogut, Turkey...

FIRST BALKANFOOT AND ANKLEMEETING6-8th SEPTEMBER 2018EUROPEAN INTERBALKAN MEDICAL CENTERTHESSALONIKI GREECE

www.gbfootandankle.eu

Under the auspices of the European Foot and Ankle SocietyHellenic Association of Orthopaedic Surgery & TraumatologyOrthopaedic & Traumatologic Association of Macedonia & Thrace

MED CONGRESSEvents OrganizerKalapothaki 3, GR 54624 ThessalonikiT: ++30 231 403 9704 - F: ++30 231 220 6898E: [email protected]

ΕΛΛΗΝΙΚΗ

ΕΤΑ

ΙΡΕ

ΙΑ Χ

ΕΙΡΟ

ΥΡΓΙΚΗΣ ΟΡΘΟΠΑΙΔΙΚΗΣ &

ΤΡΑ

ΥΜ

ΑΤΟ

ΛΟΓΙΑΣ

1947

ΑΘΗΝΑ

Organized by theBulgarian and Hellenic Foot and Ankle Societies

AD _16x24_FINAL_ENG_NEW_OUT.pdf 1 03/07/2018 15:13

Dear colleagues,

We welcome you in Thessaloniki to participate in the First Balkan Foot and Ankle Meeting. Objective of the meeting is to comprehensively cover all aspects of modern foot and ankle sur-gery (biomechanics, reconstructive surgery, artrhroscopy and sports injuries, trauma), aiming at an audience of orthopaedic surgeons in training and also specialists with an interest in foot and ankle surgery. Lectures will be delivered by experienced orthopaedic surgeons from the Balkan countries and beyond.

The structure of the meeting has been divided to lectures according to anatomical regions – hindfoot, midfoot, forefoot - and thematic sessions. Free presentations from different regions will also give us an insight of local trends and experience in foot and ankle surgery. Apart from the scientific program, Thessaloniki is a vibrant, cultural city where participants and accompanying members can enjoy sightseeing, shopping, interesting food and nearby beaches in a safe environment. Wishing you all an enjoyable and constructive meeting!

Best regards,

2018 Meeting of the Working Group on Obesity, Diabetes and the High Risk Patient6-8th SEPTEMBER 2018, EUROPEAN INTERBALKAN MEDICAL CENTER

ORGANIZING COMMITTEEAtanas Katsarov

Nikolaos GougouliasDimitris Hatziemmanuil

Evgeni NeshevPanagiotis Symeonidis

SCIENTIFIC COMMITTEEPanagiotis Symeonidis

Atanas KatsarovAthanasios Badekas

Svilen TodorovNikolaos Gougoulias

President of the Organizing Committee

Katsarov Atanas

President of the Scientific Committee

Symeonidis Panagiotis

Thursday September 06

15.00-16.00 REGISTRATIONS

16.00-17.00 FREE PAPERS 1. RECONSTRUCTION Chairmen: N. Gougoulias, Greece - S. Todorov, Bulgaria

FP1. Extensor tendon transfers for Charcot Marie Tooth disease A. Tanrıover, Turkey FP2. Mid-term results following arthroscopic ankle arthrodesis A.Yildirim, Turkey

FP3. Mid-term results of hindfoot salvage arthrodesis with retrograde compression intramedullary nail in charcot neuro arthropathy A. Yildirim, Turkey

FP4. Talectomy for severe nevrogenic equinovarus deformity A. Gerchev, Bulgaria

FP5. Our experience in the application of a nail used for tibio- talo-calcanear arthrodesis N. Tzachev, Bulgaria

FP6. Arthroscopic arthrodesis of the subtalar joint V. Lampridis, Greece

FP7. Tarso-matetarsal joints arthrodesis V. Lampridis, Greece

17.00-18.20 FOOT & ANKLE APPLIED BIOMECHANICS AND DEFORMITIES Chairmen: P. Symeonidis, Greece – R. Kehayov, Bulgaria

Applied Foot & Ankle Biomechanics N. Gougoulias, Greece

Compensation patterns relative to foot misalignment and dys function M. Panagiotidou, Greece

Planovalgus foot reconstruction V. Protsko, Russia

FIRST BALKAN FOOT AND ANKLE MEETING

Cavovarus foot reconstruction T. Ogut, Turkey

18.20-19.00 DIABETIC FOOT CARE. MULTIDISCIPLINARY TEAM APPROACH - MANAGEMENT OF SEPTIC FOOT AND BONE INFECTION Chairman: N. Gougoulias, Greece Lecturer: A. Wee, United Kingdom

19.00 OPENING SESSION - GREETINGS Chairman: N. Gougoulias Speakers: A.Katsarov - A. Drevelegkas -A. Badekas - P. Symeonidis

20.00 WELCOME RECEPTION AT INTERBALKAN MEDICAL CENTER

Friday September 07

09.00-11.00 FOREFOOT Chairmen: T. Badekas, Greece – A. Pettas, Greece

A new simple algorithm for decision making in hallux valgus T. Esemenli, Turkey

Scarf osteotomy K. Buedts, Belgium

Revision hallux valgus surgery L. Makinyan, Russia

ModifiedHelalosteotomyinthetreatmentofsevereforms of metatarsalgia and hammer toe deformities A. Mazalov, Russia

MTPJ instability and the plantar plate D. Bobrov, Russia

MIS forefoot surgery D. Hatziemmanuil, Greece

11.00-11.30 BREAK

11.30-12.30 FREE PAPERS 2. FOREFOOT AND MISCELLANEOUS Chairmen: A. Katsarov, Bulgaria - M. Drobnic, Slovenia

FP8. Arthroscopyofthefirstmetatarsophalangealjoint


D. Dimnjakovic, Croatia FP9. Doessesamoidpositioneffectpatientsatisfactionafter hallux valgus surgery? A study over tangential sesamoid view E. Uygur, Turkey FP10. Evaluation and results of PBS percutaneous correction technique for symptomatic hallux valgus deformity P. Salonikidis, Greece

F11. Innovative approach to improving the method of preoperative planning and performing corrective forefoot osteotomy A. Akulaev, Russia

FP12. Theeffectsofhumanamnioticfluidandmembraneon fracture healing on rat fracture model (experimental study) A. Gultekin, Turkey

12.30-13.30 LIVE SURGERY (MIS HALLUX VALGUS CORRECTION) Performed by D. Hatziemannouil

13.30-14.00 BREAK

14.00-15.30 HIND FOOT Chairmen: A. Eleftheropoulos, Greece - R. Kastelov, Bulgaria

Hindfoot arthritis. Treatment alternatives T. Badekas, Greece

Deformity correction around ankle and hindfoot M. Drobnic, Slovenia

Ankle Arthroplasty K. Buedts, Belgium

Neuropathic diabetic foot reconstruction V. Obolenskiy, Russia

15.30-16.00 BREAK

16.00-17.00 ANKLE TRAUMA Chairmen: S. Todorov, Bulgaria – V. Lampridis, Greece

High ankle sprain. Syndesmotic involvement A. Katsarov, Bulgaria


Ankle Fractures A. Eleftheropoulos, Greece

PilonFractures.Whyweleftearlysurgery? R. Kastelov, Bulgaria

20.00 DINNER AT NIKOPOLIS HOTEL

Saturday September 08

08.30-09.30 FREE PAPERS 3. TRAUMA AND SOFT TISSUE Chairmen: A. Katsarov, Bulgaria – N. Tzachev, Bulgaria

FP13. Two crossed Schanz pins versus calcaneal plate in the treatment of intraarticular calcaneal fractures? A comparison of functional and radiological outcomes A. Duramaz/E. Baca, Turkey

F14. Effectsofankletapingondynamicposturalcontrolin patients with ankle instability K. Sidiropoulos, Greece

FP15. Posteriormalleolusfixationforsyndesmosis E. Baca, Turkey

FP16. Translation and cross-cultural adaptation of the Turkish version of the foot health status questionnaire S. Karaborklu/E. Baca, Turkey

FP17. Retrospective study of Lisfranc fracture dislocations treatedwithfusionandinternalfixation K. Surchev, Bulgaria

FP18. Thefirst55peronealtendoscopiesofonesurgeon: analysisofintraoperativefindingsandperformedconcomitant procedures D. Dimnjakovic, Croatia

FP19. Proximal medial gastrocnemius release in the treatment of recalcitrant plantar fasciitis V. Lampridis, Greece

FP20. Salvagefibularlengtheningbyexternalfixatorafter incorrect lower leg lengthening. A two cases report. M. Zhivkov, Bulgaria


FP21. Long term results of percutaneous radiofrequency nerve ablation for chronic plantar heel pain associated with plantar fasciitis Y. Erken, Turkey

09.30-11.00 ARTHROSCOPY - SPORTS INJURIES Chairmen: T. Ogut, Turkey - D. Hatziemmanuil, Greece

Chronicpainafterananklesprain-howtosetananatomic diagnosis M. Drobnic, Slovenia

Arthroscopy:Techniqueandindications N. Gougoulias, Greece

Talus Osteochondral lesions K. Irgit, Turkey

Endoscopic treatment of chronic Achillobursitis S. Tamoev, Russia

11.00-11.15 BREAK

11.15-12.30 FOOT FRACTURES; ACHILLES’ TENDON RUPTURES Chairmen: A. Katsarov, Bulgaria – A. Konstantinidis, Greece

Acute & Chronic Achilles tendon ruptures K. Irgit, Turkey

Calcaneal fractures E. Neshev, Bulgaria

Talus fractures S. Assiov / A. Iliev, Bulgaria

Lisfranc’s injuries P. Symeonidis, Greece



FREE PAPERS PRESENTATION FREE PAPERS 1. “RECONSTRUCTION”Thursday 6th of September 2018Chairmen: N. Gougoulias – S. Todorov FP1. EXTENSOR TENDON TRANSFERS FOR CHARCOT MARIE TOOTH DISEASEA. Tanrıöver

FP2. MID-TERM RESULTS FOLLOWING ARTHROSCOPIC ANKLE ARTHRODESISA. Yildirim

FP3. MID-TERM RESULTS OF HINDFOOT SALVAGE ARTHRODESIS WITH RETRO-GRADE COMPRESSION INTRAMEDULLARY NAIL IN CHARCOT NEURO ARTHROPATHYA. Yildirim - Ali Gulec

FP4. TALECTOMY FOR SEVERE NEVROGENIC EQUINOVARUS DEFORMITYA. Gerchev

FP5. OUR EXPERIENCE IN THE APPLICATION OF A NAIL USED FOR TIBIOTALO-CAL-CANEAR ARTHRODESISN. Tzachev - N. Ivanov - D.Liljanov - N.Hariskov

FP6. ARTHROSCOPIC ARTHRODESIS OF THE SUBTALAR JOINTV. Lampridis - G. Kiziridis - N. Gougoulias FP7. TARSO-MATETARSAL JOINTS ARTHRODESISV. Lampridis - G. Kiziridis - N. Gougoulias

FREE PAPERS 2. “FOREFOOT AND MISCELLANEOUS”Friday 7th of September 2018Chairmen: A. Katsarov - M. Drobnic

FP8. ARTHROSCOPY OF THE FIRST METATARSOPHALANGEAL JOINTD. Dimnjakovic - T. Smoljanovic - I. Bojanic

FP9. DOES SESAMOID POSITION EFFECT PATIENT SATISFACTION AFTER HALLUX VALGUS SURGERY? A STUDY OVER TANGENTIAL SESAMOID VIEWE. Uygur

FP10. EVALUATION AND RESULTS OF PBS PERCUTANEOUS CORRECTION TECH-NIQUE FOR SYMPTOMATIC HALLUX VALGUS DEFORMITYP. Salonikidis

FP11. INNOVATIVE APPROACH TO IMPROVING THE METHOD OF PREOPERATIVE PLANNING AND PERFORMING CORRECTIVE FOREFOOT OSTEOTOMYA. Akulaev - A. Filippova - V. Protsko


FP12. THE EFFECTS OF HUMAN AMNIOTIC FLUID AND MEMBRANE ON FRACTURE HEALING ON RAT FRACTURE MODEL (EXPERIMENTAL STUDY)A. Gultekin - A. Meric Unal - M. Unlu - I. Safa Satoglou

FREE PAPERS 3. “TRAUMA AND SOFT TISSUE”Saturday 8th of September 2018Chairmen: A. Katsarov - N. Tzachev

FP13. TWO CROSSED SCHANZ PINS VERSUS CALCANEAL PLATE IN THE TREATMENT OF INTRAARTICULAR CALCANEAL FRACTURES? A COMPARISON OF FUNCTIONAL AND RADIOLOGICAL OUTCOMESE. Baca - A. Duramaz

FP14. EFFECTS OF ANKLE TAPING ON DYNAMIC POSTURAL CONTROL IN PATIENTS WITH ANKLE INSTABILITYK. Sidiropoulos - K. G. Tsikopoulos - D. Kitridis - P. Gkivisis

FP15. POSTERIOR MALLEOLUS FIXATION FOR SYNDESMOSISE. Baca - N. Ziroglou

FP16. TRANSLATION AND CROSS-CULTURAL ADAPTATION OF THE TURKISH VERSION OF THE FOOT HEALTH STATUS QUESTIONNAIREE. Baca - S. Karaborklu Argut - P. Tiryaki - O. Coban

FP17. RETROSPECTIVE STUDY OF LISFRANC FRACTURE DISLOCATIONS TREATED WITH FUSION AND INTERNAL FIXATIONK. Surchev - M. Rashkov FP18. THE FIRST 55 PERONEAL TENDOSCOPIES OF ONE SURGEON: ANALYSIS OF IN-TRAOPERATIVE FINDINGS AND PERFORMED CONCOMITANT PROCEDURESD. Dimnjakovic - T. Smoljanovic - I. Bojanic

FP19. PROXIMAL MEDIAL GASTROCNEMIUS RELEASE IN THE TREATMENT OF RECAL-CITRANT PLANTAR FASCIITISV. Lampridis - G. Kiziridis - A. Wee - N. Gougoulias

FP20. SALVAGE FIBULAR LENGTHENING BY EXTERNAL FIXATOR AFTER INCORRECT LOWER LEG LENGTHENING. A TWO CASES REPORTM. Zhivkov Lyubomirov

FP21. LONG TERM RESULTS OF PERCUTANEOUS RADIOFREQUENCY NERVE ABLATION FOR CHRONIC PLANTAR HEEL PAIN ASSOCIATED WITH PLANTAR FASCIITISY. Erken


FACULTY

S. Assiov, MD, PhD, Associate Professor, Head of Clinic of Orthopaedics and Traumatolo-gy, University Multiprofile Hospital “St. Anna”, Sofia, BulgariaT. Badekas, MD, Director 3rd Orthopaedic Clinic Henry Dunant Hospital. Athens, Greece,Past President Greek Foot and Ankle Society Council Member EFASD. Bobrov, MD, PhD, Associate Professor Sechenov University, The Department of Trauma-tology, Orthopaedics and Disaster Surgery, Botkin Hospital, RussiaK. Buedts, Consultant Orthopaedic and Trauma surgeon, Head of Foot and Ankle Unit, Ortho-paedic Department ZNA Middelheim, Belgium, EFAS Council Member, Ass.Editor Foot Ankle Surgery journal Editorial Board Foot Ankle International journalA.Drevelegkas, President of Interbalkan Medical Center Scientific Committee M. Drobnic, MD, PhD, Consultant orthopaedic surgeon Department of Orthopaedic Surgery, University medical centre Ljubljana, SloveniaA. Eleftheropoulos, Orthopaedic Foot and Ankle Surgeon, Clinical Director Orthopaedic Dept., Naousa General Hospital, GreeceT. Esemenli, Professor of Orthopaedics and Traumatology, Istanbul Kent UniversityIstanbul Academic Hospital, TurkeyA. Iliev, Deputy chief of Clinic of Orthopaedics and Traumatology, University Multiprofile Hospital “St. Anna”, Sofia, BulgariaN. Gougoulias, MD, PhD, Consultant Orthopaedic Foot and Ankle Surgeon, Frimley Park Hos-pital, UK, Private Practice, Greece, Member of EFAS Education CommitteeD. Hatziemmanuil, MD, Foot and Ankle Surgeon, Interbalkan Medical Center Thessaloniki, Greece K. Irgit, Assoc. Professor Marmara School of Medicine, Istanbul, Orthopaedics and Trauma-tology, Chief of Foot and Ankle Division, President of Turkish Foot and Ankle SurgeryR. Kastelov, M.D., Ph.D. Prof., Head Orthopaedics and Trauma Department Medical Insti-tute, Ministry of Interior Sofia, BulgariaA. Katsarov, MD, PhD, Assoc. Prof., President of BFAS, President of the Organizing Commit-tee, BulgariaR. Kehayov, M.D., Orthopaedic Surgery, Foot Surgery, Pediatric Surgery, BulgariaA. Konstantinidis, Attending Orthopaedic surgeon, GreeceV. Lampridis, MD, MSc , FEBOT, FRCS (Tr&Orth), Consultant Orthopaedic Surgeon, Military Hospital Thessaloniki, GreeceL. Makinyan, MD, PhD, Docent Senior lecturer at the chair of Traumatology and Orthopae-dics, PFUR, RussiaA. Mazalov, MD, Orthopaedic, Clinical Scientific Center, City Clinical Hospital Yudin S.S., Moscow, Russia, Vice President of the Russian Association of Foot and Ankle SurgeonsE. Neshev, MD, Orthopaedic trauma surgeon, specialized in the treatment of general orthopaedic trauma and Foot and ankle trauma, Chief of the Or-thopaedic and trauma department in St. Anna hospital – Sofia, Bulgaria V. Obolenskiy, PhD, Head of the Septic Surgery Unit, City Clinical Hospital, Moscow, Russia T. Ogut, M.D. Professor of Orthopaedics and Traumatology, Istanbul, Turkey M. Panagiotidou, Osteopath and Physiotherapist, Euromedica - Arogi Physiotherapy Centre, Thessaloniki, GreeceA. Pettas, Orthopaedic surgeon, GreeceV. Protsko, MD, PhD, Docent Russian, University of Peoples’ Friendship, City Clinical Hospi-tal, Yudin S.S., Moscow RussiaP. Symeonidis, MD,PhD, Orthopaedic Foot and Ankle Surgeon St’ Luke’s Hospital, Thessalon-

iki, GreeceS. Tamoev, MD, PhD, Orthopaedic Foot and Ankle Surgeon, Dept. of Foot Surgery of Sergey Yudin City Hospital Moscow, RussiaS. Todorov, MD, PhD, Assoc. Prof. Orthopaedic and trauma surgeon, BulgariaN. Tzachev, MD, PhD, Prof., Orthopaedic and trauma surgeon, Military Medical Academy So-fia, BulgariaA. Wee, FRCS (Tr&Orth), Consultant Orthopaedic Foot and Ankle SurgeonFrimley Park Hospital, UK, Surrey Foot & Ankle Clinic, United Kingdom

FREE PAPERS PRESENTERSA. Akulaev, Orthopaedic and trauma specialist, RussiaE. Baca, foot and ankle surgeon in Department of Orthopedic and Traumatology of Istanbul Bakırkoy Dr Sadi Konuk Education and Research Hospital, TurkeyD. Dimnjakovic, MD, PhD, Orthopaedic and Trauma Surgeon, Department of Orthopaedic Surgery University Hospital Center Zagreb, CroatiaA. Duramaz, foot and ankle surgeon in Department of Orthopedic and Traumatology of Istanbul Bakırkoy Dr Sadi Konuk Education and Research Hospital, TurkeyY. Erken, MD, Assoc. Prof., Istanbul Okan University Faculty of Medicine, Department of Ortho-paedics and Traumatology, TurkeyA. Gerchev, Orthopaedic and trauma specialist, BulgariaA. Gultekin, MD, Orthopaedic surgeon, TurkeyS. Karaborklu, MsC, PT, Research Assistant Istanbul University - Cerrahpasa, Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Turkey V. Lampridis, MD, MSc , FEBOT, FRCS (Tr&Orth), Consultant Orthopaedic Surgeon, Military Hospital Thessaloniki, GreeceP. Salonikidis, MD, foot and ankle surgeon, Director of the orthopaedic department of Olympi-on General Hospital Patras, PBS surgeon in Italy, and PBS representative in GreeceK. Sidiropoulos, MD, Orthopaedic surgeon, GreeceK. Surchev, MD, Resident in Orthopedic Surgery and Trauma, BulgariaA. Tanriover, Orthopedic Surgeon, Foot and Ankle specialist in Cankaya Hospital , Ankara, TurkeyN. Tzachev, MD, PhD, Prof., Orthopaedic and trauma surgeon, Military Medical Academy Sofia, BulgariaE. Uygur, M.D., Assistant Prof. Orthopaedics and Traumatology Department Istanbul Medeni-yet University Goztepe Training and Research Hospital, İstanbul, TurkeyA. Yildirim, MD, Asst. Prof. Selcuk University School of Medicine Orthopaedics and Traumatol-ogy Dep. Konya, Turkey M. Zhinkov, Paediatric orthopaedic, Bulgaria



GENERAL INFORMATION

PLACE AND DATES: Thessaloniki, Greece, 6 – 8/09/2018

VENUE: European Interbalkan Medical Center, Thessaloniki, Greece - Asklipiou 10-Avenue of Agricultural School, Pylaia, Thessaloniki, Greece

ACCOMMODATION: There would be rooms available in the nearby hotels

REGISTRATION FEES:Trainees / residents: 50 Euros

Orthopaedic Surgeons: 70 Euros

SCIENTIFIC PROGRAM: Lectures, round tables and free anouncements have been devided according to regions and pathology (hindfoot, midfoot, forefoot, applied boimachan-ics,deformities, arthroscopy and trauma).The eminent key note specialists invited as lecturers and the skilled, experienced instructors encourage the active participation of the delegates.

The whole course will be accredited. Please confirm yourattendance at the sessions with your barcode on your badge.

medical pq 2.pdf 9/19/11 11:57:35 AM

The organizing committee wishes to thank the following companies – sponsors for their help in accomplishing the First Balkan Foot

and Ankle Meeting

FREE PAPERS

FP1. EXTEN

SOR

TEND

ON

TRA

NSFER

S FOR

CHA

RC

OT M

AR

IE TOO

TH D

ISEASE

Altuğ Tanrıöver

Orthopaedic Surgeon

Private Cankaya Hospital

Ankara Turkey

Introduction:Charcot M

arie Tooth (CMT) disease is one of the m

ost comm

on inherited neurological condition, affecting m

yelin sheaths of nerves. It causes mus-

cles weakness in feet and arm

s.M

uscle imbalance usually appear at adolescent age as peroneal w

eakness, cavovarus feet, gastrosoleus contractures and lateral instability.G

old standard in treating flexible cavovarus foot is deformity correction and balancing m

uscle forces and sparing joints. Calcaneal osteotomies,

tibialis posterior and peroneal tendon transfers are comm

only applied. Extensor hallucis longus tendon transfer to first metatarsal head w

ith inter-phalangeal arthrodesis is defined for first ray elevation and ham

mer toe.

Purpose:In this study, extensor tendon transfers to all five m

etatarsals with concom

itant interphalangeal arthrodesis for semiflexible cavus foot and m

eta-tarsus adductus and plantar ulcers, is perform

ed instead of midfoot and m

etatarsal osteotomies and arthrodesis. Clinical and radiologic results and

wound healing is follow

ed.M

ethod:Four feet of tw

o patients having CMT disease and plantar ulcers under m

etatarsal heads. Both patients (ages 20 and 40, m

ale) underwent sam

e procedures, and feet are operated separately w

ith six months interval. G

astrorecession, calcaneal sliding osteotomy, tibialis posterior to lateral cu-

neiform transfer, plantar fascia release, peroneus longus to brevis transfer w

ere performed. Clinical and radiologic data w

ere collected and wound

healing is checked.R

esults:Throughout follow

up period both patients with four feet had plantigrade feet w

ithout ulcers. Conclusion:A

lthough midfoot osteotom

ies and/or metatarsal osteotom

ies are recomm

ended for midfoot and forefoot deform

ities, long extensor tendon trans-fer w

ith interphalangeal arthrodesis is a viable option for treating both metatarsus adductus and cavus w

ith hamm

ertoes and metatarsal plantar

ulcers. Extensor tendon transfer spares joints and bones, and less invasive and technically easier to perform w

ithout need for C-arm and special

implants.

FP2. MID

-TERM

RESU

LTS FOLLO

WIN

G A

RTH

RO

SCO

PIC A

NK

LE AR

THR

OD

ESIS

Ahm

et Yildirim, A

sst.Prof 1

1 Departm

ent of Orthopedics and Traum

atology, Medical Faculty of Selcuk U

niversity, Konya, Turkey

Corresponding Author: A

hmet YILD

IRIM

, Asst. Prof., D

epartment of O

rthopedics and Traumatology, M

edical Faculty of Selcuk University, 42100

Konya, Turkey

We review

ed 26 patients who underw

ent arthroscopic ankle arthrodeses. The mean age of these patients w

as 54,2 months (30 to 88 years). The

indications for operation were post-traum

atic osteoarthritis, primary osteoarthritis, inflam

matory arthropathy and rheum

otid arthritis. The mean

follow-up w

as 15 months (9 to 24). The patients w

ere assessed by clinical visit and telephone interview. The operation w

as did with the help of

fluoroscopy and through arthroscopic procedure with at least 2 lateral fixation and 1 m

edial fixation of 6,5 cannulated screw. The m

ean time to

union was 13 w

eeks (9 to 24). Nonunion occurred in 3 cases (11 %

). Other com

plications included superficial infections, 1 deep vein thromboses,

one revision of fixation, one stress fracture. Preoperative mean A

OFA

S score was 18 and postoperative A

OFA

s score was 80; as w

e see the results are good and excellent for the ankle arthritis aft

er arthroscopic arthrodesis.

FP3. MİD

-TERM

RESU

LTS OF H

İND

FOO

T SALV

AG

E AR

THR

OD

ESİS WİTH

RETR

OG

RA

DE C

OM

PRESSİO

N IN

TRA

MED

ULLA

RY

NA

İL İN CH

AR

-C

OT N

EUR

OA

RTH

RO

PATH

Y

Ahm

et Yildirim; A

sst.Prof 1, Ali G

ulec; Asst.Prof 1

1 Departm


atology, Medical Faculty of Selcuk U

niversity, Konya, Turkey

Corresponding Author: A

hmet YILD

IRIM

, Asst. Prof., D

epartment of O

rthopedics and Traumatology, M

edical Faculty of Selcuk University, 42100

Konya, Turkey

Introduction: Charcot arthropathy of the hindfoot and ankle is a hard issue mostly seen as diabetes m

ellitus complication. H

indfoot arthrodesis with

retrograde intramedullary nailing is a slight new

method to reconstruct deform

ities of the ankle and hindfoot in patients with Charcot arthropathy.

Obtaining a plantigrade foot and ankle, reducing the risk of ulceration and decreasing pain is the m

ain purpose.

Purpose: Our study is about to analyze the m

idterm results of hindfoot arthrodesis w

ith intramedullary nail to treat Charcot osteo-neuroarthropa-

thy.

Material and M

ethods: We perform

ed a retrospective analysis of 11 consecutive patients with Charcot arthropathy w

ho underwent a hindfoot and

midfoot arthrodesis using tw

o different types of retrograde intram

edullary compression nail. Patients w

ere three men and eight w

omen w

ith a m

ean age of 71.13 years (48.5 to 81.8). We describe the rate of lim

b salvage, complications requiring additional surgery, and fusion rate in both

groups. The mean duration of follow

-up was 16.24 m

onths (11 to 25).

Results: The transtibial am

putation procedure was required for one patient, lim

b salvage rate was ten. Com

plications including infection, implant

removal, nonunion, calcaneus and talus fracture aft

er mobilization and persistent ulcers requiring further intervention w

ere also seen. Mean A

OFA

S scores w

ere increased from 14 to 58 aft

er 12 months from

surgery.

Conclusions: Due to m

idterm results; use of retrograde intram

edullary compression nail show

s good results when used for hindfoot reconstruction

in patients with Charcot arthropathy.

FP4. TALEC

TOM

Y FO

R SEV

ERE N

EVR

OG

ENIC

EQU

INO

VA

RU

S DEFO

RM

ITY

Gerchev A

. , Bulgaria

Objective: R

epresent the effectiveness of Talectom

y in treatment for Equinovarus paralytic’s feet. The aim

of the orthopaedics treatment is correc-

tion of the deformity and restoration of the w

alking ability M

aterial and methods: W

e prospectively reviewed in this report, tw

o young patients brother and sister ( ♂10 y. and ♂12 y.) affected by a H

MSN

type I, w

ith rigid severe pes equinovarus (PEV) deformities that underw

ent single-stage corrective surgery. The patients were treated and follow

ed for the period 2013 - 2018 Children’s Clinic of U

SBA

LO ,, Professor. B

. Boychev “

Hereditary m

otor and sensory neuropathy (HM

SN) also know

n as Charcot-Marie-Tooth disease is the m

ost comm

on inherited neuromuscular dis-

ease which includes a group of clinically and genetically heterogeneous disorders of the peripheral nervous system

. Foot deformities are com

monly

present in children with H

MSN

. Our single stage surgery consisted of talectom

y. Complete excision of the talus is perform

ed and fixed in the cor-rected position w

ith two K

-wires through the calcaneus to the distal tibia.

Results: B

oth patients were assessed preoperatively and postoperatively both clinically and radiologically by anteroposterior and lateral radio-

graphs. The mean follow

-up was 34 m

onths (±18.3).Our tibio-calcaneal angle im

proved by 40%. B

oth patients could walk w

ithout assistive devices.Conclusion : O

ur results suggest that, with proper indications, talectom

y, despite of its palliative nature, has its place in pediatric orthopaedic sur-gery. This operation m

ay be a method of choice as a “lim

b-saving procedure” in neurogenic neglected PEV, as well as in adolescents w

ith untreated severe idiopathic congenital PEV in order to obtain a stable plantigrade foot and it’s a good alternative of a pantalar arthrodesis procedure.

FP5. OU

R EX

PERIEN

CE IN

THE A

PPLICA

TION

OF A

NA

IL USED

FOR

TIBIO

-TALO

-CA

LCA

NEA

R A

RTH

RO

DESIS.

N.Ivanov, D

.Liljanov, N.H

ariskov, N.Tzachev

Military M

edical Academ

y, Sofia, Bulgaria

Introduction: Back in 1868 Jean M

artin Charkot described an unusual hypertrofic destruction of the ankle joint. The unstability in the medial tibial

part passes through three phases of progressive collapse and arthrosis of the posterior plantar part. The final phase of the neuropatic osteoarthro-patic of Charcot features the pantalar arthrodesis. The surgical m

ethods of treatment are triple arthrodesis, tibio-talo-calcanear arthrodesis and

pantalar arthrodesis. In 1911, Lorthior is the first who uses pantalar arthrodesis aft

er poliomielit. The arthrodesis is alternative of Sym

es amputa-

tion. A

im: This presentation aim

s to share our experience in the application of a nail for tibio-talo-calcanear arthrodesis. In 1999 at the 15-th Annual

Summ

er Meeting of A

merican O

rthopaedic Foot and Ankle Society the tibio-talo-calcanear arthrodesis w

ith intramedullary nail w

as presented for the first tim

e. The indications for TTK arthrodesis are prim

al and posttraumatic arthrosis of the ankle joint, neuro-m

uscle deformation, avascular

necrosis of the talus, neuroarthropatia of Charkot, rheumatic arthrit, osteoarthrit, ankilosis and m

ultiple contractures in ankle joint. The pre-opera-tive planning includes “X”-ray in A

P and lateral position with loading and B

roden position for subtalar joint. Clinical research of the evolution of the pain is needed, the condition of the tissues, neurological and vessel status. W

e used lateral and transfibular approach. M

aterials and Method: For a period of ten years (2007-2017) w

e operated on 21 patients in our clinic, we have done 21 TTK

arthrodesis with

intramedullary nail. W

e have used Stryker nail T2AA

N in all of the cases.

Results: In all of our clinical cases w

e have reached fusion and stable painless ankle joint. We have had one case of an error in the proxim

al locking and one case of jatrogenic fractures of the m

edial malleus. B

ecause of a deep infection in one of the patients it was necessary to rem

ove the nail, w

hich did not have a negative effect on the arthrodesis.

Conclusion: The pantalar and TTK arthrodesis have a good functional result and is preferred to am

putation. The arthrodesis with IM

nail reaches better rigidity and stability in com

parison to the cross screw fixation.

FP6. AR

THR

OSC

OPIC

AR

THR

OD

ESIS OF SU

BTA

LAR

JOIN

TVasileios Lam

pridis1,2, Georgios K

iziridis1, Nikolaos G

ougoulias1.1.Frim

ley Park Hospital N

HS Trust, U

K, 2. 424 M

ilitary Hospital Thessaloniki

Introduction: Subtalar joint (STJ) arthrodesis can be performed either in isolation or in com

bination with arthrodesis of other joints for the treat-

ment of several conditions, like arthritis, tarsal coalition and posterior tibial tendon dysfunction. A

rthroscopic procedures are an alternative to conventional open techniques, in order to decrease soft

tissue damage and increase union rates w

hilst reducing complications.

Purpose: We w

anted to evaluate and present the results of arthroscopic STJ arthrodesis regarding union rate, time to union and com

plications.M

aterial-Methods: This is a retrospective review

of 15 patients (16 feet) that underwent arthroscopic STJ arthrodesis, w

ith the technique of two

arthroscopic portals through the sinus tarsi, between 2014 and 2017. A

ll procedures were perform

ed by the senior author or under his direct supervision. M

ean patients’ age was 57 years (range 32-76). In addition, arthroscopic arthrodesis of the talo-navicular joint w

as performed in five

patients, of the calcaneo-cuboid joint in one patient and of the ankle joint in six patients. 6.5 or 8 mm

screws w

ere used for the arthrodesis, but in tw

o cases that included the ankle joint a tibio-talo-calcaneal nail was used. G

astrocnemius slide, or A

chilles tendon release was perform

ed in three patients for flatfoot correction.R

esults: Union rate for STJ arthrodesis w

as 94% (15 from

16 feet). One patient w

ho developed non-union had concomitant ankle joint arthrodesis.

He subsequently had revision surgery. O

ne diabetic patient with pre-existing neuropathy, that underw

ent also ankle joint arthrodesis, developed CR

PS. Mean union tim

e was 14 w

eeks (range 6-40).Conclusions: A

rthroscopic STJ arthrodesis revealed high union and low com

plication rates, performed either in isolation or in com

bination with

other joints, for the treatment of arthritis and/or deform

ity correction.

FP7. TAR

SO-M

ATETA

RSA

L JOIN

TS AR

THR

OD

ESISVasileios Lam

pridis1,2, Georgios K

iziridis1, Nikolaos G

ougoulias1.1.Frim

ley Park Hospital N

HS Trust, U

K, 2. 424 M

ilitary Hospital Thessaloniki

Introduction: Arthrodesis of the tarso-m

etatarsal joints (TMTJs) is com

monly perform

ed in patients with painful osteoarthritis or for correction

of foot deformities. It is also frequently perform

ed in conjunction with other procedures in the m

idfoot or forefoot. In the literature there are few

original studies reporting on outcomes aft

er these operations.Purpose: W

e wanted to evaluate and present the results of a cohort from

a fellowship trained orthopaedic foot and ankle surgeon, regarding union

rate, time to union and com

plications.M

aterial-Methods: This is a retrospective review

of 62 patients (68 feet) that underwent TM

TJs arthrodesis between 2010 and 2017. A

ll procedures w

ere performed by the senior author or under his direct supervision. The m

ean patients’ age was 60 years (range 26-80). In addition, talonavicular

joint arthrodesis was perform

ed in seven patients, subtalar arthrodesis in four patients, naviculo-cuneiform arthrodesis in 22 patients and forefoot

procedures for correction of hallux valgus in nine patients. Gastrocnem

ius slide, or Achilles tendon release w

as performed in seven patients. M

ean duration of surgery w

as 105 mins and m

ean hospital stay was 1 day.

Results: U

nion rate for TMTJs w

as 94,1% (64 out of 68 feet). Tw

o of the patients who developed non-union w

ere smokers and one w

as diabetic. All

four were successfully treated w

ith revision arthrodesis. One patient developed a post-operative infection and w

as treated initially with antibiotics

and removal of the m

etalwork. M

ean union time w

as eight weeks (range 6-12).

Conclusions: TMTJs arthrodesis is oft

en part of a major and technically dem

anding foot reconstructive procedure. Complications are uncom

mon,

and fusion rates and time to union can be sim

ilar to other foot fusion procedures.

FP8. AR

THR

OSC

OPY

OF TH

E FIRST M

ETATA

RSO

PHA

LAN

GEA

L JOIN

TD

amjan D

imnjaković1, Tom

islav Smoljanović2, Ivan B

ojanić2 1- D

epartment of O

rthopaedic Surgery, University H

ospital Centre Zagreb, Zagreb, Croatia5- D

epartment of O


ospital Centre Zagreb, University of Zagreb School of M

edicine, Zagreb, Croatia IntroductionA

rthroscopy of the first metatarsophalangeal joint (M

TP-1) in comparison to classical open surgery, allow

s an excellent view of intra-articular

structures and thus a detailed overview of the entire joint. Furtherm

ore, morbidity is significantly sm

aller, rehabilitation is faster, and return to dai-ly activities is also faster. B

ut, on the other hand, this procedure is only a part of the treatment of hallux disorders and should be considered w

ithin the m

anagement algorithm

.Purpose The aim

of this study is to present 18 patients who underw

ent arthroscopy of the MTP-1 in a 3-year period in our D

epartment.

Material and m

ethods18 consecutive patients underw

ent arthroscopy of the MTP-1 in our institution from

1st July 2014 until 1st July 2017 and were follow

ed up for a m

inimum

of 6 months. A

ll arthroscopies were done by the senior author (IB

). R

esultsThere w

ere 12 men and 6 w

omen w

ith a mean age of 39.5 (range, 16 to 62) years. The m

ost comm

on indication for arthroscopy in our series was

hallux rigidus (15 cases). Other diagnoses included arthrofibrosis, nonunion of sesam

oid fracture in and osteochondral lesion of metatarsal head in

a single case each. A 2.7-m

m 30° arthroscope and sm

all joint instruments w

ere used in all cases as well as m

anual longitudinal noninvasive distrac-tion to the great toe.ConclusionThe M

TP-1 joint arthroscopy should be performed in selected cases of hallux disorders, and is not for the occasional arthroscopist. It is recom

-m

ended for early stages of hallux rigidus, osteochondral lesions of the metatarsal head, sesam

oid bone pathology and MTP-1 arthrofibrosis. G

ood preoperative planning as w

ell as great experience in arthroscopy of small joints is necessary for good perform

ance and optimal result.

FP9. DO

ES SESAM

OİD

POSİTİO

N EFFEC

T PATİEN

T SATİSFA

CTİO

N A

FTER H

ALLU

X V

ALG

US SU

RG

ERY

? A STU

DY

OV

ER TA

NG

ENTİA

L SESA-

MO

İD V

İEWE. U

ygur, Turkey Introduction:To evaluate sesam

oid position,standard sesamoid tangential view

is taken while the foot is laying over the cassette w

ithout weight-bearing.To

simulate the ground forces better, w

e produced a special semi-rigid cushion for x-ray im

agining.By this cushion 30 degree of m

etatarso-phalangeal angle occurs in sagittal (lateral) plane w

hich simulates push off

phase while w

alking and which perm

its evaluating the position of the sesamoids

while bearing w

eight.

Purpose:In this study,w

e aimed to investigate the correlation of patient satisfaction and sesam

oid positions using weight-bearing tangential view

.We

hypothesized that i) sesamoid positions in tangential view

would be related w

ith anteroposterior (AP) view

s and ii) sesamoid positions w

ould be related w

ith patient satisfaction.

Patients and Methods:

Patients who w

ere undergone hallux valgus surgery with 6 m

onths of follow-up,w

ere included into the study.W

eight-bearing tangential radiographs were taken w

hile the patient was standing on both feet w

ith the knees in full extention.X-ray beam w

hich w

as centered at third metatarsal head w

as sent parallel to the ground.Patient outcom

es were assessed by M

anchester satisfaction score which has been translated and validated into patients’ language.

Results:

24patients were evaluated retrospectively.A

ll of them w

ere female.The average age of them

were 44(24-67).D

istal chevron osteotomy w

as per-form

ed in 18patients and proximal osteotom

y in 6patients.Pearson(one-tailed) correlation test w

as utilized for the analyses.A significant correlation w

as detected between sesam

oid positions in tangential view

and AP view

(r=0.04).On the other hand there w

as no significant correlation between sesam

oid position and AO

FAS scores(r=0.136) nor sesa-

moid position and patient satisfaction(r=0.183).

Conclusions:In this study w

hile AP and tangential view

s were detected to be correlated,our second hypothesis (correlation betw

een tangential view and patient

satisfaction) was not supported.The reason of this result m

ay be because of the diversity of factors effecting the patient satisfaction or because of

our small cohort w

hich is a limitation of this study.

FP10. EVA

LUA

TION

AN

D R

ESULTS O

F PBS PER

CU

TAN

EOU

S CO

RR

ECTIO

N TECH

NIQ

UE FO

R SY

MPTO

MA

TIC H

ALLU

X V

ALG

US D

EFOR

MITY

P.Salonikidis, Greece

Abstract

Background

Many procedures and diff

erent osteotomies have been described for percutaneous hallux valgus correction. Percutaneous techniques m

ay lead to reduced m

orbidity, operation and recovery time. A

im of this study is to evaluate the clinical and radiological outcom

e of a new percutaneous proce-

dure (PBS-Percutaneous B

ianchi System).

Methods

One hundred tw

elve (112) patients have been treated with Percutaneous B

ianchi System for correction of their m

ild, moderate or severe hallux

valgus deformity. A

ll patients were clinically assessed preoperatively and during the last follow

-up examination, by w

eight-bearing x-rays, AO

FAS

score, VAS scale and patient satisfaction.

Results

AO

FAS scores im

proved from preoperative 29.9 to 91 at last follow

-up. VAS pain score im

proved from 6.6 before surgery to 0.5 at last follow

-up. M

ean HVA

, IMA

and DM

AA

were significantly decreased from

preoperatively to last follow-up.

ConclusionPB

S technique is a safe, reliable and effective procedure for correction of sym

ptomatic m

ild to-severe hallux valgus deformity.

FP11. INN

OV

ATIV

E APPR

OA

CH TO

IMPR

OV

ING

THE M

ETHO

D O

F PREO

PERA

TIVE PLA

NN

ING

AN

D PER

FOR

MIN

G C

OR

REC

TIVE FO

REFO

OT

OSTEO

TOM

Y.

Anton A

kulaev, Anastasia Filippova, Victor Protsko

St Peterburg State University. The Pirogov Clinic of A

dvanced Medical Technologies.

Introduction. At the current level of developm

ent of visualization technologies, the use of conventional routine planning methods seem

s inad-equate, since overlapping projections and im

age distortions result in inaccuracies when planning, w

hich undoubtedly limits the predictability of

results.

The purpose of this study is to improve the technique of preoperative planning and perform

ing corrective osteotomy in patients w

ith forefoot deform

ities (Valgus deformity of the great toe of the foot) by developing a new

preoperative planning protocol - 3D m

odeling - and performing

corrective osteotomy using individually custom

ized high polygonal directional templates.

Materials and m

ethods. In this study 36 patients aged 30 to 70 years were exam

ined. The study was conducted on a com

puter tomograph

“Toshiba Aquilion 64” using specifically developed protocols. U

sing a set of our own custom

ized 3D soft

ware , w

e carried out individual 3D m

odeling and prototyping on 3D

printers “Picaso 250 Pro”, “Objet Eden 260”. For com

parison, the second group of patients underwent classical m

easure-m

ents with the help of radiographs.

Results. The analysis of the results of planning and perform

ing corrective osteotomy of the forefoot in 36 patients show

ed that in 100% of

cases the average difference in the m

easurement of angular param

eters was 6˚ ± 2˚ (р <0,05). The expected results of 3D

modeling w

ere exactly the sam

e as the results obtained.

Conclusion. This technique will be very useful not only for a professional, but also for a beginner specialist, allow

ing them to accurately plan,

predict the result of surgical treatment and, m

ost importantly, to accurately im

plement it all in the operating room

using individual high polygonal directional tem

plates.

FP12. THE EFFEC

TS OF H

UM

AN

AM

NİO

TİC FLU

İD A

ND

MEM

BR

AN

E ON

FRA

CTU

RE H

EALİN

G O

N R

AT FR

AC

TUR

E MO

DEL(EX

PERİM

ENTA

L STU

DY

)A

lper GU

LTEKIN

(1), A.M

eric UN

AL(2), M

ehtat UN

LU(3), I.Safa SATO

GLU

(4)1-SB

U K

ocaeli Derince Training and R

esearch Hospital O

rthopaedıcs and Traumatology

2-Suleyman D

emirel U

niversity Hospital Sports M

edicine3-D

okuz Eylul Unıversıty H

ospıtal Pathology4-D

okuz Eylul Unıversıty H

ospıtal Orthopaedics and Traum

atology

Introduction and Purpose: Hum

an amniotic fluid contains several grow

th factors and hyaluronic acid. It has positive effect in healing the tendon,

nerve and bone injuries. Hum

an amniotic m

embrane has positive eff

ects on tendon, nerve healing and is also used for skin healing in burns and com

plex wounds. W

e hypothesized that human am

niotic fluid and human am

niotic mem

brane have positive stimulating eff

ects on fracture healing. The aim

of this study is to investigate the effects of hum

an amniotic fluid and hum

an amniotic m

embrane on bone healing in rat tibial bone frac-

ture model.

Materials and M

ethods: A 72 open fracture m

odel was created for both tibial bones of 36 m

ale Wistar rats. They w

ere divided into three groups. G

roup-1 was the control group. In G

roup-2, human am

niotic fluid which w

as taken from am

niocentesis of seronegative pregnants in their second trim

ester was injected to the fracture site. In group-3, hum

an amniotic m

embrane w

hich was taken from

normal seronegative term

pregnants after

their caesarean sections was w

rapped around fracture site and then human am

niotic fluid was injected to the fracture site. R

adiological fracture union patterns and histopathological evaluations w

ith Modified Lane-Sandhu classification w

ere performed w

ith Modified Lane-Sandhu classifica-

tion at the end of third and sixth weeks.

Results: A

t third week, G

roup-2 and Group-3 had better histopathological results than G

roup-1. At sixth w

eek, Group-2 had significantly better

results than Group-1. G

roup-3 had also better results than Group-1 although there w

as no statistical significance. At third and sixth w

eeks, histo-pathological scores of G

roup-2 were significantly better than G

roup-3(p=0.021, p=0.019).

Conclusion: Our data suggested that hum

an amniotic fluid had positive eff

ect while hum

an amniotic m

embrane had no positive eff

ect on bone healing. W

ith its low im

munity and easy delivery, hum

an amniotic m

embrane can also be used to stim

ulate bone healing in combination w

ith human

amniotic fluid w

ith different application techniques.

Keyw

ords: Tibia fracture model, hum

an amniotic fluid, hum

an amniotic m

embrane, anim

al study, fracture healing

FP13. TWO

CR

OSSED

SCHA

NZ PİN

S VER

SUS C

ALC

AN

EAL PLA

TE İN TH

E TREA

TMEN

T OF İN

TRA

AR

TİCU

LAR

CA

LCA

NEA

L FRA

CTU

RES? A

C

OM

PAR

İSON

OF FU

NC

TİON

AL A

ND

RA

DİO

LOG

İCA

L OU

TCO

MES

Altuğ D

UR

AM

AZ, M

.D., B

akırköy Dr Sadi K

onuk Education and Research H

ospitalEm

re BA

CA, M

.D., B

akırköy Dr Sadi K


ospital

Introduction: Many surgical techniques have been tried in the treatm

ent of of intraarticular calcaneus fractures and they have been changed over tim

e.

Purpose: The aim of this study w

as to compare the functional and radiological results of the anatom

ic calcaneus plate (ACP) and tw

o crossed schanz pins (CSP) in the treatm

ent of intraarticular calcaneal fractures.

Material: B

etween M

arch 2010 and Novem

ber 2014, thirty-four patients who underw

ent surgery using CSP and 31 patients who underw

ent surgery using A

CP for isolated closed unilateral calcaneus fracture were included in the study.

Methods: The fractures w

ere typed according to the Sanders classification. Trauma type, preoperative and postoperative period, com

plications, postoperative functional and radiological results w

ere evaluated. AO

FAS hind foot score and ankle function w

ere evaluated at final postoperative control of the patients. The tw

o surgical methods w

ere compared in term

s of functional and radiological outcomes.

Results: The duration of surgery w

as significantly longer in ACP than CSP (p <0,001). Fluoroscopy exposure w

as significantly less in ACP than CSP (p

<0.001). Postoperative Böhler and G

issane angles was significantly higher in A

CP than in CSP (p <0,001 and p <0,001). AO

FAS score w

as signifi-cantly higher in A

CP (88,4±4,1) than in CSP (81,7±4,9) (p <0,001).

Conclusions: Although CSP shortens the operation tim

e in the the treatment of intraarticular calcaneal fractures, it has disadvantages com

pared to A

CP due to increased floroscopy exposure, low functional and radiological results. There are no significant diff

erences between the tw

o surgical m

ethods in terms of com

plications. ACP is better technique than percutaneous CSP in the treatm

ent of intraarticular calcaneal fractures.

FP14. EFFECTS O

F AN

KLE TA

PING

ON

DY

NA

MIC

POSTU

RA

L CO

NTR

OL IN

PATIEN

TS WITH

AN

KLE IN

STAB

ILITY 1.K

onstantinos Sidiropoulos, MD

, Orthopedic Surgeon 2nd O

rthopaedic Departm

ent, Papageorgiou Hospital Thessaloniki

2.Konstantinos G

. Tsikopoulos, MD

, MSc, PhD

Candidate 2nd Orthopaedic D

epartment Papageorgiou H

ospital Thessaloniki3.D

imitrios K

itridis, MD

, MSc, PhD

Candidate 1st Orthopaedic D

epartment Papanikolaou H

ospital Thessaloniki,Greece

4.Panagiotis Gkivisis, M

D, M

Sc, PhD Professor of 1st O

rthopaedic Departm

ent Papanikolaou Hospital Thessaloniki, G

reece A

bstract Introduction: Prim

ary managem

ent of chronic lateral ankle instability consists of non-operative treatments, how

ever there is no specific protocol show

ing the most eff

ective method. R

ehabilitation has been shown to be eff

ective at decreasing symptom

s, although methods of increasing its

effectiveness, such as passive restraints, m

ust be evaluated.

Purpose: To conduct a meta-analysis to assess the im

pact of ankle taping on dynamic postural control in patients w

ith ankle instability.

Material: R

andom-eff

ects network m

eta-analysis.

Methods: W

e searched PubMed, Scopus, and CEN

TRA

L up to the 1/6/2018 for completed studies. R

andomized trials assessing the results of real

taping, wait-and-see protocols, and sham

taping for the primary m

anagement of chronic lateral ankle instability w

ere considered in the quantita-tive synthesis. W

e assessed dynamic balance in term

s of the star-excursion balance test in the posteromedial direction, the m

ost representative. W

e also judged the quality of the trials using the Cochrane risk of bias tool and the quality of evidence using the (GR

AD

E) approach.

Results: W

e enrolled seven trials in this systematic review

. There were no statistically significant diff

erences in favor of real taping over watch-and-

wait policy or placebo (standardized m

ean difference w

as -0.11 [95% CIs -0.72 to 0.5], and -0.27 [95%

CIs -0.17 to 0.71], respectively).

Conclusions: The network m

eta-analysis showed that real taping w

as ineffective in im

proving dynamic postural control in patients w

ith ankle insta-bility. There w

as also no evidence of a placebo effect in participants treated w

ith sham taping.

FP15. POSTER

İOR

MA

LLEOLU

S FİXA

TİON

FOR

SYN

DESM

OSİS

1.Nezih ZIR

OG

LU M

D B

akirkoy Dr Sadi K

onuk Training and Research

Hospital ISTA

NB

UL

2.Emre B

ACA

MD

Bakirkoy D

r Sadi Konuk Training and R

esearch Hospi-

tal ISTAN

BU

L - IntroductionD

oes isolated posterior malleolus fixation provide suffi

cient proper syn-desm

osis reduction on the posterior malleolus fracture cases associated

with syndesm

otic injury? PurposeSyndesm

otic ligament is a com

plex structure consisting of a combina-

tion of anterior inferior talofibular ligament (A

ITFL), posterior inferior talofibular ligam

ent (PITFL), interosseous ligament (IO

L) and transvers inferior talofibular ligam

ent (TITFL). Stability contributions of each parts are A

İTFL %35, İO

L %22 and PİTFL %

42.A

single screw is usually perform

ed from lateral plan to provide tibiofib-

ular covering, at the treatment of the m

ost ankle sprain cases associat-ing w

ith syndesmotic injury.

PITFL avultion fractures which is the highest contribution to syndes-

motic ligam

ent cause syndesmotic instability at the posterior m

alleolus fracture cases associating w

ith syndesmotic injury.

We aim

ed to explore syndesmotic ligam

ent reduction status at the pa-tients w

ho’ve had posterior malleolus fixation surgery w

ithout perform-

ing screw fixation from

lateral plan according to our hypothesis.M

aterial – Methods

A total of 41 patients, 27 fem

ales and 14 males, w

ho were follow

ed up at B

akırkoy Dr Sadi K

onuk Training and Research H

ospital in our study w

ere evaluated.In the evaluated patients, posterior m

alleolus injury accompanying syn-

desmosis injury w

as absolute, and some of the patients had m

edial and / or lateral m

alleolus fracture. All of the patients w

ho were underw

ent lateral screw

ing were excluded from

the study.B

y the way all patients w

ho underwent posterior approach w

ere used one of these diff

erent implants like cannulated screw

s, malleolus screw

and plate screw

systems.

We assessed the reduction status of the syndesm

otic ligament by eval-

uating our patients’ radiographs and tomographies (CT). The evaluation

was carried out according to evaluation criteria m

ade by the mea-

surements described by Futum

ara et al in their study in 2017 from the

transverse CT section taken 1 cm proxim

al to the ankle joint. R

esultsA

t the procedures which posterior m

alleolus had fixated , it was thought

that the syndesmotic ligam

ent would be reducted and it w

ould not be necessary to perform

an extra syndesmosis screw

from the lateral side.

Forty-one patients who had at least one year follow

-up, post-op x-ray and CT scans w

ere identified. While the youngest of the patients is 15

years old and the oldest one is 75 years old. The average age is 42.65. The aff

ected extremity is right in 24 patients and left

in 17 patients. The follow

-up period of patients is at least one year and average is 19.2 m

onths.It w

as seen that isolated posterior fixation reduced syndesmotic liga-

ment in 38 of the patients. W

hen 3 patients without adequate reduction

were exam

ined, it was seen that 1 had com

plicated ankle heterotrophic ossification due to ankle arthrosis and the related syndesm

otic interval w

as open. In another patient, it was found that the syndesm

osis liga-m

ent due to posterior malleolus m

alreduction was not reduced. In the

third patient, it was observed that the screw

applied to the posterior m

alleolus reduction gradually moved to the tibiofibular region and pre-

vented the reduction of the syndesmosis ligam

ent. ConclusionsFixation posterior m

alleolus fracture associated with syndesm

otic injury (isolated orw

ith medial and / or lateral m

allolus fracture) is eliminating neccessity

of appliying an extra syndesmotic screw

from lateral plan and achiving

an anatomic reduction of syndesm

otic ligament. The m

ost important

issue is the appropriate anatomical reduction of the fracture and rigid

fixation. When the patients w

ith inadequate reduction of syndesmosis

ligament w

ere examined, insuffi

cent reduction and malfixation w

as show

ned.

FP16. TRA

NSLA

TION

AN

D C

RO

SS-CU

LTUR

AL A

DA

PTATIO

N O

F THE TU

RK

ISH V

ERSIO

N O

F THE FO

OT H

EALTH

STATU

S QU

ESTION

NA

IRE

Sezen KA

RA

BO

RK

LU A

RG

UT1, Pelin TIRYA

KI2, O

zge COB

AN

3, Emre B

ACA

4 1Istanbul U

niversity-Cerrahpasa, Faculty of Health Science, D

epartment of Physiotherapy and R

ehabilitation, Istanbul, Turkey2 Istanbul G

elisim U

niversity, School of Health Sciences, D

epartment of Physiotherapy and R

ehabilitation, Istanbul, Turkey3Yıldırım

Beyazıt U

niversity, Faculty of Health Science, D

ivision of Physiotherapy and Rehabilitation, A

nkara, Turkey4B

akirköy Dr. Sadi K


ospital, Departm


atology, Istanbul, Turkey. Introduction: The Foot H

ealth Status Questionnaire(FH

SQ) w

as originally developed in English for evaluating foot health and problems. It has not

yet been translated or culturally adapted for Turkish-speaking individuals.

Purpose: The purpose of this study was to translate and culturally adapt the FH

SQ into Turkish.

Material&

Methods:The FH

SQ w

as translated into Turkish, consistent with published m

ethodological guidelines. In the first stage, 2 Turkish individ-uals w

ith a good comm

and of English were responsible for the translation of the questionnaire(T1,T2). The translations w

ere completed inde-

pendently. Then, both translations were com

pared and reviewed by a bilingual individual w

ho highlighted any conceptual errors or inconsistencies in the translations to establish the first Turkish translation(T12). In the third stage, aft

er the first Turkish translation was agreed upon, 2 native En-

glish speakers with a good com

mand of Turkish separately translated it back into English(B

1,B2). B

oth translators were unaw

are of the purpose of the study and the original English version. In the fourth stage, the back-translated version w

as compared to the initial English version. A

comm

ittee evaluated the 4 translations and com

pared the discrepancies. Aft

er that, the comm

ittee finalized the Turkish version of the FHSQ

. Thirty patients w

ith foot disorders were enrolled for the pilot test. The questions that w

ere difficult to understand and their recom

mendations w

ere noted.

Results: FH

SQ w

as generally found easy to understand by patients(n=30, 43.6±12.8 years;30.1±4.1kg/m2,20fem

ales).For cultural adaptation purposes, the term

of “podiatrist’’ had to be changed to “clinician” due to podiatrist was not a profession in Turkey. The questions 25 and 28 w

ere about health insurance system

in that country where the FH

SQ w

as developed. Therefore, these questions were revised by considering health insur-

ance system in Turkey.

Conclusions: The translation and cultural adaptation of the FHSQ

were com

pleted. Reliability and validity of the Turkish FH

SQ has been studying.

Keyw

ords: Foot pain, Outcom

e, FHSQ

.

FP17. RETR

OSPEC

TIVE STU

DY

OF LISFR

AN

C FR

AC

TUR

E DISLO

CA

TION

S TREA

TED W

ITH FU

SION

AN

D IN

TERN

AL FIX

ATIO

N K

iril Surchev, Mihail R

ashkov 3rd Clinic of O

rthopedics and Trauma, U

MPH

ATT “N. I. Pirogov”, Sofia, B

ulgaria Fracture dislocations of the tarsom

etatarsal (Lisfranc) joint are relatively rare injuries that still pose a lot of questions in terms of choosing proper

treatment strategy according to the preoperative diagnostics. The aim

of the study was to evaluate and com

pare internal fixation sparing the tarsom

etatarsal joints versus primary arthrodesis in the operative treatm

ent of Lisfranc fracture dislocations. Furthermore, the current study tries

to derive a relationship between the type of fracture and operation and the long-term

outcome.

This is a retrospective study encompassing 40 patients treated in the hospital over a 5 year period. X-rays, CT-scans, patient records, clinical data,

Am

erican Orthopedic Foot and A

nkle (AO

FAS) scores and dynam

ic and static plantograms w

ere analyzed and compared.

The results show that prim

ary arthrodesis was chosen as a m

ethod of treatment for com

plex fractures involving more than one tarsom

etatarsal joints. The recovery period aft

er surgery was slightly faster for the fused patients w

ith them reporting less pain and daily hindrances at 1 year

after surgery. M

ore than 80% of the patients treated w

ith joint sparing internal fixation manifested posttraum

atic arthritis after the second year,

both clinically and on X-rays. Clinical symptom

s of posttraumatic arthritis w

ere marginally less expressed aft

er arthrodesis. Plantograms dem

on-strated less loss of foot arches in the fused patients, although som

e of them w

ere hyper corrected.The results of this study suggest that prim

ary arthrodesis is a viable method of treatm

ent for Lisfranc fracture dislocations leading to fewer com

-plications in the long term

follow up, but care should be taken to choose suitable cases for prim

ary fusion.

F18. THE FIR

ST 55 PERO

NEA

L TEND

OSC

OPIES O

F ON

E SUR

GEO

N: A

NA

LYSIS O

F INTR

AO

PERA

TIVE FIN

DIN

GS A

ND

PERFO

RM

ED C

ON

CO

M-

ITAN

T PRO

CED

UR

ESD

amjan D

imnjaković1, Tosm

islav Smoljanović2, Ivan B

ojanić2 1- D

epartment of O


ospital Centre Zagreb, Zagreb, Croatia2- D

epartment of O


ospital Centre Zagreb, University of Zagreb School of M

edicine, Zagreb, Croatia IntroductionPeroneal tendons disorders oft

en occur combined w

ith other symptom

s derived by intra- or extra-articular pathology of the ankle needing the com-

bined single-step procedure of peroneal tendoscopy with arthroscopic or open procedures of the ankle.

PurposeThis study analyses the intraoperative findings of the first 55 peroneal tendoscopies done by a single surgeon and show

s which concom

itant proce-dures w

ere performed.

Materials and m

ethodsFrom

January 2013 to July 2017, 55 consecutive peroneal tendoscopies were perform

ed in our Departm

ent. Peroneal tendoscopy was perform

ed before any other arthroscopic or open procedure in all patients w

ith a 4.5-mm

30°- arthroscope in a standard fashion. Postoperative managem

ent w

as performed depending on specific type of pathology that w

as treated. R

esultsPeroneal tendoscopy w

as performed in 14 m

ale and 40 female patients (m

ean age, 46 years; range, 13-60 years) who w

ere followed-up for a m

ini-m

um of 6 m

onths (clinical or telephone). None of the patients underw

ent open or tendoscopic procedure on peroneal tendons prior to surgery in our departm

ent. We have perform

ed peroneal tendoscopy as a solitary procedure in 23, while in the rem

aining 32 cases it was perform

ed together with

ankle arthroscopy (28 cases), subtalar arthroscopy (1 case) and excision of the os peroneum (3 cases). The m

ost comm

on pathology was low

-lying peroneus brevis m

uscle belly (28 cases), followed by partial longitudinal rupture of the peroneus brevis tendon (20 cases), isolated tenosynovitis (5

cases) and an accessory peroneus quartus tendon (2 cases). Due to persistent posterolateral pain tw

o patients were reoperated (one in our institu-

tion) six months aft

er the initial operation. All the other patients w

ere symptom

-free at a minim

um of six m

onths follow-up.

ConclusionPeroneal tendoscopy is an eff

ective minim

ally invasive procedure to treat miscellaneous peroneal tendon disorders w

ith low m

orbidity and excellent functional results.

FP19. PRO

XIM

AL M

EDIA

L GA

STRO

CNEM

IUS R

ELEASE IN

THE TR

EATM

ENT O

F REC

ALCITR

AN

T PLAN

TAR

FASCIITIS

Vasileios Lampridis1,2, G

eorgios Kiziridis1, A

lex Wee1, N

ikolaos Gougoulias1.

1.Frimley Park H

ospital NH

S Trust, UK

, 2. 424 Military H

ospital Thessaloniki Introduction: Isolated gastrocnem

ius contracture has been implicated as the cause of a num

ber of foot and ankle pathologies, due to altered foot biom

echanics. Plantar fasciitis (PF) is the comm

onest of these conditions. Chronic PF can affect the quality of life of the patients and its treatm

ent can be challenging.

Purpose: We report our results w

ith an isolated release of the proximal m

edial head of gastrocnemius (PM

GR

) for the treatment of recalcitrant PF.

Material-M

ethods: This is a retrospective review of 64 patients (70 legs), w

ith mean age of 49 years (range 32-74) that underw

ent PMG

R betw

een 2009 and 2017. PF w

as diagnosed clinically and confirmed radiologically (ultrasound or M

RI) in all cases. In this cohort w

e included patients that had at least 1 year of conservative treatm

ent and an isolated gastrocnemius contracture w

as confirmed clinically using Silfverskiold’s test preop-

eratively. Outcom

e measures included a 5-point Likert scale as w

ell as subjective and objective calf weakness assessm

ents. Final follow up w

as on average 47 m

onths (range 12 to 94) after the surgery.

Results: 51 patients (55 heels) (79%

) reported total or significant pain relief following the surgery and none reported w

orsening of their symptom

s. 30 patients im

proved within eight w

eeks and the rest within 3-6 m

onths. No patient had subjective or objective evidence of calf w

eakness. One

patient developed a superficial wound infection and w

as treated with a course of antibiotics. Three patients (6%

) developed DVT and w

ere treated w

ith LMW

H.

Conclusions: PMG

R is a sim

ple way of treating a patient w

ith recalcitrant PF who has failed to respond to conservative m

anagement. In our series,

the results were favourable, the recovery w

as fast and the complication rate low

.

FP20. SALV

AG

E FIBU

LAR

LENG

THEN

ING

BY

EXTER

NA

L FIXA

TOR

AFTER

INC

OR

REC

T LOW

ER LEG

LENG

THEN

ING

. A TW

O C

ASES R

EPOR

T. M

IRO

SLAV ZH

IVKO

V LYUB

OM

IRO

VU

NIV. H

OSPITA

L “SAIN

T AN

NA” , VA

RN

A , B

ULG

AR

IA R

elative shortening of the fibula may occur aft

er improper low

er leg lengthening when the fibula is not fixed to the external fixator. Patients com

-plain of pain and restriction of their daily and sporting activities. Clinically, there is valgus of the ankle and hind foot due to abduction and lateral rotation of the talus. Lim

b lengthening is performed usually in childhood age if the fibula is not fixed and lengthened together w

ith tibia leads to incongruence of the ankle joint and early degenerative changes .

The purpose of this article is to present our two case experience to restore congruency of ankle joint by lengthening of the fibula by rail m

ini fixa-tor.

Betw

een 2014 and 2018 , two patients w

ere treated by fibular lengthening. Both w

ere female w

ith the average age 7y (5 and 9y)

The average shortening of the fibula was 15m

m w

ith valgus of the ankle and painful gait. The interval between artificial shortening of the fibula

and correction was 1 m

onths in first case and 6 years in second case.

We perform

ed lengthening of the fibula by mini B

iomed or m

ini rail fixator with 4 or 6 H

A 3m

m pins. O

steotomy of the fibula w

as transverse , 3-4 cm

above syndesmosis . D

istraction rate was 0.75m

m/day and fixator tim

e was 3 m

onths.

Restoration of length of fibula and correction of ankle valgus w

as achieved in all two cases. There w

as no pain during walking and norm

al sport activities.

Early results of so-called salvage ex-fix fibular lengthening is save and successfully restores normal length of the fibula and ankle congruency. Thus

prevent early degenerative changes and restores plantigrade walking.

FP21. LON

G TER

M R

ESULTS O

F PERC

UTA

NEO

US R

AD

IOFR

EQU

ENC

Y N

ERV

E AB

LATIO

N FO

R CH

RO

NIC

PLAN

TAR

HEEL PA

IN A

SSOCIA

TED

WITH

PLAN

TAR

FASCIITIS

H. Yener Erken1

1: Istanbul Okan U

niversity Faculty of Medicine D

epartment of O

rthopaedic Surgery, Istanbul, Turkey A

bstractIntroductionChronic plantar heel pain is one of the m

ost painful foot conditions and is generally associated with plantar fasciitis.

PurposeThis study reports long term

followup results of radiofrequency radiofrequency nerve ablation (R

FNA

) of the calcaneal branches of the inferior calcaneal nerve in patients w

ho did not respond to conservative treatments.

Material and M

ethodsW

e prospectively evaluated the results of the RFN

A of the calcaneal branches of the inferior calcaneal nerve on 68 feet in 58 patients w

ith plantar heel pain betw

een 2008 and 2013. All of the patients w

ho were treated had been com

plaining of heel pain for over six months and had been re-

sistant to conservative treatments. Patients included in the study w

ere evaluated (quantitatively) using the average 10-point Visual Analog Scale

(VAS) before the treatm

ent, as well as at their one m

onth followup, one year follow

up, two years follow

up, and last followup aft

er the procedure, respectively.R

esultsThe m

ean last followup w

as 62 months (range, 47-110 m

onths). The average VAS score of the feet w

as 9.54 + 1.66 before treatment, 0.75 +1.24

one month aft

er the procedure, and 1.59+ 2.23 at one year followup, 1.72 + 1.88 at tw

o years followup, and 2.34+ 0.92 at last follow

up(p<0.001). In the evaluation of the patients’ feet, 81 %

of the patients rated their treatment as very successful or successful at the last follow

up.ConclusionsThese findings suggest that R

adiofrequency nerve ablation (RFN

A) of the calcaneal branches of the inferior calcaneal nerve provide a long term

eff

ective treatment for chronic heel pain associated w

ith plantar fasciitis.

NOT P

RESE

NTED

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