Treatment of the Mirror Foot with Central Ray Resection: Report of 2 Cases

The mirror foot is a rare congenital foot anomaly which is often associated with 6- to 8-toed polydactyly. Postaxial polydactyly is the most common form of this anomaly, while central polydactyly is seen infrequently. We report on 2 cases of the central mirror-foot anomaly. Calcaneus duplication and fibular hypoplasia were present in 1 case. We treated both patients by resecting the middle foot rays and narrowing the foot width through cuneiform excision and use of cerclage wires or heavy suture approximation of the remaining adjacent rays. In the mirror foot, the old and more common treatment was the resection of the border extra toes or rays. Central-ray amputation with dorsal and plantar incisions and narrowing the foot with soft-tissue reduction and cuneiform excision confer excellent functional and cosmetic results

Development and psychometric evaluation of a pneumatic tourniquet work standards scale

Abstract Objective Pneumatic tourniquets are among the most essential equipment for controlling bleeding in orthopedic surgeries. However, incorrect application of pneumatic tourniquets is accompanied by many hazards and complications for patients. Evaluation of surgical teams’ use of pneumatic tourniquets and establishment of protocols can play an important role in improving patient safety, minimizing risks, and increasing the lifetime of this equipment. Accordingly, the present study was conducted to develop and assess the psychometric properties of a pneumatic tourniquet work standards scale. Methods The present study is a methodological work carried out in two stages. In the first stage, an initial version of the scale was developed based on existing research and panel reviews. In the second stage, the psychometric properties of the scale were tested in terms of face validity (measured qualitatively and quantitatively), content validity (measured qualitatively and quantitatively), item analysis, construct validity, and reliability (internal consistency and stability). Results The initial version of the scale consisted of 91 items. After several meetings of the research team, the number of items decreased to 81. In the course of face and content validity testing, 40 items were eliminated, leaving 41 items on the scale when it entered the construct validity testing stage. For evaluation of construct validity, a sample of 300 operating room nurses was recruited. The Exploratory Factor Analysis (EFA) results showed a structure supported by seven factors and 41 items. The reliability of the scale was confirmed by internal consistency analysis, with a good Cronbach’s alpha (0.85), and test–retest analysis, with good values of ICC (0.95). Conclusion The present instrument is a reliable and valid scale which fills the gap in assessment of surgical team members’ use of pneumatic tourniquets. The developed scale can be employed by researchers and managers of medical centers to identify hazards in applying pneumatic tourniquets and devise educational programs to eliminate or reduce the existing issues