Ankle arthrodesis vs TTC arthrodesis: Patient outcomes, satisfaction, and return to activity

10.1177/1071100713478929Foot and Ankle International345657-665FAIN

Arenas, arena architecture and the impact on location desirability: the case of `Olympic Arenas' in Prenzlauer Berg, Berlin

This paper investigates impacts of three multifunctional sports arenas situated in Berlin-Prenzlauer Berg, Germany, employing highly disaggregated data on land values. The three arenas, their architecture and location within the city were explicitly designed to contribute to revitalisation of their economically deprived neighbourhoods. A difference-in-differences approach is employed to check for structural breaks in development of land values within areas of potential impact. The results suggest that arenas emanate positive externalities that improve location desirability in their neighbourhoods. However, evidence also supports concerns that the negative external effects of arenas may adversely affect neighbourhoods, when not addressed appropriately during planning

Is it necessary to re-fuse a non-union of a hallux metatarsophalangeal joint arthrodesis?

BACKGROUND: The standard treatment for a non-union of the hallux metatarsophalangeal joint fusion has been to revise the fusion. Revision fusion is technically more demanding, often involving bone grafting, more substantial fixation and prolonged period of immobilization postoperatively. We present data to suggest that removal of hardware and debridement alone is an alternative treatment option. ---------- MATERIALS AND METHODS: A case note review identified patients with a symptomatic non-union after hallux metatarsophalangeal joint (MTPJ) fusion. It is our practice to offer these patients revision fusion or removal of hardware and debridement. For the seven patients that chose hardware removal and were left with a pseudarthrosis, a matched control group was selected from patients who had had successful fusions. Three outcome scores were used. Hallux valgus and dorsiflexion angles were recorded.---------- RESULTS: One hundred thirty-nine hallux MTPJ arthrodeses were carried out. Fourteen non-unions were identified. The rate of non-union in males and following previous hallux MTPJ surgery was 19% and 24%, respectively. In females undergoing a primary MTPJ fusion, the rate was 2.4%. Twelve non-union patients were reviewed at 27 months (mean). Eleven patients had elected to undergo removal of hardware and debridement. Four patients with pseudarthrosis were unhappy with the results and proceeded to either revision fusion or MTPJ replacement. Seven non-union patients, who had removal of hardware alone, had outcome scores marginally worse compared to those with successful fusions.---------- CONCLUSION: Removal of hardware alone is a reasonable option to offer as a relatively minor procedure following a failed arthrodesis of the first MTPJ. This must be accepted on the proviso that in this study four out of 11 (36%) patients proceeded to a revision first MTPJ fusion or first MTPJ replacement. We also found that the rate of non-union in primary first MTPJ fusion was significantly higher in males and those patients who had undergone previous surgery