The Ankle Energetic Effect of Functional Insoles on Walking

Background：Although insoles made of various materials and shapes have been developed to improve performance in sport activities, few objective evaluations on their effectiveness have been conducted. We investigated the effect of insoles supporting the cuboid bone and anterior part of the calcaneus in healthy individuals.Methods:The subjects included 18 healthy males and females. They walked in standardized shoes with a flat insole (a flat insole made of polyurethane without an arched shape on the surface) and a functional insole (made of carbon and supporting the cuboid and anterior part of the calcaneus). We used a three-dimensional motion analysis device and a force plate to analyze gait and quantitatively compared the effect of functional insoles.Results:There was no difference in the parameters of gait analysis (walking speed, cadence, step length, stride length) between flat insoles and functional insoles. The functional insoles reduced ankle power without reducing walking ability. A comparison between Group A (n = 7), in which the left-right difference in ankle power was more than 20%, and Group B (n = 11), in which the left-right difference in ankle power was less than 20%, indicated that the use of functional insoles reduces the left-right difference of ankle power in the group with a larger difference in power.Conclusion：We believe that the use of functional insoles reduced ankle power without reducing walking ability and equalized left-right power. It may therefore reduce the burden on the muscles of the unilateral lower limbs and improve sport performance.Trial registration：The medical research ethics review committee for individuals at Gunma University (study number HS2017-229) Registered 20 febluary 2018, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034362

Cuboid nutcracker fracture in a 9-year-old child

A 9-year-old girl presented to the emergency department reporting intense pain and inability to bear weight on her left foot after a classmate tripped over it. Imaging studies confirmed a fracture of the cuboid bone due to compression of the lateral column of the foot (also known as nutcracker fracture). The patient was treated surgically, with direct reduction of the compression fracture and definitive fixation with two Kirschner wires. Cuboid nutcracker fracture is rare in children and adolescents, and potential consequences can occur if it is not correctly diagnosed and adequately managed. Literature on this type of fracture is scarce, along with information on treatment options and results over medium-term and long-term follow-up. We describe this case and review the literature on this particular topic.

A Morphometric and Morphological Study on Dry Adult Cuboid Bones

Introduction: Precise biometric data of cuboid and calcaneocuboid joint are not discussed very distinctly in the text books of Anatomy. A better knowledge of the joint surfaces of cuboid and biometric data would generate a three dimensional modeling of the calcaneocuboid joint and would help in the management of Cuboid Syndrome. Aim: To study about morphological and morphometric analysis in adult dry cuboid bone. Materials and Methods: This study was conducted in the Department of Anatomy of a Medical College using 60 dry cuboid bones from museum. Each bone was observed for its morphometric analysis as well as its pattern of calcaneal and metatarsal articular facets. Results were statistically analysed using the Statistical Package for the Social Sciences (SPSS)software, version 19. Students t-test was applied to find the difference between the mean values of the parameters. Results: Mean medial length of cuboid was 33.41 mm, lateral length was 19.73 mm, height was 26.17 mm, length index was 169.33, vertical and transverse diameters of calcaneal articular facet were 24.24 mm and 16.45 mm respectively, vertical and transverse diameters of metatarsal articular facet were 21.32 mm and 13.85 mm respectively, depth of peroneal groove was 0.63mm. Concavo-convex facet with posteromedial projection and oval or reniform in shape (Type 1A) was the most common calcaneal articular facet and convex pattern was the most common metatarsal articular facet of cuboid. Conclusion: Morphological characterisation of articular facet of cuboid and its morphometric analysis help to understand the degree of movement at calcaneocuboid joint, its associated pathologies and instabilities.

Osteoid Osteoma of Cuboid Bone- A Rare Cause of Chronic Foot Pain in Childhood –A Case Report

Chronic foot pain in pediatric age group is less common. The usual differential diagnosis may vary from musculoskeletal injury to serious diseases such as osteomyelitis. Benign bone tumor such as osteoid osteoma of foot is exceedingly rare in this age group. Here we present a rare case of osteoid osteoma of cuboid mimicking osteomyelitis. Patient was managed conservatively by Non-steroidal Anti-inflammatory drugs (NSAIDs) with good clinical outcome. Osteoid osteoma of foot bones should be kept in mind in cases with normal blood parameters.

Results of treatment of congenital clubfoot after soft tissue release in children

Topicality. Widespread use of the method of I. Ponseti allows to significantly reduce the number of reconstructive surgeries and/or reduce their volume. However, if presence the rigid, severe deformities that cannot be corrected with staged plaster casts, or recurrences, surgical treatment is advisable. The literature describes many surgical techniques, the main purpose of which is to reduce the frequency of postoperative complications. And at the same time find the most convenient access to eliminate contractures, further wound healing by primary tension with minimal formation of connective tissue elements. Objective: to reduce the incidences of complications in the surgical treatment of congenital clubfoot by using a modified surgical approach. Materials and methods. In the Department of Orthopedics and Traumatology of NCSH «OKHMATDYT» 57 children (72 feet) with a diagnosis of congenital clubfoot underwent surgical treatment using a modified Carroll approach for the period from January 2014 to September 2018. The mean age of patients was 3±0.4 years. 41 of them boys and 16 girls. Bilateral deformity was observed in 12 patients. 48 patients (58 feet) were underwent surgical treatment after initial treatment with staged plaster casts according to the method of I. Ponseti. Recurrences of deformity after surgery was observed in 9 patients (14 feet). Results. When assessing the immediate results during surgery in all patients, complete correction of foot deformity was achieved. No postoperative complications were noted. Long-term treatment results 2 years after surgery showed that good results were in 12 patients (21±9.53%), satisfactory in 39 (68.4±27.14%) and unsatisfactory in 6 (7±2.18%). Four patients with unsatisfactory results and residual manifestations of deformity in the form of passively corrected isolated adduction of the anterior foot, subsequently underwent surgery to transplant the anterior tibialis tendon to the lateral cuneiform bone. And 2 patients – wedge-shaped resection of the cuboid bone. Indication of which was not the possibility of passive correction of deformity. Conclusions. The comparative analysis of the obtained results and literature data testifies to the effectiveness of the proposed method of treatment of idiopathic clubfoot in children (using three approaches), as well as in the presence of residual deformity after conservative and surgical treatment. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. Key words: clubfoot, children, posteromedial release, surgical treatment.

Should We Think More About Chronic Osteomyelitis After Trauma? A Case Report of Osteomyelitis of the Cuboid Bone

Osteomyelitis is a refractory infectious disease in surgery, which takes a long time to be treated and the condition is easy to be repeated, which causes a heavy burden to individuals and families. Actively looking for the cause is the key to the treatment of osteomyelitis. In our work, we encountered a patient with cuboid osteomyelitis who had forgotten the history of injury and had received surgical treatment before seeing a doctor in our hospital, which caused great difficulties to our work. In the work of diagnosis and treatment, we constantly adjust the treatment plan and treatment ideas, and finally remove the branches from the infected focus, and obtain satisfactory treatment results.

Disseminated Nannizziopsis Infection in an Adolescent With a STAT1 Mutation

An adolescent with failure to thrive developed cuboid bone osteomyelitis and brain abscesses. Mold isolated from both locations was identified by universal genetic sequencing as Nannizziopsis spp, which is typically a pathogen of reptiles. The patient was subsequently diagnosed with a STAT1 mutation and was successfully treated.