Journal of the American Podiatric Medical Association

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Open AccessArticle

Local anesthetics. Is there an advantage to mixing solutions?

by Bm Ribotsky, Kd Berkowitz and Jr Montague

J. Am. Podiatr. Med. Assoc. 1996, 86(10), 487-491; https://doi.org/10.7547/87507315-86-10-487 - 1 Oct 1996

Cited by 55 | Viewed by 151

The advantages to using a 50/50 mixture of lidocaine and bupivacaine with respect to onset and duration of local anesthesia instead of using the solutions independently were evaluated. In a double-blind randomized experiment, 12 subjects, each volunteering both feet, were studied. One foot was injected with 1 ml of one of the following three solutions: 1% plain lidocaine, 0.25% plain bupivacaine (Marcaine), or a 50/50 mixture of 1% lidocaine and 0.25% bupivacaine; and in the other foot, a 1-ml injection of normal saline as a blinded control. A 5.07 (10 g) Semmes-Weinstein monofilament wire was used for testing for sensory blockade, and the onset and duration of anesthesia was recorded for each subject. It was determined that there was no significant difference in the mean onset times for the three solutions, and no significant difference between the durations of anesthesia of plain lidocaine and the 50/50 mixture. Additionally, it was determined that bupivacaine had a prolonged duration of anesthesia compared with the other two solutions. The results of this preliminary study suggest that there is no clinical advantage, with respect to onset and duration of local blockade, to using a 50/50 mixture of plain lidocaine and plain bupivacaine in place of their independent use. Full article

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Open AccessArticle

Functional motion of the medial column joints of the foot during propulsion

by Rd Phillips, Ea Law and Ed Ward

J. Am. Podiatr. Med. Assoc. 1996, 86(10), 474-486; https://doi.org/10.7547/87507315-86-10-474 - 1 Oct 1996

Cited by 33 | Viewed by 137

Abstract

Motion in the ankle, subtalar, midtarsal, and first metatarsophalangeal joints has been well documented. However, motion in the first metatarsocuneiform, the first cuneonavicular, and the first interphalangeal joint has not been addressed. Motion in these joints has not been documented because many believe that little motion occurs at these joints, and because of the difficulty in assessing motion at these joints. Using two-dimensional motion analysis, the authors present sagittal plane ranges of motion occurring in the first metatarsophalangeal joint, the first metatarsocuneiform joint, the medial cuneonavicular joint, and the first interphalangeal joint during the propulsive period of gait. This pilot study indicates that sagittal plane motion between the navicular and calcaneus and between the first metatarsal and first cuneiform are very mild and inconsistent. However, plantarflexion motion between the first cuneiform and the navicular is significant and comprises most of the plantarflexion motion of the first ray during propulsion. Motion in the first interphalangeal joint is slight during the first 80% of the propulsive period but shows slight-to-moderate dorsiflexion during the last 20% of the propulsive period of gait. Full article

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Open AccessArticle

Closed kinetic chain tarsal mechanics of subtalar joint arthroereisis

by Jc Christensen, N Campbell and K DiNucci

J. Am. Podiatr. Med. Assoc. 1996, 86(10), 467-473; https://doi.org/10.7547/87507315-86-10-467 - 1 Oct 1996

Cited by 38 | Viewed by 119

Abstract

The weightbearing biomechanics of the tarsus with and without subtalar joint arthroereisis was investigated in 11 fresh frozen cadaver specimens using a three-dimensional (3-D) radiowave tracking system. Specimens, consisting of the distal half of the tibia and fibula and the intact ankle and foot, were mounted on a nonmetallic loading frame test system that allowed positioning of the foot to simulate midstance position of gait. The tibia was axially loaded to 756 N (one bodyweight) with 15% of the total load diverted through the fibula. Receiving transducers were attached to the talus, navicular, calcaneus, and cuboid bones. Tarsal movements were monitored as the specimen was loaded with and without subtalar joint arthroereisis. Three-dimensional data sets of osseous positions and orientations were collected and analyzed. Significant rotational differences were detected with and without subtalar joint arthroereisis for all four tarsal bones (p < or = 0.05). Tarsal translational position changes were small and not statistically significant. Full article

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J. Am. Podiatr. Med. Assoc., Volume 86, Issue 10 (10 1996) – 3 articles , Pages 467-491

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