This paper describes a rapid assessment of current infant feeding practices conducted during a mass immunization campaign in an urban area of São José do Rio Preto, São Paulo State, Brazil. Parents or guardians of all infants (<1 year) attending the 8 randomly-selected health centers were interviewed. Median duration of breastfeeding practices was estimated by probit analysis. Of the 719 infants, 692 (96.2%) began breastfeeding, and only 63 (8.9%) were in exclusive breastfeeding. Median duration of total breastfeeding (exclusive plus partial) was 205.93 days. Infants born by cesarean section showed a higher risk of early weaning: OR (95%CI)=1.51 (1.09-2.09) after adjusting for confounding variables (mother's educational level, gestational age, birth weight, whether breastfed). Median duration of total breastfeeding was higher among infants born by vaginal delivery (227.38 days; 95%CI=195.19-271.16) as compared to cesarean section (192.84 days; 95%CI=128.23-273.34). Early introduction of weaning foods such as water/herbal tea and cow's milk was observed with a median age at introduction of 30 days. These findings indicate the need to improve strategies by the public health services to promote exclusive breastfeeding.

Objective: Evaluate the impact of Chevron and extended Chevron techniques associated with Akin osteotomy on the range of motion (ROM) of hallux metatarsophalangeal joint (MPJ) and interphalangeal joint (IPJ) after three months and one year. Methods: Sixteen patients (17 feet) were evaluated for the ROM of hallux MPJ and IPJ pre-and postoperatively, the flexion-extension measurements were performed using a goniometer. Results: Comparing the pre-and postoperative measurements at three months and one year, the ROM decreased in MPJ extension and flexion, 9o and 5o, respectively, and IPJ flexion, 5o. The values presented statistical significance according to the analysis demonstrated (p>0.05). However, the decrease in IPJ extension was not statistically significant (decrease of 0.8o and p<0.05). Conclusions: Periarticular osteotomies of hallux MPJ had a significant decrease in the ROM after three months and one year. Level of Evidence II; Therapeutic Studies - Investigating the Results of Treatment; Prospective Comparative Study.

Objective: To evaluate whether the initial degree of metatarsal rotation interferes with the surgical correction of severe hallux valgus. Methods: A retrospective study was performed using weight-bearing AP radiographs to measure first metatarsal rotation based on the shape of the lateral edge of the metatarsal head and the hallux valgus (HVA) and intermetatarsal (IMA) angles. Participants were then classified into two groups. Those with less rotational deformity were placed in the negative pronation group, while those with greater rotational deformity were placed in the positive pronation group. Mean HVA and IMA correction were calculated and compared between groups. Participants underwent the modified Lapidus procedure with correction of pronation. Results: Data were collected for 26 feet with hallux valgus. The negative and positive pronation groups contained 14 and 12 feet, respectively. Successful surgical correction of pronation was observed in 11 of the 12 feet, which were ultimately classified in the negative pronation group based on postoperative radiographs. The negative pronation group showed a mean difference of 15.05o in the HVA and 4.20o in the IMA. The positive pronation group showed a mean difference of 14.22o in the HVA and 3.2o in the IMA. These values did not significantly differ between groups. Conclusion: The initial degree of pronation does not affect the degree of angular correction as long as metatarsal rotation is also addressed. Level of Evidence IV; Diagnostic Studies; Case Series.

Objective: To evaluate the degree of sesamoid complex correction in patients with moderate and severe hallux valgus undergoing cuneometatarsal arthrodesis by comparing general pre- and postoperative values and also post-reduction outcomes between moderate and severe cases. Methods: The radiographs of 24 patients (83.3% females and 16.7% males) who underwent arthrodesis of the first cuneometatarsal joint wereretrospectively analysed. The patients’ mean age was 52.58 years. The metatarsophalangeal, intermetatarsal and sesamoid dislocation angles were measured on the preoperative and immediate postoperative radiographs, with the former measured in the standing position and the latter measured intraoperatively, all in the anteroposterior incidence. The first metatarsal lateralization necessary to centralize the sesamoids wasmeasured in degrees. We refer to this angle as the “angle to be corrected”. Results: We achieved sesamoid dislocation correction, reducing the indicated angles in relation to their preoperative values. Both moderate and severe cases showed statistically significant differences in angular correction after surgery, with p=0.018 and p<0.001, respectively. Comparing the moderate and severe cases, a statistically significant difference was observed preoperatively, with p=0.007; however, the results were not statistically significant postoperatively (p=0.227). Conclusion: We achieved effective correction of the ABC in terms of both the total patient sample and the isolated analysis of the moderate and severe groups. Preoperatively, the moderate cases had smaller angles than the severe cases, but both groups exhibited reductions in these angles in the postoperative period and had similar outcomes. Level of Evidence III; Retrospective Study.

Objective: Assess patient performance and quality of the stump after amputation at the Chopart (midtarsal) joint, with double-bundle transfer of the tibialis anterior muscle tendon to the talar neck. Methods: This study evaluated the medical records of 5 patients who underwent Chopart amputation with double-bundle transfer of the tibialis anterior tendon to the talar neck, assessing pre and postoperative performance and gait. Results: The patients were operated on between January 2008 and December 2018, and the data obtained from the survey allow us to conclude that, after the proposed procedure, all patients reported an improvement in walking, besides noting a significant reduction in the degree of stump equinus. Conclusion: The surgical technique described in this article produced a significant improvement in patient performance as assessed by the AOFAS hindfoot score, and prevented the formation of ulcers in the anterior region of the stump. Level of Evidence IV; Therapeutic Study; Case Series.

Objective: To measure and evaluate the distance from the medial plantar nerve (MPN) to six predetermined anatomical landmarks, identifying 12 distances, and establish a correlation with the trajectory of the flexor hallucis longus (FHL) tendon, especially the knot of Henry, and the location of the bifurcation of the posterior tibial nerve (PTN) relative to the tarsal tunnel. Methods: A descriptive and quantitative study was conducted in which 15 adult feet (six right and nine left) from cadavers were dissected, and the anatomical relationship between the MPN and predetermined structures was evaluated. The distance from the medial border of the medial malleolus to the inferior calcaneal tuberosity [defined as a fixed reference (FR)] was measured to compensate for variability in foot size. Results: The results indicated that the bifurcation of the PTN was proximal to the tarsal tunnel in 11 feet (73.3%), within the tunnel in three feet (20%), and distal to the tunnel in one foot (6.66%). A statistically significant (p=0.035) association was found between the FR and the distance from the superior calcaneal tuberosity to the MPN, a strong correlation (p=0.004) was found between the FR and the distance from the inferior calcaneal tuberosity to the MPN, and a significant association (p=0.013) was found between the FR and the distance from the medial calcaneal tuberosity to the knot of Henry. Conclusion: Some anatomical structures, especially the knot of Henry, have a strong correlation with the MPN and should be considered by surgeons who intend to approach the FHL in the plantar region. Bifurcation of the PTN proximal to the tarsal tunnel was the most common presentation.Level of Evidence V; Expert opinion.