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Foot and Ankle Clinics

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https://www.readbyqxmd.com/read/28167068/current-controversies-in-foot-and-ankle-trauma
#1
EDITORIAL
Michael P Swords
No abstract text is available yet for this article.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167067/early-fixation-of-calcaneus-fractures
#2
REVIEW
Michael P Swords, Phillip Penny
The treatment of calcaneus fractures is controversial. Historically, most operatively treated fractures have been approached with a lateral extensile incision requiring delay in operative treatment until swelling has improved. There is a current trend and interest in small incision approaches allowing, and in some cases requiring, earlier operative fixation. Clinical scenarios amenable to consideration for early fixation are reviewed. The sinus tarsi surgical approach and reduction techniques are outlined in detail...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167066/calcaneal-fracture-management-extensile-lateral-approach-versus-small-incision-technique
#3
REVIEW
Nathan J Kiewiet, Bruce J Sangeorzan
Calcaneal fracture management has historically been a controversial topic and represents an area of sustained interest over the past several decades. The authors review current methods for calcaneal fracture fixation with an extensile lateral approach and small incision techniques. Early reports of small incision techniques have reported promising outcomes and reduced risks for complications. These techniques may be beneficial to reduce the risk of soft tissue complications and improve the rate of recovery.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167065/late-treatment-of-syndesmotic-injuries
#4
REVIEW
Michael P Swords, Andrew Sands, John R Shank
Normal syndesmosis anatomy and alignment are essential to ankle function. Although injuries to the syndesmosis are common with ankle injuries, accurate diagnosis and reduction continue to be a challenge. Late reconstruction for syndesmosis is reviewed. A surgical technique for late reconstruction is outlined in detail.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167064/syndesmosis-stabilisation-screws-versus-flexible-fixation
#5
REVIEW
Matthew C Solan, Mark S Davies, Anthony Sakellariou
Orthopedic surgery is not short of situations where there is controversy regarding optimum management. Treating ankle syndesmosis injuries is an example where practice varies widely and there are many questions that remain unsatisfactorily answered. When addressing the type of syndesmosis stabilization that is required it is essential to ascertain the extent of instability. Only then can a logical approach to restoring the ankle mortise be achieved. Fixation of fibula shaft fractures and posterior malleolus fractures can restore sufficient stability to render syndesmosis stabilization unnecessary...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167063/complex-foot-injury-early-and-definite-management
#6
REVIEW
Tim Schepers, Stefan Rammelt
Complex foot injuries occur infrequently, but are life-changing events. They often present with other injuries as the result of a high-energy trauma. After initial stabilization, early assessment should be regarding salvagability. All treatment strategies are intensive. The initial treatment includes prevention of progression ischemia/necrosis, prevention of infection, and considering salvage or amputation. Definitive treatment for salvage includes anatomic reconstruction with stable internal fixation and early soft tissue coverage followed by aggressive rehabilitation...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167062/treatment-of-peripheral-talus-fractures
#7
REVIEW
John R Shank, Stephen K Benirschke, Michael P Swords
Peripheral talus fractures include injuries to the lateral process, posteromedial talar body, and talar head. These injuries are rare and are often missed. Nonunion with conservative treatment is high and excision can lead to joint instability, rapid arthrosis, and earlier need for arthrodesis. Open reduction internal fixation of most peripheral talus fractures is critical to achieving a good outcome. Open reduction leads to more rapid union and ability to mobilize the ankle and subtalar joints, quicker revascularization of the talus, and lower rates of arthrosis...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167061/chopart-injuries-when-to-fix-and-when-to-fuse
#8
REVIEW
Stefan Rammelt, Tim Schepers
Chopart joint injuries have a profound effect on global foot function. Surgical treatment aims at joint reconstruction and axial alignment with restoration of the normal relationship of the lateral and medial foot columns. Internal fixation is tailored to the individual fracture pattern and achieved with resorbable pins, Kirschner wires, screws, and/or anatomically shaped minifragment plates. If instability persists, temporary joint transfixation may be achieved with Kirschner wires or bridge plating. Primary fusion sacrifices essential joints and should be reserved for severe initial cartilage damage...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167060/the-role-of-percutaneous-reduction-and-fixation-of-lisfranc-injuries
#9
REVIEW
Rupesh A Puna, Matthew P W Tomlinson
To be able to perform percutaneous fixation of Lisfranc injuries, this article emphasizes that an anatomic reduction must be mandatory. When uncertainty remains as to whether closed reduction is anatomic, formal open reduction is recommended because accuracy of reduction is correlated with long-term outcome. Closed injuries with minimal displacement, bony avulsions, and skeletally immature individuals seem the most appropriate indications for percutaneous fixation. Not all injuries are ideal for this method of treatment, and this is an area that needs to be more clearly defined in the future...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167059/primary-arthrodesis-for-tibial-pilon-fractures
#10
REVIEW
Bryant Ho, John Ketz
Staged primary ankle arthrodesis is a viable option for high-energy pilon fractures that are nonreconstructible, in patients with delay in treatment or multiple medical comorbidities, or in patients with peripheral neuropathy. Small retrospective series demonstrate high union and low wound complication rates, although further studies are needed to determine the long-term results. Ankle arthrodesis offers decreased complication rates while eliminating the potential of posttraumatic ankle arthritis pain.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167058/posterior-malleolar-fractures-changing-concepts-and-recent-developments
#11
REVIEW
Jan Bartoníček, Stefan Rammelt, Michal Tuček
Injuries to the posterior malleolus are of prognostic relevance in ankle fracture-dislocations. The three-dimensional outline of the fragments as reflected by computed tomography classification, involvement of the fibular notch, and the presence of intercalary fragments seem to be of greater therapeutic relevance than the size of the fragment and amount of the articular surface involved. Operative treatment aims at reconstruction of the posterior tibial plafond, the fibular notch, and the integrity of the posterior inferior tibiofibular syndesmosis...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167057/gastrocnemius-or-achilles-lengthening-at-time-of-trauma-fixation
#12
REVIEW
Stephen K Benirschke, Patricia Ann Kramer
Gastrocnemius equinus is a frequent comorbidity with traumatic injuries of the foot and ankle. Gastrocnemius lengthening at the time of definitive treatment facilitates obtaining and maintaining an anatomic reduction of the injury. The lengthening procedure is accomplished in 5 steps and results in fewer long-term, problematic sequelae.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167056/managing-complications-of-calcaneus-fractures
#13
REVIEW
Michael P Clare, William S Crawford
Calcaneus fractures remain among the most complicated fractures for orthopedic surgeons to manage because of the complexity of various fracture patterns, the limited surrounding soft tissue envelope, and the prolonged rehabilitation issues impacting function after successful treatment. Despite this, appropriate management of complications associated with calcaneus fractures is critical for the complete care of this injury, whether treated operatively or nonoperatively. The authors present the common complications encountered with fractures of the calcaneus and management thereof...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167055/open-reduction-and-internal-fixation-versus-primary-arthrodesis-for-lisfranc-injuries
#14
REVIEW
Brian M Weatherford, Donald R Bohay, John G Anderson
Management of injuries to the tarsometatarsal (Lisfranc) joint complex continues to generate heated debate. Arthrodesis of the Lisfranc joint complex has historically been reserved as a salvage procedure for failed treatment. Recently, primary arthrodesis has emerged as a viable treatment alternative to open reduction and internal fixation for these injuries. The objective of this article was to examine the current literature regarding open reduction and internal fixation versus primary arthrodesis of Lisfranc injuries...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871424/orthobiologic-in-foot-ankle
#15
EDITORIAL
Sheldon S Lin
No abstract text is available yet for this article.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871423/the-science-behind-surgical-innovations-of-the-forefoot
#16
REVIEW
Judith F Baumhauer, Michele Marcolongo
One of the areas of foot and ankle surgery that has had particular attention over the last 5 years has been forefoot surgery. Common procedures include correction of the lessor metatarsophalangeal joints and hammertoe deformities, specifically metatarsal shortening osteotomies and proximal interphalangeal joint fusions. The goals of these surgeries are to improve patient function and allow patients to fit into shoes more comfortably in metatarsal shortening and hammertoe.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871422/the-science-behind-wear-testing-for-great-toe-implants-for-hallux-rigidus
#17
REVIEW
Judith F Baumhauer, Michele Marcolongo
Various methods of repairing damaged articular cartilage surfaces have been proposed and a variety of implant materials have been tried in an attempt to decrease pain and improve function after cartilage repair. The hydrogel made of polyvinyl alcohol and saline is a unique material used as an implant in the great toe for advanced stage arthritis.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871421/mesenchymal-stem-cell-bearing-sutures-for-tendon-repair-and-healing-in-the-foot-and-ankle
#18
REVIEW
Eric W Tan, Lew C Schon
Improving the quality and strength of soft tissue repairs remains an important area of orthopedic research and innovation. The need for immobilization and early motion is an important balance essential for the successful treatment of tendon repair and reconstruction. Mesenchymal stem cell (MSC)-bearing sutures represent an emerging biological augmentation to traditional suture repair. Two previous large studies using stem cell sutures in rat Achilles tendon models have demonstrated early increased biomechanical strength and significantly increased ultimate failure strength...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871420/platelet-rich-plasma-and-concentrated-bone-marrow-aspirate-in-surgical-treatment-for-osteochondral-lesions-of-the-talus
#19
REVIEW
Youichi Yasui, Andrew W Ross, John G Kennedy
Platelet-rich plasma (PRP) and concentrated bone marrow aspirate (CBMA) have the potential to improve the quality of cartilage repair in osteochondral lesions of the talus (OLT). In this review, we describe the basic science and clinical evidence that has been published on the topic of PRP and CBMA on 2 commonly used surgical techniques for the treatment of OLT: bone marrow stimulation and osteochondral autograft transfer.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871419/the-use-of-allostem-in-subtalar-fusions
#20
RANDOMIZED CONTROLLED TRIAL
J Chris Coetzee, Mark S Myerson, John G Anderson
Subtalar arthrodesis is the mainstay for treatment of a variety of hindfoot problems associated with arthritis, however with an unpredictable if not high rate of nonunion. This article covers the use of adipose-derived stem cells as an adjunct or alternative to autologous or other bone grafting materials. Promising development and encouraging data exist with respect to the use of adipose-derived mesenchymal stem cells for bone arthrodesis, which is discussed in more detail in the article.
December 2016: Foot and Ankle Clinics
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