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Foot and ankle trauma

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https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#1
Paul M Inclan, Adam S Hyde, Michael Hulme, Jeffrey E Carter
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27895200/demographics-mechanisms-of-injury-and-concurrent-injuries-associated-with-calcaneus-fractures-a-study-of-14-516-patients-in-the-american-college-of-surgeons-national-trauma-data-bank
#2
Daniel D Bohl, Nathaniel T Ondeck, Andre M Samuel, Pablo J Diaz-Collado, Stephen J Nelson, Bryce A Basques, Michael P Leslie, Jonathan N Grauer
: Background This study uses the American College of Surgeons National Trauma Data Bank (NTDB) to update the field on the demographics, injury mechanisms, and concurrent injuries among a national sample of patients admitted to the hospital department with calcaneus fractures. Methods Patients with calcaneus fractures in the NTDB during 2011-2012 were identified and assessed. Results A total of 14 516 patients with calcaneus fractures were included. The most common comorbidity was hypertension (18%), and more than 90% of fractures occurred via traffic accident (49%) or fall (43%)...
November 28, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#3
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27871101/morphomics-of-the-talus
#4
David Gorman, Ebram Handy, Sikui Wang, Annette L Irwin, Stewart Wang
Previous studies of frontal crash databases reported that ankle fractures are among the most common lower extremity fractures. While not generally life threatening, these injuries can be debilitating. Laboratory research into the mechanisms of ankle fractures has linked dorsiflexion with an increased risk of tibia and fibula malleolus fractures. However, talus fractures were not produced in the laboratory tests and appear to be caused by more complex loading of the joint. In this study, an analysis of the National Automotive Sampling System - Crashworthiness Data System (NASS-CDS) for the years 2004-2013 was conducted to investigate foot-ankle injury rates in front seat occupants involved in frontal impact crashes...
November 2016: Stapp Car Crash Journal
https://www.readbyqxmd.com/read/27849465/outcomes-associated-with-the-intrepid-dynamic-exoskeletal-orthosis-ideo-a-systematic-review-of-the-literature
#5
M Jason Highsmith, Leif M Nelson, Neil T Carbone, Tyler D Klenow, Jason T Kahle, Owen T Hill, Jason T Maikos, Mike S Kartel, Billie J Randolph
High-energy lower extremity trauma is a consequence of modern war and it is unclear if limb amputation or limb salvage enables greater recovery. To improve function in the injured extremity, a passive dynamic ankle-foot orthosis, the Intrepid Dynamic Exoskeletal Orthosis (IDEO), was introduced with specialized return to run (RTR) therapy program. Recent research suggests, these interventions may improve function and return to duty rates. This systematic literature review sought to rate available evidence and formulate empirical evidence statements (EESs), regarding outcomes associated with IDEO utilization...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27703418/association-between-achilles-tightness-and-lower-extremity-injury-in-children
#6
Raymond W Liu, Katherine K Xie
BACKGROUND: It is unclear whether isolated gastroc/soleus tightness can increase the risk of lower extremity injury in an otherwise healthy child. QUESTIONS/PURPOSES: (1) Is there a difference in gastroc/soleus tightness, as represented by ankle dorsiflexion with the knee extended, in children presenting with upper versus lower extremity complaints? (2) Is there a difference in gastroc/soleus tightness in children presenting with atraumatic versus traumatic lower extremity complaints? METHODS: We performed a cross-sectional study of 206 consecutive walking age children presenting to a county orthopedic clinic with new upper or lower extremity complaints...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/27649402/the-rare-lesser-metatarsal-bipartite-sesamoid-a-case-report-and-literature-review
#7
Christopher R Hood, Stephanie Eldridge, Matthew Tran, Jason R Miller
INTRODUCTION AND OBJECTIVES: There are several various accessory ossicles and sesamoid bones that can be seen throughout the foot and ankle, with reported incidence of 21.2% and 9.6%, respectively. Accessory ossicles and sesamoid bones usually remain asymptomatic until an inciting event (trauma, overuse) occurs and can then cause pain or degenerative changes. They can also be found in routine imaging. One of these confusing findings are lesser metatarsal sesamoids, which are a rare occurrence...
September 2016: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/27628500/a-biomechanical-comparison-study-of-a-modern-fibular-nail-and-distal-fibular-locking-plate-in-ao-ota-44c2-ankle-fractures
#8
Paul J Switaj, Daniel Fuchs, Mohammed Alshouli, Avinash G Patwardhan, Leonard I Voronov, Muturi Muriuki, Robert M Havey, Anish R Kadakia
BACKGROUND: A lateral approach with open reduction and internal fixation with a plate is a very effective technique for the majority of distal fibular fractures. However, this open approach for ankle fixation may be complicated by wound dehiscence and infection, especially in high-risk patients. An alternative to plating is an intramedullary implant, which allows maintenance of length, alignment, and rotation and which allows for decreased soft tissue dissection. While there has been clinical data suggesting favorable short-term outcomes with these implants, there is no current biomechanical literature investigating this technology in this particular fracture pattern...
September 15, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27599438/arthroscopic-approach-to-posterior-ankle-impingement
#9
REVIEW
Michael H Theodoulou, Laura Bohman
Posterior ankle pain can occur for many reasons. If it is produced by forced plantarflexion of the foot, it is often a result of impingement from an enlarged posterior talar process or an os trigonum. This condition may present in an acute or chronic state. Management is initially nonoperative, but surgical treatments are available. This condition is often seen in athletes, so procedures that limit surgical trauma and allow early return to activity are ideal. An arthroscopic approach for this disorder produces good outcomes with limited complications...
October 2016: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27550340/radiographic-and-functional-outcomes-after-displaced-intra-articular-calcaneal-fractures-a-comparative-cohort-study-among-the-traditional-open-technique-orif-and-percutaneous-surgical-procedures-ps
#10
Carlo Biz, Elia Barison, Pietro Ruggieri, Claudio Iacobellis
BACKGROUND: Open reduction with internal fixation (ORIF) and percutaneous surgery (PS) are the most common surgical procedures for the treatment of displaced intra-articular calcaneal fractures. The purpose of this retrospective study was to compare the clinical and radiological results of these techniques and to verify the prognostic value of the radiographic measurement tools proposed in the literature. METHODS: A consecutive series of 104 calcaneal fractures was included in this analysis...
2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27535086/evaluation-of-reduction-accuracy-of-suture-button-and-screw-fixation-techniques-for-syndesmotic-injuries
#11
Onur Kocadal, Mehmet Yucel, Murad Pepe, Ertugrul Aksahin, Cem Nuri Aktekin
BACKGROUND: Among the most important predictors of functional results of treatment of syndesmotic injuries is the accurate restoration of the syndesmotic space. The purpose of this study was to investigate the reduction performance of screw fixation and suture-button techniques using images obtained from computed tomography (CT) scans. METHODS: Patients at or below 65 years who were treated with screw or suture-button fixation for syndesmotic injuries accompanying ankle fractures between January 2012 and March 2015 were retrospectively reviewed in our regional trauma unit...
December 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27528840/primary-retrograde-tibiotalocalcaneal-nailing-for-fragility-ankle-fractures
#12
Benjamin C Taylor, Dane C Hansen, Ryan Harrison, Douglas E Lucas, Daniel Degenova
BACKGROUND: Ankle fragility fractures are difficult to treat due to poor bone quality and soft tissues as well as the near ubiquitous presence of comorbidities including diabetes mellitus and peripheral neuropathy. Conventional open reduction and internal fixation in this population has been shown to lead to a significant rate of complications. Given the high rate of complications with contemporary fixation methods, the present study aims to critically evaluate the use of acute hindfoot nailing as a percutaneous fixation technique for high-risk ankle fragility fractures...
2016: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/27521355/effect-of-custom-orthosis-and-rehabilitation-program-on-outcomes-following-ankle-and-subtalar-fusions
#13
Andrew J Sheean, David J Tennent, Johnny G Owens, Jason M Wilken, Joseph R Hsu, Daniel J Stinner
BACKGROUND: Fractures of the distal tibia, ankle, and foot sustained through a high-energy mechanism can be extremely debilitating, and ankle and/or subtalar fusion may be indicated if the limb is deemed salvageable. Functional outcomes among this population are often poor. The purposes of this study were to evaluate the effect of an advanced rehabilitation program combined with the use of a custom ankle-foot orthosis for patients with ankle or subtalar fusion on selected physical performance measures and patient-derived outcome measures and to determine if the response to treatment was predicated upon the type of fusion...
August 11, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27496717/randomized-prospective-comparison-of-bioabsorbable-and-steel-screw-fixation-of-lisfranc-injuries
#14
Jamal Ahmad, Kennis Jones
OBJECTIVE: This study's objective is to compare outcomes of bioabsorbable versus steel screws for treating Lisfranc injuries. DESIGN: This research was conducted in a prospective and randomized manner between September 2008 and December 2013. SETTING: This study was performed in the outpatient setting at a tertiary-level care center in a single surgeon's practice. PATIENTS/PARTICIPANTS: Forty patients with acute Lisfranc injuries, amenable to open reduction and screw fixation, enrolled and presented for final follow-up...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27479834/extremity-war-injuries-x-return-to-health-and-function
#15
Col Jeffrey N Davila, Marc F Swiontkowski, Col Ret Romney C Andersen
The symposium Extremity War Injuries X: Return to Health and Function, presented by the American Academy of Orthopaedic Surgeons, the Orthopaedic Trauma Association, the Society of Military Orthopaedic Surgeons, and the Orthopaedic Research Society, was held in Washington, DC, on January 27 and 28, 2015. Course chairs Marc F. Swiontkowski, MD, and COL Jeffrey N. Davila, MD, presided over 2 days of general session lectures focusing on war/trauma-related musculoskeletal injuries resulting in service member disability, followed by small group discussions, with a goal of identifying knowledge gaps in the treatment of these injuries...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27465987/relevance-of-adjacent-joint-imaging-in-the-evaluation-of-ankle-fractures
#16
Valentin Antoci, Shaun P Patel, Michael J Weaver, John Y Kwon
BACKGROUND: Routinely obtaining adjacent joint radiographs when evaluating patients with ankle fractures may be of limited clinical utility and an unnecessary burden, particularly in the absence of clinical suspicion for concomitant injuries. METHODS: One thousand, three hundred and seventy patients who sustained ankle fractures over a 5-year period presenting to two level 1 trauma centers were identified. Medical records were retrospectively reviewed for demographics, physical examination findings, and radiographic information...
October 2016: Injury
https://www.readbyqxmd.com/read/27427994/bilateral-central-foot-drop-in-a-pediatric-patient
#17
Semra Işık, Akın Akakın, Murat Şakir Ekşi, Baran Yılmaz, Tamer Aksoy, Murat Konakçı, Zafer Orkun Toktaş, Türker Kılıç
Foot drop is an inability to dorsiflex the ankle and toe. Primary causes of foot drop are compression or lesion of the 5th lumbar nerve and entrapment of the peroneal nerve at the head of the fibula. Rarely, some central nervous system lesions lead to foot drop. A 16-year-old boy was admitted with blunt head trauma that had happened in an assault. The muscle strength of the bilateral tibialis anterior, bilateral extensor digitorum longus and bilateral extensor digitorum brevis were Medical Research Council grade 1...
2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27426712/patterns-of-orthopaedic-injuries-among-motorbike-accident-admissions-presenting-to-a-tertiary-care-hospital-in-kathmandu
#18
B Banskota, S Shrestha, R K Chaudhary, T Rajbhandari, S Rijal, B K Shrestha, A K Banskota
BACKGROUND: The anecdotal burden of morbidity secondary to motorbike accidents is thought to enormous by personnel involved in trauma care. The objective of the present study is to ascertain patterns and association of injuries and causes of mortality in a cohort of motorbike accident victims. METHODS: A retrospective chart review of 1337 motorbike accident admissions B and B Hospital in Kathmandu between January 2009 and December 2010 was undertaken. RESULTS: Majority of victims were between 20 to 50 years [1230 (92%) males]...
January 2016: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/27380397/promis-computer-adaptive-tests-compared-with-time-to-brake-in-patients-with-complex-lower-extremity-trauma
#19
Chang-Yeon Kim, Daniel H Wiznia, Leon Averbukh, Andrea Torres, Edward Kong, Seewan Kim, Michael P Leslie
OBJECTIVES: To compare the PROMIS Physical Function and Pain Interference Computer Adaptive Tests (PROMIS PF CAT and PROMIS PI CAT) with time to brake (TTB) in patients with complex lower extremity traumas for evaluating whether patients can safely return to driving. DESIGN: Prospective. SETTING: Level-1 trauma center. PATIENTS: Sixty-three patients with lower extremity injuries to the pelvis, acetabulum, hip, femur, knee, tibia/fibula, ankle, and foot within 15 weeks of treatment...
November 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27343132/minimally-invasive-plate-osteosynthesis-using-posterolateral-approach-for-distal-tibial-and-tibial-shaft-fractures
#20
Norio Yamamoto, Kenichi Ogawa, Chuji Terada, Yoshiki Okazaki, Kazuo Munetomo, Tomoyuki Noda, Toshifumi Ozaki
OBJECTIVE: The objective of the study was to evaluate the effectiveness of the posterolateral minimally invasive plate osteosynthesis (MIPO) method for managing distal tibial or tibial shaft fractures with severe anterior and medial soft tissue injuries. MATERIALS AND METHODS: Five consecutive patients with three distal tibial and two tibial shaft fractures (three open fractures) at a level-1 trauma and tertiary referral center were retrospectively reviewed. All patients were definitively treated and followed to bone union...
August 2016: Injury
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