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Foot and ankle fracture

Philip Ashley, Shawn R Gilbert
Obese children with high-energy injuries present with more severe injuries, more extremity injuries, and higher Injury Severity Scores. They are at increased risk for complications, prolonged ventilation, and ICU stay and have increased mortality. Obesity is associated with altered bone mass accrual and higher fracture rates. Obese patients have a higher risk of loss of reduction of forearm fractures, more severe supracondylar fractures, and a higher likelihood of lateral condyle fractures. Obese patients are more likely to have complications with femur fractures and have higher rates of foot and ankle fracture...
July 2018: Orthopedic Clinics of North America
Claudia Beaudoin, Sonia Jean, Lynne Moore, Philippe Gamache, Louis Bessette, Louis-Georges Ste-Marie, Jacques P Brown
Prognostic tools are available to identify individuals at high risk of osteoporotic fracture and assist physicians in management decisions. Some authors have suggested improving the predictive ability of current tools by integrating characteristics of prior fractures (number, location and time since prior fracture). The objectives of this study were i) to evaluate the sex-age-specific association between characteristics of prior fractures and the occurrence of a future osteoporotic fracture and ii) to assess whether the characteristics of prior fractures could increase the discriminative ability of fracture risk prediction tools...
June 20, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Aditya V Karhade, John Y Kwon
BACKGROUND: While investigations have been performed examining the quality of US-based cost-utility analyses for other orthopaedic subspecialties and have provided important insights, a similar analysis has not been performed examining the foot and ankle literature. METHODS: A systematic review of foot and ankle studies was conducted to identify cost-utility analyses published between 2000 and 2017. Of 687 studies screened by abstract, 4 cost-utility studies were identified and scored by the Quality of Health Economic Studies instrument...
June 1, 2018: Foot & Ankle Specialist
Sander van Hoeve, Michael Houben, Jan P A M Verbruggen, Paul Willems, Kenneth Meijer, Martijn Poeze
Ankle fractures are among the most common lower limb fractures. Associations between postoperative radiographic results and clinical outcome have been found, but less is known about the relevant ankle biomechanics. This study analysed ankle kinematics, radiographic findings and patient-reported outcome measures (PROM) in patients treated for ankle fractures. The hypothesis was that patients after ankle fracture surgery had less flexion/extension in the ankle compared to healthy subjects and that fracture severity had significant influence on kinematics and patient satisfaction...
June 19, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Abdel-Salam A Ahmed, Mohammed S Singer, Hossam A El Bigawi
OBJECTIVES: To evaluate the outcomes of neglected pilon fractures treated by the Ilizarov fixator and to determine whether this technique was successful in avoiding an ankle arthrodesis. DESIGN: Retrospective case series. SETTING: Level I university trauma center. PATIENTS: Between January 2003 and March 2015, 18 patients (mean age of 42.17 years) with an untreated pilon fracture with late presentation (>1 month) were evaluated...
July 2018: Journal of Orthopaedic Trauma
Sam Peeperkorn, Stefaan Nijs, Harm Hoekstra
The reference standard treatment of unstable AO type 44-B ankle fractures is open reduction and internal fixation. However, delayed-staged surgery because of compromised soft tissues results in prolonged hospitalization and increased total healthcare costs in the elderly (age ≥65 years). The aim of the present study was to measure the efficiency of intramedullary fibular nailing (IMFN) in the elderly. A prospective series of 15 elderly patients with an AO type 44-B ankle fracture treated with IMFN were compared with a retrospective cohort of 97 elderly patients treated with plate and screw osteosynthesis (PSOS)...
June 15, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
C van den Berg, T Haak, N L Weil, J M Hoogendoorn
BACKGROUND: In general, stable type B ankle fractures are treated conservatively with cast immobilization or a walking boot during six weeks. Some disadvantages of casting are joint stiffness, muscle wasting and lack of comfort. This study was designed to evaluate whether functional treatment with a removable brace is a safe and more comfortable alternative. MATERIAL AND METHODS: Randomized controlled trial. In the period March 2013 - May 2015, 44 patients visiting the emergency department due to a stable type B ankle fracture were included...
June 4, 2018: Injury
Henriette Bretschneider, Stefan Rammelt
Combined fractures of the talar body and the adjacent bones are rare. We present a case of a 35-year-old male with a complex foot and ankle trauma resulting in an unusual combined ipsilateral fracture of the anterolateral tibial plafond, talar body, and sustentaculum tali of the calcaneus. To the best of our knowledge, this particular combination of fractures has not yet been reported in the literature. The combination of talar body fracture with fractures of the adjacent bones was treated by a bilateral open reduction with anatomic reconstruction of the joint surfaces resulting in an excellent clinical outcome at 4-year followup...
May 2018: Indian Journal of Orthopaedics
Bilgehan Tosun, Ozgur Selek, Umit Gok, Halil Ceylan
Background: In ankle fractures involving the posterior malleolus, the issue of which types of fractures require posterior malleolus fixation is still controversial. Recent studies have demonstrated that trimalleolar fractures adversely affect the functional outcomes in comparison to bimalleolar fractures of the lateral and medial malleolus. The purpose of this study was to assess the effects of posterior malleolus fixation on the functional and radiological outcomes. Materials and Methods: Reduction quality, development of posttraumatic ankle osteoarthritis, and functional outcomes in 49 consecutive trimalleolar ankle fractures were evaluated retrospectively in patients with and without posterior malleolus fixation...
May 2018: Indian Journal of Orthopaedics
S R Sundararajan, Abdul Azeem Badurudeen, R Ramakanth, Shanmuganathan Rajasekaran
Fractures of talar body are uncommon injuries often associated with fractures of other long bones and in polytraumatized patients. The integrity of the talus is essential for the normal function of the ankle, subtalar, and midtarsal joints. The relative infrequency of this injury limits the number of studies available to guide treatment. They occur as a result of high-velocity trauma and are therefore associated with considerable soft tissue damage. Axial compression with supination or pronation is the common mechanism of injury...
May 2018: Indian Journal of Orthopaedics
Mandeep Dhillon, Ankit Khurana, Sharad Prabhakar, Siddharth Sharma
The anterior end of calcaneum fractures can present as inversion injuries, stress fractures or as a part of displaced intraarticular calcaneum fracture. Rarely, these may occur due to abduction injury from a laterally directed force that crushes the anterior calcaneum instead of the cuboid, and has associated medial column injuries which are unrecognized. Compression fractures of the anterior calcaneum are actually lateral column shortening injuries with poor outcomes in the few published reports. We describe three patients with compression fractures of the anterior end of calcaneum resulting from foot abduction injury which were managed by reduction and column length restoration via distraction by external fixator...
May 2018: Indian Journal of Orthopaedics
Dror Lakstein, Alexander Bermant, Evgeny Shoihetman, David Hendel, Zeev Feldbrin
Background: Conventionally, the extended lateral approach (ELA) served as the standard extensile approach for intraarticular calcaneal fracture fixation. However, this approach has a high rate of wound complications. The purpose of this study was to describe an alternative approach, the posteriorlateral approach (PLA) and compare it to the ELA regarding soft tissue complications and functional outcome. Materials and Methods: 32 patients operated through PLA and 66 patients treated through ELA were included in this retrospective study...
May 2018: Indian Journal of Orthopaedics
Sharad Prabhakar, Mandeep S Dhillon, Ankit Khurana, Rakesh John
Background: Minimally invasive surgery (MIS) has a significant and evolving role in the treatment of displaced intra articular calcaneal fractures (DIACFs), but there is limited literature on this subject. The objective was hence to assess the clinicoradiological outcomes of DIACFs fixed with an innovative open-envelope MIS technique. Materials and Methods: 42 closed Sanders Type 2 and 3; DIACFs were included in this study. The Open-envelope approach was developed, which is essentially a limited open, dual incision, modified posterior longitudinal approach allowing excellent visualisation and direct fragment manipulation...
May 2018: Indian Journal of Orthopaedics
Renata R Almeida, Mohammad Mansouri, David K Tso, Anne H Johnson, Michael H Lev, Ajay K Singh, Efren J Flores
PURPOSE: Radiography has a low sensitivity for the detection of fractures related to the talonavicular and calcaneocuboid articulations, also known as Chopart fractures. The purpose of this study is to determine the sensitivity of radiographs for detecting additional foot and ankle fractures related to Chopart fracture using CT or MRI as the reference standard. METHOD: We performed an IRB-approved, retrospective review of radiology reports between 2010 and 2014...
June 6, 2018: Emergency Radiology
Anna Ekwall, Eva Carlberg, Gunilla Palmberg, Rut Sloberg
Patients of all ages present to the Emergency Department (ED) with fractures that require immobilization using a cast. Various casting materials are used, all with advantages and disadvantages and there are considerable risks associated with fracture management using cast immobilization. The frequency and severity of complications from fiberglass or hybrid casts applied in the emergency setting has not previously been studied. The aim of this audit was to describe all the complications that occurred within 30 days in patients who had a fiberglass cast applied for immobilization of uncomplicated, non-angulated fractures of the foot, ankle or forearm...
June 1, 2018: International Journal of Orthopaedic and Trauma Nursing
Quirine M J van der Vliet, Falco Hietbrink, Fabio Casari, Luke P H Leenen, Marilyn Heng
BACKGROUND: Subtalar arthrodesis is a common salvage operation for posttraumatic subtalar arthritis. This study aimed to identify factors associated with functional outcomes and quality of life after subtalar fusion for posttraumatic subtalar arthritis after calcaneal fracture. METHODS: This is a retrospective study with follow-up by questionnaire in two level 1 trauma centers. Patients who underwent subtalar arthrodesis for posttraumatic arthritis after a calcaneal fracture between 2001 and 2016 were identified and contacted for completion of a survey consisting of the Foot and Ankle Ability Measure (FAAM), Maryland Foot Score (MFS), Patient-Reported Outcomes Measurement System Physical Function (PROMIS PF, Short Form 10a) questionnaire, EuroQol 5-dimensional (EQ-5D) questionnaire, and EuroQol visual analog scale (EQ-VAS)...
June 1, 2018: Foot & Ankle International
Giovanni Lovisetti, Alexander Kirienko, Charles Myerson, Ettore Vulcano
BACKGROUND: Nonunions of the distal tibia in close proximity to the ankle joint can be a challenge to treat. The purpose of this study was to evaluate radiographic and clinical outcomes of patients who underwent ankle-sparing bone transport for periarticular distal tibial nonunions. METHODS: Twenty-one patients underwent ankle-sparing bone transport between January 2006 and July 2016. The mean age of the patients was 48.6 years, and 71% (15/21) were male. Patients were followed for an average of 14...
June 1, 2018: Foot & Ankle International
Weixiang Shi, Xiaozhong Luo, Gang Wu, Yong Ding, Xin Zhou
Objective: To explore the effectiveness and advantage of three-dimensional (3D) printing technology in treatment of internal or external ankle distal avulsed fracture. Methods: Between January 2015 and January 2017, 20 patients with distal avulsed fracture of internal or external ankle were treated with the 3D guidance of shape-blocking steel plate fixation (group A), and 18 patients were treated with traditional plaster external fixation (group B). There was no significant difference in gender, age, injury cause, disease duration, fracture side, and fracture type between 2 groups ( P >0...
February 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Rongliang Yan, Jiafu Qu, Lihai Cao, Hongda Liu, Jianghua Chen, Yan Gao, Yi Peng
Objective: To summarize the effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture. Methods: Between January 2011 and October 2016, 25 cases with comminuted Jones fracture were treated with mini locking plate combined with Kirschner wire. There were 9 males and 16 females with an average age of 31.4 years (range, 16-66 years). The fractures located on the left side in 11 cases and on the right side in 14 cases...
May 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Zhenhui Sun, Chengli Zhao, Yifei Chen, Nan Li, Tao Zhang, Jingyi Xin, Xinlong Ma
Objective: To investigate the anatomical characters of the sustentaculum tali (ST), accurate entry point and direction for the placement of ST screw from posterior subtalar joint facet to the constant fragment (CF) in calcaneal fractures. Methods: A total of 100 patients with calcaneal fractures performed ankle CT scans were enrolled between January 2016 and April 2016. According to the inclusion criteria, the clinical data of 33 patients were analyzed, including 18 males and 15 females, with a median age of 41...
May 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
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