Anatomical and Micro-CT Assessment of the First Metatarsal Head Vascularization and Soft Tissue Envelope Following Minimally Invasive Chevron Osteotomy for Hallux Valgus Deformity.

Background: Minimally invasive surgical (MIS) chevron-type osteotomy for hallux valgus (HV) treatment offers a surgical alternative to open surgery with minimal surgical dissection and a hypothetical decreased risk for soft tissue complications. The objectives of this study were to assess the incidence of injuries to the soft tissue envelope and to the blood supply of the first metatarsal head through gross dissection and, using micro-computed tomography (micro-CT), to identify the safe position to perform the MIS chevron-type osteotomy of the first metatarsal head based on the anatomical data.

Methods: Twenty cadaveric specimens with HV were used for the study.

Research Toward Understanding the Benefits and Limitations of Orthotic Use To Improve Mobility and Balance for Individuals With Neuropathic Conditions.

Background: Walking is a vital activity often compromised in individuals with neuropathic conditions. Charcot-Marie-Tooth (CMT) disease and Cerebral Palsy (CP) are two common neurodevelopmental disabilities affecting gait, predisposing to the risk of falls. With guiding scientific evidence limited, there is a critical need to better understand how surgical correction affects mobility, balance confidence, and gait compared to ankle foot orthosis (AFO) bracing.

Timolol in the treatment of hard-to-heal wounds: a comprehensive review.

Objective: The aims of this study were to ascertain the effectiveness and safety of the off-label use of topical timolol as an adjunct treatment for hard-to-heal (chronic) wounds. Furthermore, to review and analyse the existing literature regarding the use of topical timolol on wounds of varying aetiologies.

Method: A systematic review of literature in the English language published between May 1961-May 2021 on the application of topical timolol for hard-to-heal wounds in adults was performed.

A 10-Year Review of Designated Leadership Positions of the American Orthopaedic Foot & Ankle Society (AOFAS).

Background: In 2019 the majority of US medical students were women (50.5%). However, despite this representation, female representation within orthopaedic surgery remains low when compared to male counterparts.

The First Tarsometatarsal Joint in Lisfranc Injuries.

Background: Lisfranc injuries are among the most debilitating injuries to the foot. Characterization of first tarsometatarsal (TMT) joint involvement in Lisfranc injuries is limited. Multiple studies have indicated that this joint is damaged in a variety of Lisfranc injury patterns, but there is sparse information regarding how often and in what form.

Factors Associated With Nonunion and Infection Following Ankle Arthrodesis Using a Large Claims Database: Who Has Elevated Risk?

Background: Complications such as nonunion and infection following ankle arthrodesis can lead to increased patient morbidity and financial burden from repeat operations. Improved knowledge of risk factors can improve patient selection and inform post-ankle arthrodesis surveillance protocols.

Methods: This is a large retrospective, database study with structured query of a national insurance claims database (PearlDiver Technologies) for patients treated with ankle arthrodesis from 2015 to 2019 as identified by (), codes.

The Prevalence of Metabolic and Endocrine Disturbances on Fracture Nonunion.

Objective: This study aims to determine the prevalence of metabolic disturbance in all fracture nonunion cases and identify the most common endocrine abnormalities seen using a simple screening algorithm.

Methods: A retrospective review study was performed evaluating patients who underwent operative intervention for nonunion from January 2010 to December 2018 at 2 level-1 trauma centers. Preoperative laboratory values were recorded for a 9-test "nonunion panel.

Modified Lapidus vs Scarf Osteotomy Outcomes for Treatment of Hallux Valgus Deformity.

Background: The Lapidus procedure and scarf osteotomy are indicated for the operative treatment of hallux valgus; however, no prior studies have compared outcomes between the procedures. The aim of this study was to compare clinical and radiographic outcomes between patients with symptomatic hallux valgus treated with the modified Lapidus procedure versus scarf osteotomy.

Methods: This retrospective cohort study included patients treated by 1 of 7 fellowship-trained foot and ankle surgeons.

Influence of Complications and Revision Surgery on Fulfillment of Expectations in Foot and Ankle Surgery.

Background: Fulfillment of patients' expectations following foot and ankle surgery has been previously studied, and shown to be an effective modality in assessing patient-reported outcomes (PROs). Although this assessment has been shown to correlate well with patient satisfaction and other validated PROs, the impact of postoperative complications on fulfillment of expectations is unknown. The aim of this study is to therefore investigate the impact of postoperative complications on fulfillment of patients' expectations.

Comparison Between Polyvinyl Alcohol Implant and Cheilectomy With Moberg Osteotomy for Hallux Rigidus.

Background: In 2016, the US Food and Drug Administration (FDA) approved the use of a polyvinyl alcohol (PVA) hydrogel implant for the surgical management of hallux rigidus. Though recent studies have evaluated the safety and efficacy of the implant, no study has compared outcomes following PVA implantation with those following traditional joint-preserving procedures for hallux rigidus, such as cheilectomy with Moberg osteotomy. The purpose of this study was to compare clinical and patient-reported outcomes for patients undergoing cheilectomy and Moberg osteotomy, with or without PVA implant, at a single multisurgeon academic center.

Outcomes of Polyvinyl Alcohol Hydrogel Implant of the Lesser Metatarsals.

Background: Lesser toe metatarsophalangeal (MTP) joint pathology presents a challenge for surgical treatment. At our institution, arthroplasty using a polyvinyl alcohol (PVA) hydrogel implant has been utilized in the second and third MTP joints for advanced arthritis, failed management of Freiberg's infraction, and osteochondral defects. We present a case series describing the clinical outcomes of 13 patients following PVA implantation of the second or third MTP.

Relationship Between Posterior-Inferior Tibial Slope and Bilateral Noncontact ACL Injury.

Is there a correlation between increased posterior-inferior tibial slope angle and noncontact anterior cruciate ligament (ACL) injury? Does increasing the posterior-inferior tibial slope angle increase the risk of bilateral ACL injury? A computerized relational database (Access 2007; Microsoft Inc, Redmond, Washington) was used to conduct a retrospective review of patients undergoing bilateral or unilateral ACL reconstruction surgery or treatment by a single surgeon between 1995 and 2013. Included in the study were patients with bilateral and unilateral ACL injuries and patellofemoral pain syndrome with no associated ACL deficiency. Exclusion criteria included concomitant ligament injury, previous ACL reconstruction, and previous knee surgery.

Safety and Short-Term Complication Rates Using Single-Puncture T-Fastener Gastropexy.

Purpose: To report a single operator's experience using a modified single-puncture gastrostomy technique deploying up to three nonabsorbable gastropexy anchors.

Materials And Methods: A retrospective review of 69 consecutive patients undergoing gastrostomy, gastrojejunostomy, or jejunostomy tube insertion between March 2012 and January 2014 was performed. Technical success and 30-day local, major, and minor complication rates were assessed according to the Society of Interventional Radiology (SIR) Standards of Practice for Gastrointestinal Access.

Enhancing pedicle screw fixation in the lumbar spine using allograft bone plug interference fixation.

Study Design: A within-subjects controlled laboratory study.

Objective: To examine a biological alternative to cement augmentation for pedicle screw fixation comparing bilateral axial pullout tests of augmented and nonaugmented (controls) pedicle screws.

Summary Of Background Data: Fixation in the osteoporotic spine remains a difficult challenge with failure by loosening or backout.

Small is challenging; distal femur fracture management in an elderly lady with achondroplastic dwarfism.

Achondroplasia is an autosomal dominant dwarfing condition that represents the most common form of skeletal dysplasia. The disease is caused by a mutation in the gene encoding fibroblast growth factor receptor 3 (FGFR3) found at the p16.3 locus on chromosome 4 which results in severe inhibition of subchondral bone growth.