Should the location of distal tibial plating be influenced by the varus or valgus fracture pattern of tibial pilon fracture?

Introduction: Operative treatment of tibial pilon fracture is challenging. There is a lack of consensus and only one clinical study on the optimal location of distal tibial plating for fixation of pilon fractures based on varus or valgus fracture patterns. We hypothesize that complications rates, specifically mechanical complications, are not influenced by the location of the tibial plating in the fixation of pilon fractures with respect to varus or valgus fracture patterns.

Biomechanical analysis of proximal tibia bone grafting and the effect of the size of osteotomy using a validated finite element model.

Harvesting bone graft from the proximal tibia is gaining popularity, with lower complication rates and adequate quantity of cancellous bone. The amount of harvested bone is dependent on the size of the cortical window introduced via osteotomy onto the proximal tibia, and its mechanical strength after surgery could be compromised. The aim of the study was to investigate the proximal tibia's mechanical stability after bone harvesting and the effect of varying window sizes using a validated finite element model.

Anatomic Basis for Minimally Invasive Flexor Hallucis Longus Transfer in Chronic Achilles Tendon Rupture.

The present cadaveric study was designed to measure the flexor hallucis longus (FHL) tendon length and obtain anatomic data regarding the graft-to-tunnel length ratio in an interference screw fixation model for the FHL short-harvest single-incision technique to the calcaneus. Ten fresh-frozen paired cadaveric specimens were used for the FHL short-harvest technique. The length of the osseous tunnel in the calcaneus was measured.

Suture Anchor Fixation for Fifth Metatarsal Tuberosity Avulsion Fractures: A Case Series and Review of Literature.

Fifth metatarsal tuberosity avulsion fractures are common. Despite good outcomes with nonoperative treatment, acute fractures with displacement, intra-articular involvement, comminution, or painful nonunion have been reported to benefit from early open reduction and internal fixation, especially in athletes. No consensus has been reached regarding the best surgical fixation technique.

A biomechanical study of proximal tibia bone grafting through the lateral approach.

Background: Autologous bone graft remains the gold standard source of bone graft. Iliac crest has traditionally been the most popular source for autologous bone graft. However, iliac crest bone graft harvesting is associated with high donor site morbidity.

Forklift-Related Crush Injuries of the Foot and Ankle.

Background: Forklift-related crush injuries of the foot and ankle are relatively common in cities with shipping and construction industries. There is a paucity of literature on the incidence and sequelae of such injuries. We aimed to describe the incidence, patterns of injuries, sequelae, and morbidity associated with this type of injury.

Doctor, I sprained my ankle.

Ankle sprains constitute the majority of ankle injuries, and result in pain, limited mobility/exercise and loss of school/work days. Ankle sprains involve at least one of the ankle ligaments and range from a micro tear to complete tear of the ligament or group of ligaments. The most common mechanism of ankle sprains is inversion stress of a plantar-flexed foot, while the most frequently injured ligament is the anterior talofibular ligament.

Use of a definitive cement spacer for simultaneous bony and soft tissue reconstruction of mid- and hindfoot diabetic neuroarthropathy:a case report.

The prevalence of diabetes mellitus has been increasing, and ≤25.8 million people, or 8.3% of the US population, have diabetes.

Osteomyelitis after TightRope(®) fixation of the ankle syndesmosis: a case report and review of the literature.

Fixation of ankle syndesmosis injuries using the Ankle TightRope(®) has been gaining popularity. It has been shown to produce good results, facilitate early weightbearing, reduce the need for implant removal, and allow an earlier return to work and, possibly, a more anatomic syndesmotic reduction compared with screw fixation. However, its usage has been associated with complications such as soft tissue irritation, infection and wound breakdown, suture-button subsidence, and pathologic fracture from the screw tract.

Impact of trimalleolar ankle fractures: how do patients fare post-operatively?

Background: We aim to evaluate the clinical and functional outcome of trimalleolar fractures and the ability of patients to return to sporting activities.

Methods: A retrospective review of 31 patients with operatively managed trimalleolar fractures was conducted. Their Olerud and Molander scores and ability to return to sports was analyzed at 1 year postoperatively.

The Anatomic Pattern of Injuries in Acute Inversion Ankle Sprains: A Magnetic Resonance Imaging Study.

Background: There are little data on the incidence and patterns of injuries seen on magnetic resonance imaging (MRI) in acute inversion ankle sprains. This study may help in the understanding of the pathomechanics, natural history, and outcomes of this common injury.

Study Design: Case series; Level of evidence, 4.

A useful surgical technique for retrieval of a broken guide pin in the midfoot.

Perioperative instrument breakage is not an infrequent occurrence, even for experienced surgeons. The most commonly reported instrument breaks in orthopedic procedures are drill bits, followed by Kirschner wires and cannulated guide pins. The reasons for failure include improper technique and repetitive use.

Ankle arthrodesis vs TTC arthrodesis: patient outcomes, satisfaction, and return to activity.

Background: It is believed that patients with an ankle arthrodesis (AA) have better outcomes than after a tibiotalocalcaneal (TTC) arthrodesis due to preservation of subtalar motion. However, there are no studies comparing actual functional outcomes and patient satisfaction between AA and TTC arthrodesis.

Methods: We retrospectively analyzed patient satisfaction and functional outcomes of patients after an AA and TTC arthrodesis using a postal survey.

Functional outcome and limitation of sporting activities after bimalleolar and trimalleolar ankle fractures.

Background: Ankle fractures are extremely common. However, the outcomes of operatively treated bimalleolar and trimalleolar ankle fractures remain unclear. We aimed to evaluate and compare the functional outcomes of operatively treated bimalleolar versus trimalleolar ankle fractures and the ability of patients to return to sporting activities.

A modified suture technique for fixation of the Akin osteotomy.

The Akin osteotomy is a frequently performed medial closing wedge osteotomy of the proximal phalanx of the hallux. It is usually used as a complimentary procedure in the correction of hallux valgus. Various implants and techniques have been described for fixation.

Planning correction of the varus ankle deformity with ankle replacement.

Ankle replacement in the presence of a varus deformity is an evolving field. Although the initial results were disappointing, numerous advances in the understanding of the condition and operative techniques have been made. More recent reports show good short-term results, especially when adjunctive procedures are combined, not only to achieve a neutral alignment but also the restore lateral ligamentous stability.

The natural history of adolescent idiopathic scoliosis.

There have been great advances in the conservative and surgical treatment for adolescent idiopathic scoliosis in the last few decades. The challenge for the physician is the decision for the optimal time to institute therapy for the individual child. This makes an understanding of the natural history and risk factors for curve progression of significant importance.

Curve progression in idiopathic scoliosis: follow-up study to skeletal maturity.

Study Design: This is a follow-up study to skeletal maturity on a cohort of students screened for a 1-year prospective epidemiological prevalence study for scoliosis.

Objectives: This study aims to identify the prognostic factors for curve progression to a magnitude of 30 degrees at skeletal maturity in skeletally immature patients with adolescent idiopathic scoliosis.

Summary Of Background Data: The natural history of idiopathic scoliosis is not well understood.

Effects of corticosteroids on nerve root recovery after spinal nerve root compression.

Corticosteroids have been used in the treatment of radiculopathy and postoperative pain after lumbar disc surgery. Although the effects of steroids are thought to be antiinflammatory, the underlying nature of action may be more complex and may involve a direct effect on pain mediators like substance P. A feline model of nerve root compression and decompression was used to study the effect of steroids on the expression of cytokine differentiation antigens 4 and 5, and substance P.