Role of the posterior deep deltoid ligament in ankle fracture stability: A biomechanical cadaver study.

Background: The deltoid ligament is a key component of ankle fracture stability. Clinical tests to assess deltoid ligament injury have low specificity. In supination external-rotation (SER) type-IV ankle fractures, there is either a medial malleolus fracture or deltoid ligament injury.

A voluntary activation deficit in m. abductor hallucis exists in asymptomatic feet.

M. abductor hallucis (AbH) is the strongest intrinsic foot muscle and its dysfunction underlies various foot disorders. Attempts to strengthen the muscle by voluntary exercises are constrained by its complex morphology and oblique mechanical action, which leads to an inability even in asymptomatic individuals to fully activate AbH.

Direct muscle electrical stimulation as a method for the in vivo assessment of force production in m. abductor hallucis.

In vivo assessment of the force-generating capacity of m. abductor hallucis (AbH) is problematic due to its combined abduction-flexion action and the inability of some individuals to voluntarily activate the muscle. This study investigated direct muscle electrical stimulation as a method to assess isometric force production in AbH about the 1st metatarsal phalangeal joint (1MPJ) at different muscle-tendon lengths, with the aim of identifying an optimal angle for force production.

Trampoline Park Injuries and Their Burden on Local Orthopaedic and Emergency Services.

Objective: To investigate the incidence of trampoline park injuries (TPIs) at a local recreational facility and to quantify the burden on emergency and orthopaedic services at our institute.

Methods: All patients that presented to the Emergency Department (ED) from the trampoline park via ambulance from July 2014 to November 2015 were included in the study. Patients' medical records were reviewed for clinical details including date, location and type of injury, treatment received, length of stay and outpatient follow-up.

Midterm Outcomes of a Synthetic Cartilage Implant for the First Metatarsophalangeal Joint in Advanced Hallux Rigidus.

Background:: A prospective, randomized, noninferiority clinical trial of synthetic cartilage implant hemiarthroplasty for hallux rigidus demonstrated functional outcomes and safety equivalent to first metatarsophalangeal (MTP) joint arthrodesis at 24 months. We prospectively assessed safety and efficacy outcomes for synthetic cartilage implant hemiarthroplasty at a minimum of 5 years.

Methods:: Of 135 eligible patients from the original trial, 112 (83.

Wide-pulse, high-frequency, low-intensity neuromuscular electrical stimulation has potential for targeted strengthening of an intrinsic foot muscle: a feasibility study.

Background: Strengthening the intrinsic foot muscles is a poorly understood and largely overlooked area. In this study, we explore the feasibility of strengthening . abductor hallucis (AH) with a specific paradigm of neuromuscular electrical stimulation; one which is low-intensity in nature and designed to interleave physiologically-relevant low frequency stimulation with high-frequencies to enhance effective current delivery to spinal motoneurones, and enable a proportion of force produced by the target muscle to be generated from a central origin.

Treatment of first metatarsophalangeal joint arthritis using hemiarthroplasty with a synthetic cartilage implant or arthrodesis: A comparison of operative and recovery time.

Background: First metatarsophalangeal joint (MTPJ1) hemiarthroplasty using a novel synthetic cartilage implant was as effective and safe as MTPJ1 arthrodesis in a randomized clinical trial. We retrospectively evaluated operative time and recovery period for implant hemiarthroplasty (n=152) and MTPJ1 arthrodesis (n=50).

Methods: Perioperative data were assessed for operative and anaesthesia times.

Cadaveric experiments to evaluate pressure wave generated by radial shockwave treatment of plantar fasciitis.

Background: Shockwave treatment is increasingly used for plantar fasciitis and Achilles tendinopathy. To be effective it is believed that high pressure must be achieved in the tissues. We report on the first human cadaveric experiments to characterize pressure from radial shockwave therapy (rSWT) for plantar fasciitis.

Correlation of Hallux Rigidus Grade With Motion, VAS Pain, Intraoperative Cartilage Loss, and Treatment Success for First MTP Joint Arthrodesis and Synthetic Cartilage Implant.

Background: Grading systems are used to assess severity of any condition and as an aid in guiding treatment. This study examined the relationship of baseline motion, pain, and observed intraoperative cartilage loss with hallux rigidus grade.

Methods: A prospective, randomized study examining outcomes of arthrodesis compared to synthetic cartilage implant was performed.

Association Between Patient Factors and Outcome of Synthetic Cartilage Implant Hemiarthroplasty vs First Metatarsophalangeal Joint Arthrodesis in Advanced Hallux Rigidus.

Background: We evaluated data from a clinical trial of first metatarsophalangeal joint (MTPJ1) implant hemiarthroplasty and arthrodesis to determine the association between patient factors and clinical outcomes.

Methods: Patients ≥18 years with hallux rigidus grade 2, 3, or 4 were treated with synthetic cartilage implant MTPJ1 hemiarthroplasty or arthrodesis. Pain visual analog scale (VAS), Foot and Ankle Ability Measure (FAAM) sports and activities of daily living (ADL) scores, and Short Form-36 Physical Function (SF-36 PF) subscore were obtained preoperatively, and at 2, 6, 12, 24, 52, and 104 weeks postoperatively.

Syndesmosis Stabilisation: Screws Versus Flexible Fixation.

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.

Prospective, Randomized, Multi-centered Clinical Trial Assessing Safety and Efficacy of a Synthetic Cartilage Implant Versus First Metatarsophalangeal Arthrodesis in Advanced Hallux Rigidus.

Background: Although a variety of great toe implants have been tried in an attempt to maintain toe motion, the majority have failed with loosening, malalignment/dislocation, implant fragmentation and bone loss. In these cases, salvage to arthrodesis is more complicated and results in shortening of the ray or requires structural bone graft to reestablish length. This prospective study compared the efficacy and safety of this small (8/10 mm) hydrogel implant to the gold standard of a great toe arthrodesis for advanced-stage hallux rigidus.

Finite element modelling of radial shock wave therapy for chronic plantar fasciitis.

Therapeutic use of high-amplitude pressure waves, or shock wave therapy (SWT), is emerging as a popular method for treating musculoskeletal disorders. However, the mechanism(s) through which this technique promotes healing are unclear. Finite element models of a shock wave source and the foot were constructed to gain a better understanding of the mechanical stimuli that SWT produces in the context of plantar fasciitis treatment.

Posterior ankle and hind foot arthroscopy - how do you responsibly learn this new technique?

Posterior ankle and hind foot arthroscopy has become an important diagnostic and therapeutic tool when dealing with ankle pathology. Although not yet widely adopted it is gaining popularity and there have been various descriptions of the technique [1] and its outcomes [2,3]. With posterior arthroscopy there are well-documented risks of injury to the sural nerve and medial neurovascular bundle in particular [7-9].

Gastrocnemius shortening and heel pain.

Pain and reduced function caused by disorders of either the plantar fascia or the Achilles tendon are common. Although heel pain is not a major public health problem it affects millions of people each year. For most patients, time and first-line treatments allow symptoms to resolve.

Nonunion of fifth metatarsal fractures.

Metatarsal fractures are those most frequently encountered in the foot. More than half of these are of the 5th metatarsal. The incidence is increasing, along with the activity levels of the general population.

Periprosthetic supracondylar femoral fractures above a total knee replacement: compatibility guide for fixation with a retrograde intramedullary nail.

The incidence of total knee arthroplasty (TKA) is increasing, as are periprosthetic supracondylar femoral fractures. Treatment is complex and may involve the use of a retrograde intramedullary femoral nail, and it is essential to know the nail will fit through the femoral prosthesis in line with the intramedullary canal. Knowledge of certain measurements is crucial i.

Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs.

Background: Plantar fasciitis is the most common cause of heel pain. It may remain symptomatic despite conservative treatment with orthoses and analgesia. There is conflicting evidence concerning the role of extracorporeal shock wave therapy (ESWT) in the management of this condition.