Introduction: Diagnosis and treatment of ankle medial ligament lesions in malleolar fractures has always been a matter of controversy. Even when deltoid involvement is clear, the direct repair of this structure is not a consensus. Recently, deltoid repair through an arthroscopic technique was described aiming to potentialize better clinical results and minimize complications.
Objective: Demonstrate safety and functional results on patients with ankle fractures submitted to open reduction and internal fixation and arthroscopic deltoid repair.
Methods: This is a retrospective study in patients diagnosed with ankle fractures associated with acute deltoid injuries submitted to open malleolar fixation and deltoid arthroscopic repair between June 2016 and January 2020. All patients were evaluated for pain and functionality according to the Visual Analogue Scale (VAS) and the American Orthopedic Foot and Ankle Society Score (AOFAS) at a minimum of 6 months follow-up.
Results: From January 2016 to January 2020, 20 ankles with fractures or dislocations were operated and the deltoid ligament rupture was repaired arthroscopically. A mean follow-up of 14.45 months (6-48) was observed, and patients presented an average AOFAS of 93.5 (SD 7.25) and a VAS of 0.75 (SD 1.05). Three minor complications were noticed and no signs of medial chronic instability, loss of reduction or osteoarthritis were observed.
Discussion: The repair of the deltoid complex and the low morbidity of the arthroscopic technique used may improve the clinical outcomes of these patients. Additional studies, with a prospective and comparative methodology are required to sustain this proposal.
Design: Level IV. Retrospective case series.
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http://dx.doi.org/10.1016/j.injury.2021.06.020 | DOI Listing |
JBJS Case Connect
January 2025
Department of Orthopaedics, Mass General Brigham, Boston, Massachusetts.
Case: A 51-year-old male polytrauma patient presented with bilateral calcaneus fractures after a fall. This report describes treatment of his right comminuted Sanders IV calcaneus fracture with percutaneous open reduction internal fixation (ORIF) and minimally invasive surgery (MIS) primary subtalar fusion to restore alignment and preserve soft tissue.
Conclusion: Unlike traditional open approaches, which are prone to wound complications due to larger incisions, our approach of maintaining fracture alignment during joint preparation using an MIS burr for acute posttrauma subtalar arthrodesis and percutaneous ORIF appears to have reduced these risks, resulting in successful radiological healing and functional recovery at 1-year follow-up.
Eur J Trauma Emerg Surg
January 2025
Department of Trauma Surgery, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
Purpose: The aim was to assess the long-term functional outcome and quality of life after staged surgical treatment of complex Lisfranc and Chopart injuries in a patient cohort, and to perform a systematic review of the literature.
Methods: A retrospective cohort of all trauma patients with complex Lisfranc and/or Chopart injuries treated at our level 1 trauma center between July 1, 2010, and July 1, 2020 with ≥ 3 years follow-up was analyzed in terms of management, complications, and patient-reported outcomes (American Orthopaedic Foot & Ankle Society midfoot score, AOFAS and Foot Function Index, FFI). A systematic review of the literature (according to PRISMA 2020 guidelines) was performed of studies published between January 2000 to April 2024.
Expert Rev Hematol
January 2025
Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Objective: Deep vein thrombosis (DVT) is a known complication of fractures. This study aimed to explore the genetic causal relationship between DVT and fracture sites.
Research Design And Methods: The exposures analyzed in this study included fracture of femur (FFE), fracture of lower leg, including ankle (FLLA), fracture of shoulder and upper arm (FSUA), fracture of forearm (FFO), fracture of rib, sternum and thoracic spine (FRSTS) and fracture of lumbar spine and pelvis (FLSP).
Foot Ankle Int
January 2025
University Center for Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus at TU Dresden, Dresden, Germany.
Background: Bosworth fractures (BFs) with entrapment of a fibular fragment behind the posterior malleolus (PM) are rare but potentially serious injuries to the ankle. Despite an increased awareness through a more regular use of computed tomography (CT) scanning, there is still a scarcity of clinical outcome studies.
Methods: Over a course of 25 years, data on 23 patients treated for BF at our institutions (mean age 44 years) were collected prospectively.
The aim of the study was to compare the outcomes of bone transport in treating upper- middle vs. lower- middle tibial bone defects. Sixty-two patients with tibial infected large segmental defects treated by bone transport were analyzed retrospectively and divided into distal group (lower- middle tibial bone defects and proximal transport, n=38) and proximal group (upper- middle tibial bone defects and distal transport, n=24).
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