Determination of Pathogens in Surgical Site Infections in Ankle Fractures and Implications for Empirical Antibiotic Treatment.

Surgical site infections (SSIs) are the most common complication after surgery for ankle fractures. This retrospective study aimed to determine the pathogens cultured in SSI and their antimicrobial susceptibility patterns to provide a recommendation for empirical therapy. Patients who underwent surgical treatment for an ankle fracture were included.

Computerized Tomography for Diagnosing Traumatic Arthrotomies of the Ankle.

Background: Owing to the risk for septic arthritis, traumatic arthrotomies are an urgent surgical problem for the treating orthopaedic surgeon. Traditionally, diagnosis is with the saline load test (SLT), although in the awake patient is an invasive and potentially painful procedure. While computerized tomography (CT) has been shown to be a reliable diagnostic tool for traumatic arthrotomies of other joints, its role has only recently been investigated in the setting of ankle arthrotomy.

Crossed Screws Versus Plating Supplemented with an Interfragmentary Screw in First Metatarsophalangeal Joint Fusion: A Systematic Review and Meta-Analysis.

First metatarsophalangeal joint (MTPJ) fusion an effective surgical intervention for conditions such as hallux valgus and hallux rigidus. This systematic review and meta-analysis aims to compare safety and efficacy of crossed screws versus plating supplemented with an interfragmentary screw. A literature search of the Scopus, Embase, Web of Science, and MEDLINE databases was performed to identify all studies directly comparing the two techniques.

Rescue of Interfragmentary Compression in Screw Stripping Failures: The Efficacy of NiTiNOL.

Orthopedic screws are widely used to achieve bone reduction, compression, and construct stability. However, the relationship between insertion torque, interfragmentary compression, and fixation strength, especially when comparing standard screws with NiTiNOL/sustained dynamic compression (SDC), has not been thoroughly investigated. This study measured insertion torque, interfragmentary compression, and fixation strength for two types of headed orthopedic devices-standard and SDC-using solid foam bone replicates and cadaver validation.

Handheld dynamometry testing during dialysis: intra and inter-rater reliability study.

Objective: The aim was to assess the intra and inter-rater reliability of the handheld dynamometry testing of lower limb muscles during hemodialysis.

Methods: This is a cross-sectional study including subjects undertaking hemodialysis for at least 3 months. Handheld dynamometer measurements of hip and ankle muscle strength (N) were registered on 4 different occasions, 2 trials by raters A and 2 by raters B, to evaluate the intra and inter-rater reliability.

Preoperative anxiety and depression are associated with poorer patient-reported outcomes following total ankle replacements.

Introduction: It is unclear how pre-operative anxiety/depression affects patient reported outcome measures (PROMs) following total ankle replacements (TAR). We investigated the effects of anxiety/depression on PROMs using the Manchester-Oxford Foot Questionnaire (MOXFQ) following TAR.

Methods: PROMs data for primary TAR patients between 2011 and 2022 were extracted from a single-centre regional registry.

Single-centre, double-blinded, randomised placebo-controlled trial to determine the effect of a 12-week home-based programme of footplate neuromuscular electrical stimulation on walking capacity in people with peripheral artery disease: a protocol for the Foot-PAD trial.

Introduction: Patients with peripheral artery disease (PAD) can experience intermittent claudication, which limits walking capacity and the ability to undertake daily activities. While exercise therapy is an established way to improve walking capacity in people with PAD, it is not feasible in all patients. Neuromuscular electrical stimulation (NMES) provides a way to passively induce repeated muscle contractions and has been widely used as a therapy for chronic conditions that limit functional capacity.

Medial collateral ligament ganglion cyst: a rare cause of medial knee pain.

Ganglion cysts are commonly found in areas of constant mechanical stress such as the joints and tendons of the wrist or hand as well as the anterior aspect of the ankle. In the knee, parameniscal cysts are often encountered secondary to meniscal tears or articular degeneration. Intra-articular ganglion cysts are uncommon and often arise from the cruciate ligaments and are found in the intercondylar notch.

Arterial Stiffness and Subsequent Incidence of CKD and Kidney Function Decline in a Large Longitudinal Community Cohort: The Atherosclerosis in Communities (ARIC) Study.

Rationale & Objective: Arterial stiffness is associated with prevalent chronic kidney disease (CKD). Whether arterial stiffness is prospectively associated with incident CKD is inconclusive.

Study Design: Longitudinal cohort study.

Risk Factors for Postoperative Infection in Patients After Pilon Fracture Fixation.

The combination of high energy fractures, extensive soft tissue trauma, and high infection rates in pilon fractures of the distal tibia have long challenged surgeons. Despite the ample evidence, there is no consensus regarding the factors that may influence postoperative infections following surgical management of these fractures. This study aimed to investigate the risk factors for postoperative infections in patients undergoing surgical management for pilon fractures.

Influence of prosthetic foot selection on walking performance during various load carriage conditions.

Background: Ambulatory individuals with lower limb amputations often face challenges with body support, body propulsion, and balance control. Carrying an infant, toddler, backpack, or other load can exacerbate these challenges and highlights the importance of prescribing the most suitable prosthetic foot. The aim of this study was to examine the influence of five different prosthetic feet on walking performance during various load carriage conditions.

How do neuromuscular characteristics of the peroneal muscles differ in adults with and without chronic ankle instability? A systematic review with meta-analysis.

Background: Chronic ankle instability (CAI) has been associated with neuromuscular control dysfunction, particularly of the peroneal musculature.

Research Question: How do neuromuscular characteristics of the peroneal muscles, including corticospinal excitability, strength, proprioception (force sense) and electromyographic measures differ in individuals with CAI compared to healthy control counterparts aged 18-45?

Methods: A systematic review with meta-analysis was conducted by retrieving relevant articles from electronic databases including EBSCOhost (CINAHL Complete, AMED, SPORTDiscus), Ovid (MEDLINE, Embase), Web of Science, Scopus and Cochrane Library as well as Grey literature sources. The eligibility and methodological quality of the included case-control and cross-sectional studies were assessed by two reviewers.

High mortality among elderly with surgical treated femoral fracture in comparison to other surgical treated lower extremity fractures. A population-based register study from the Danish National Patient Registry.

Background: Proximal femoral fractures has been associated with high mortality risk, while little is known about more distal lower extremity fractures. The aim was to report 30- and 365-days mortality in surgically treated lower extremity fractures in individuals above 65 years.

Materials And Methods: We extracted data from the Danish National Patient Register on all surgically treated lower extremity fracture in the period 1998-2017.

What does the patients' perception of alignment tell us about alignment targets in total knee arthroplasty?

Introduction: Knee alignment significantly impacts the outcome of total knee arthroplasty (TKA). Understanding patient perceptions of their knee alignment in relation to objective measurements is essential to ensure optimal surgical outcomes and to meet patients' expectations. This study reports patients' perception of pre- and postoperative knee alignment in relation to radiographic alignment measurements.

Reconstruction of anterior talofibular ligament and posterior tibiotalar ligament enhance ankle stability after total talus replacement by finite element analysis.

Total talus replacement has been demonstrated to increase ankle instability. However, no studies have explored how to enhance postoperative stability. This study aims to explore the effect of collateral ligament reconstruction on ankle stability by finite element analysis.

Three-Plane Calcaneal Osteotomy With Joint Preservation vs Subtalar Arthrodesis to Treat Painful Calcaneal Fracture Malunions.

Background: Calcaneal fracture malunion (CFM) commonly occurs with multiple pathologic changes and progressive pain and difficulty walking. The purpose of this study was to propose a modified 3-plane joint-preserving osteotomy for the treatment of CFM with subtalar joint incongruence, and to compare its efficacy to subtalar arthrodesis.

Methods: A retrospective comparative analysis of the data of 56 patients with CFM admitted from January 2017 to December 2022 was performed.

A Comprehensive Weightbearing Computed Tomography Study on Patients With Hallux Valgus: Exploring Multiplanar Deformity Interrelationships.

Background: Hallux valgus (HV) is a complex, multiplanar deformity. In this study, we examined the interrelationships between various components of this deformity using weightbearing computed tomography (WBCT). We hypothesized that the severity of traditional axial plane deformities would correlate with malpositioning of the metatarsosesamoid complex, first-ray coronal rotational deformity, and malalignment of the hindfoot and midfoot.

A Comparison of Wound Related Complications Between Intramedullary and Lateral Plate Osteosynthesis After Fibula Osteotomy in the Lateral Approach Total Ankle Replacement.

Background: Total ankle replacement (TAR) has evolved in the last decade from a procedure rife with complication and failure to a promising alternative to arthrodesis. The ability to maintain ankle joint range of motion is showing great promise in patient-reported outcomes, postsurgical pain, as well as long-term sequalae of joint fusion. Although TAR can be performed via either an anterior or lateral approach both with their own sets of benefits and potential complications, the consensus seems to be that one is no better than the other when performed by high-volume surgeons.

An Injectable Oil-Based Depot Formulation of -Acyloxymethyl Prodrug of Ropivacaine for Long-Acting Local Analgesia: Formulation Development and In Vitro/In Vivo Evaluation.

The development of novel long-acting injectables for local anesthetics is necessary to effectively manage the acute postoperative pain. The aim of this study was to prepare an injectable oil-based formulation of ropivacaine (ROP) prodrug (ropivacaine stearoxil, ROP-ST) and to investigate the pharmacokinetics and pharmacodynamics after injectable administration. A novel -acyloxymethyl prodrug of ROP, i.

Identifying the Primary Kinetic Factors Influencing the Anterior-Posterior Center of Mass Displacement in Barbell Squats: A Factor Regression Analysis.

Barbell squats are commonly used in strength training, but the anterior-posterior displacement of the Center of Mass (COM) may impair joint stability and increase injury risk. This study investigates the key factors influencing COM displacement during different squat modes.; Methods: This study recruited 15 male strength training enthusiasts, who performed 60% of their one-repetition maximum (1RM) in the Front Barbell Squat (FBS), High Bar Back Squat (HBBS), and Low Bar Back Squat (LBBS).

Using Inertial Measurement Units and Machine Learning to Classify Body Positions of Adults in a Hospital Bed.

In hospitals, timely interventions can prevent avoidable clinical deterioration. Early recognition of deterioration is vital to stopping further decline. Measuring the way patients position themselves in bed and change their positions may signal when further assessment is necessary.

Biomechanics Parameters of Gait Analysis to Characterize Parkinson's Disease: A Scoping Review.

Parkinson's disease (PD) is characterized by a slow, short-stepping, shuffling gait pattern caused by a combination of motor control limitations due to a reduction in dopaminergic neurons. Gait disorders are indicators of global health, cognitive status, and risk of falls and increase with disease progression. Therefore, the use of quantitative information on the gait mechanisms of PD patients is a promising approach, particularly for monitoring gait disorders and potentially informing therapeutic interventions, though it is not yet a well-established tool for early diagnosis or direct assessment of disease progression.

Are We Ready for Pseudotumors in Total Ankle Arthroplasty? A Case Report.

Pseudotumors are defined as exuberant non-neoplastic inflammatory masses. This condition can be associated with hip and knee arthroplasty but has not been reported in Total Ankle Arthroplasty (TAA). This paper reports a pseudotumor that formed following TAA, highlighting its clinical presentation, management, and histopathology.

Impact of Earthquakes During COVID-19 Lockdown on the Pediatric Injury Pattern in the Zagreb Urban Area.

: Previous works on the epidemiology of pediatric trauma during the COVID-19 lockdown observed a decrease in pediatric surgical emergency consultations and fracture referrals. None of those works describes a unique situation in which there is the coexistence of another opposing factor, like an earthquake, that influences the number of injured children's referrals. Therefore, this study aimed to investigate the influence of earthquakes during the COVID-19 lockdown on pediatric injury pattern referrals at a tertiary care hospital in a urban setting.

Real-World 12-Month Outcomes with Sirolimus-Coated Balloon Angioplasty for Complex Femoropopliteal Disease.

: Sirolimus-coated balloons (SCBs) have emerged as a promising alternative to paclitaxel-coated devices for the treatment of femoropopliteal lesions. However, real-world data on SCB performance in also complex peripheral arterial disease remains unknown. We sought to evaluate the safety and 12-month clinical outcomes of the Selution SLR™ balloon angioplasty in a challenging real-world patient cohort.