Is there an optimal perioperative risk assessment tool for older adult ankle fractures?

Objective: To measure the predictive value of three perioperative risk assessment tools (National Surgical Quality Improvement Program-NSQIP, Modified 5-factor Frailty Index-mFI-5, and Score for Trauma Triage in Geriatric and Middle Aged-STTGMA) in predicting postoperative complications in older adult ankle fractures.

Materials And Methods: This is a retrospective study of surgically treated isolated older adult ankle fractures at an academic center between 2007 and 2022. Exclusion criteria included age < 55 years, presence of pathologic fractures, and having multiple orthopaedic injuries.

Arthrodesis in the treatment of ankle osteoarthritis due to neglected malleolar fractures in the elderly.

Neglected malleolus fracture cases, among other conditions in which arthrodesis is inevitable, usually present with pseudoarthrosis of the malleolus and impaired ligament balancing. The study aimed to summarize the clinical data results of neglected malleolus fractures accompanied by ankle instability. The retrospective study was conducted at Adana City Training and Research Hospital.

Paradoxical Agitation and Masseter Spasm During Propofol Procedural Sedation: A Case Report.

Introduction: Propofol is an anesthetic agent commonly used in emergency department (ED) procedural sedation. It is often preferred in orthopedic procedures because of its muscle-relaxing properties. Rarely, however, it can induce agitation and muscle hypertonicity.

Erratum: Clinical relevance of current patient-reported outcome measures for ankle fracture: surgeons' perspective-Erratum.

[This corrects the article DOI: 10.1097/OI9.0000000000000349.

Group and Spend: An Evaluation of Perioperative Group and Save Practices in Traumatic Forearm, Wrist, Hand, Foot and Ankle Fracture Fixations and Their Associated Costs.

Background Fractures of the peripheral limbs make up a significant proportion of the caseload seen by an Orthopaedic Department. Some of these fractures will require surgical intervention and typically undergo open reduction and internal fixation (ORIF). Current guidance states that patients undergoing such procedures do not require group and save testing prior to theatre.

Reconstruction of Bilateral Hindfoot Open Fracture Using the Femoral Head Allograft: A Three-Year Follow-Up Case Report.

This case report presents a three-year follow-up of a young male with bilateral hindfoot fractures due to a high-energy road traffic accident, resulting in a comminuted open calcaneal fracture on the left and an open fracture-dislocation of the right talus. Staged reconstruction was performed, including initial debridement, temporary cement spacers, and subsequent fixation with femoral head allografts (FHAs). The right foot underwent a tibiotalocalcaneal (TTC) fusion, and the left foot received a double arthrodesis.

Epidemiology of talus fractures in Finland: a nationwide register study from 1997 to 2020.

Background: The aim of this study was to estimate the nationwide incidence of talus fractures (per 100 000 person-years) and to determine the incidence of operative treatment in the Finnish population.

Methods: Based on Finnish Care Register for Health Care data, all patients 18 years and older admitted to hospital with talar fractures between 1997 and 2020 were included.

Results: During the 24-year study period, 5247 patients with primary or secondary diagnoses of talar fracture were identified.

Comparative 3D finite element analysis of intramedullary fixation versus locking plate fixation in calcaneal fractures using micro-CT image technology.

Objective: Calcaneal fracture fixation remains a challenging procedure in orthopedics, with computational tools increasingly aiding in the optimization of preoperative planning. To compare the biomechanical stability of intramedullary fixation and locking plate fixation for Sanders II and III calcaneal fractures by three-dimensional (3D) finite element analysis and to provide a theoretical basis for clinical application.

Methods: The Computed Tomography (CT) images were segmented using Mimics software (Materialise NV, Belgium) to identify the region of interest based on threshold segmentation.

[Biomechanical study of screw implant angle in reconstruction of tibiofibular syndesmosis injury].

Objective: To investigate ideal screw implant angle in reconstruction of tibiofibular syndesmosis injury by using a biomechanical test.

Methods: A total of 24 ankle specimens from adult cadavers were used as the tibiofibular syndesmosis injury model. According to the angle of screw placement, the tibiofibular syndesmosis injury models were randomly divided into groups A (0°), B (10°-15°), C (20°-25°), and D (30°-35°), and the screws were placed at a level 2 cm proximal to the ankle joint.

Novel Use of Exoskeleton Assist Device in an Ankle Fracture: A Case Report.

Lower extremity fractures and musculoskeletal injuries are among the leading causes of morbidity for Special Operations Forces (SOF), frequently resulting in prolonged immobilization and weeks of therapeutic exercises and strength training to return to full status. This is a case of a 34-year-old Caucasian combat rescue officer with a stable right distal fibula (Weber B) fracture managed with early mobilization and assisted plantarflexion using a Dephy Exoboot device. Early mobilization resulted in no adverse events and resulted in a significant reduction in down-time compared with usual care.

Medial Malleolar Stress Fracture Treatment and Return to Activity: A Systematic Review.

Background: Medial malleolar stress fractures (MMSFs) naturally appear to occur primarily in athletes participating in sports requiring prolonged running or repetitive jumping. Nonoperative and operative modalities have been described, yielding a wide range of outcomes and return to activity (RTA) rates.

Hypothesis/purpose: To systematically review the current literature to identify reports of MMSFs to better understand the current state of treatment, outcomes, and RTA rate.

Lateral malleolus-first fixation improves short-term recovery in patients with trimalleolar fractures.

Objective: To evaluate the impact of different surgical fixation sequences on ankle joint stability and functional recovery in patients with trimalleolar fractures.

Methods: A retrospective analysis was conducted on the medical records of 144 patients with trimalleolar fractures treated at Xi'an International Medical Center Hospital. Among these, 78 patients underwent the fixation sequence of lateral malleolus-posterior malleolus-medial malleolus (Group A), while 66 patients underwent the sequence of posterior malleolus-lateral malleolus-medial malleolus (Group B).

Perioperative Antibiotic Choice Does Not Affect Wound Complications in the Operative Treatment of Ankle Fractures.

Background and aims Ankle injuries are one of the most common lower extremity traumas reported, with nearly half needing surgical intervention. For those who undergo surgical treatment, surgical site infection (SSI) is not a rare complication. Cefazolin is the recommended preoperative surgical chemoprophylaxis for surgical site infection.

The Influence of Timing of Surgery on Postoperative Length of Hospital Stay in Closed Ankle Fractures.

Background Ankle fractures are prevalent lower limb injuries that often necessitate surgical intervention to restore joint stability and functionality. Delays in surgical management can extend hospital stays and elevate the risk of complications. This study aims to evaluate the effect of surgical timing on the postoperative length of hospital stay in patients with closed ankle fractures managed through open reduction and internal fixation (ORIF).

Utility of external fixation for traumatic periprosthetic fracture after total ankle arthroplasty in patients with rheumatoid arthritis: A report of two cases.

This report describes two cases of implant-stable traumatic periprosthetic fractures after total ankle arthroplasty (TAA) in patients with rheumatoid arthritis (RA). One case with low body mass index (BMI) [14 kg/m2] achieved complete bone union with the use of an external fixator, while the other case with a high BMI [32.83 kg/m2] failed to achieve bone union with the external fixator; however, complete union was achieved utilizing secondary internal plate fixation.

The acute management of Pilon fractures (ENFORCE) study: a national evaluation of practice.

Introduction: Pilon fractures are potentially limb-threating injuries. Staged soft tissue damage control is described, but actual practices are unknown. We report a national trainee collaborative evaluating how tibial Pilon fractures are acutely managed.

Treatment and Rehabilitation of Complicated Fractures of Both Lower Limbs: A Case Report.

Introduction: Few studies have reported the treatment and rehabilitation of combined fractures of the femur, tibia, and ankle in the same lower limb.

Case Report: A 69-year-old man presented to our hospital with a fall injury due to high-energy trauma after falling from a 5 m ladder while painting and landing on both feet. Examination revealed right femoral supracondylar; left tibial plateau; right calcaneal; left ankle crush; first and third lumbar vertebrae burst; sacral; C7, Th1, and Th9 compression; and bilateral acetabular fractures.

Comparison of screw fixation and dynamic fixation in the treatment of ankle fractures with syndesmotic ruptures.

Background: Syndesmosis injuries in ankle fractures can significantly impact patient mobility and recovery, making the choice of fixation method crucial for optimal outcomes. This study aimed to compare the quality of reduction and functional results between screw fixation and dynamic fixation in treating syndesmosis injuries in ankle fractures.

Methods: This cohort study included 48 patients (28 males, 20 females) with an ankle fracture accompanied by syndesmosis injury.

[Efficacy comparison of dorsal approach and medical approach in treating Lisfranc injury].

To compare the efficacy of dorsal approach and medial approach in the treatment of Lisfranc injury. A retrospective cohort study was conducted to analyze the clinical data of 43 patients with closed Lisfranc injuries admitted to Tongji Hospital of Tongji University from January 2017 to December 2021. The surgical approach were open reduction and internal fixation or metatarsal cuneiform joint fusion, with 23 cases using the dorsal approach and 20 cases using the medial approach.

Anatomical analysis of the traditional postero-medial approach to the ankle and evaluation of structures at risk.

Introduction: The presence of a fracture of the posterior malleolus gives a poor prognosis for ankle fractures. This study aimed to analyze the anatomical structures at risk in the traditional postero-medial (TPM) approach.

Methods: Of a total of 21 cadaveric pieces, 11 were female and 10 were male; 9 ankles/right foot and 11 ankles/left foot.

Frequent complications of deficient patellae after component removal in 1.5-stage exchange arthroplasty for periprosthetic joint infection.

Purpose: To compare the complication rates between deficient patellae (remnant patellae after component removal) and non-resurfaced patellae after 1.5-stage exchange arthroplasty for periprosthetic joint infection and identify risk factors for complications of deficient patellae.

Methods: Complications in 76 deficient patellae (group D) and 41 non-resurfaced patellae (group N), with a minimum follow-up of 2 years after 1.

Metatarsal Aneurysmal Bone Cysts Treated With En Bloc Resection and Reconstruction With Fibular Allograft.

Background: Treatment of Primary metatarsal aneurysmal bone cyst (ABC) with curettage and bone grafting unfortunately has a high recurrence rate, particularly in short tubular bones. This study presents a 16-year experience treating ABCs in the bones of the foot at an orthopaedic oncology referral center. Treatment involved en bloc resection and reconstruction of the defect with fibular allograft in all cases.

Temporary Circular External Fixation for Spanning the Traumatized Ankle Joint.

Background: Temporary ankle-spanning circular fixation aims to provide osseous stability while (1) allowing access to and recovery of the traumatized soft-tissue envelope and (2) facilitating safe, comfortable, and clinically relevant cross-sectional imaging for surgical planning. It is most commonly utilized in a "span-scan-plan" treatment strategy in cases of peri-articular fractures around the ankle. Conventional monolateral fixators are prone to morbidity at the half-pin sites in the foot and variation in construct stability.