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.

Neurophysiological Effects of Latent Trigger Point Dry Needling on Spinal Reflexes.

Deep dry needling (DDN) is a method to treat muscle trigger points (TrPs) often found in persons with neuromuscular pain and spasticity. Currently, its neurophysiological actions are not well established. Thus, to understand how DDN affects spinal cord physiology, we investigated the effects of TrP DDN on spinal reflexes.

Polymeric Microneedles for Transdermal Delivery of Human Placental Tissue for the Treatment of Osteoarthritis.

Biologics targeting matrix-degrading proteases, cartilage repair, and inflammation are emerging as promising approaches for osteoarthritis (OA) treatment. Recent research highlights biologic-human placental tissue (HPT) as a potential OA therapy due to its biocompatibility, abundant protein biofactors, and ability to reduce cartilage degradation by suppressing protease expression. Microneedles (MNs) are receiving growing attention for enhancing transdermal delivery of biologics as an alternative to conventional subcutaneous injections.

Single-Incision Peroneal Tendon Repair With Concomitant Modified Dwyer Calcaneal Osteotomy: Report of 15 Cases With Plate Fixation.

Background: Addressing hindfoot varus via calcaneal osteotomy with simultaneous peroneal tendon repair from a single incision has not been thoroughly assessed. Some concerns with one incision are wound complications, nerve damage, and symptomatic hardware.

Methods: Patients operated on by one surgeon May 2012 to January 2022 were retrospectively reviewed with minimum 2-year follow-up via in-person visit, telephone, and chart review.

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.

Injury epidemiology in Australian women's professional football.

Objective: To describe the injury epidemiology of the Australian women's professional football (soccer) league (A-League W) over 7 consecutive seasons.

Design: Prospective observational cohort study.

Methods: Match-loss injury data was collected from each A-League W club (n = 8-9) for each competition round (n = 12/season) over 7 seasons (2013/14-2019/20).

Cadaveric Diagnostic Study of Subtle Syndesmotic Instability Using a 3-Dimensional Weight-Bearing CT Distance Mapping Algorithm.

Background: The diagnosis of syndesmotic instability is challenging, and chronically unstable injuries can potentially lead to ankle arthritic degeneration. The objective of this cadaveric study was to utilize a 3-dimensional (3D) weight-bearing computed tomography (WBCT) distance mapping algorithm for the detection of subtle syndesmotic instability, induced by complete syndesmotic ligament sectioning and stressed by isolated axial load. We hypothesized that this algorithm would accurately detect subtle syndesmotic instability.

Is there a correlation among landing stability, ankle dorsiflexion range of motion, and ankle stiffness during single-leg landing?

Background: Even though both landing stability and ankle dorsiflexion stiffness (ankle DR-stiffness) have been independently identified as risk factors associated with non-contact injuries, no study has specifically investigated the relationship between these two variables.

Methods: Twenty male recreational athletes volunteered to participate in this study. Their ankle DF-ROM based on the weight-bearing lunge test, and landing stability based on the dynamic postural stability index (DPSI) and time to stabilization (TTS) were evaluated during a single-leg landing (SLL).

[A comparative study of dynamic versus static rehabilitation protocols after acute Achilles tendon rupture repair with channel assisted minimally invasive repair technique].

Objective: To explore the difference in effectiveness between a dynamic rehabilitation protocol and a traditional static rehabilitation protocol after the treatment of acute Achilles tendon rupture with channel assisted minimally invasive repair (CAMIR) technique through a prospective comparative trial, aiming to provide a reference for clinically selecting a feasible treatment regimen.

Methods: Patients with acute Achilles tendon rupture admitted between June 2021 and June 2022 were included in the study, with 60 patients meeting the selection criteria. They were randomly divided into a dynamic rehabilitation group ( =30) and a static rehabilitation group ( =30) using a computer-generated random number method.

[Comparative study of Achillon Achilles tendon suture guide combined with circuit suture via perineural channel and Krachow suture via posterolateral incision of Achilles tendon in treatment of Kuwada type Ⅱ acute closed Achilles tendon rupture].

Objective: To compare the effectiveness of Achillon Achilles tendon suture guide combined with circuit suture under the perineural channel and Krachow suture with posterolateral incision of Achilles tendon in the treatment of Kuwada type Ⅱ acute closed Achilles tendon rupture.

Methods: The clinical data of 38 patients with Kuwada type Ⅱ acute closed Achilles tendon rupture who met the selection criteria between January 2020 and December 2023 were retrospectively analyzed. Krachow suture via posterolateral incision was used in 24 cases (traditional group), and Achillon Achilles tendon suture guide combined with circuit suture via perineural channel was used in 14 cases (minimally invasive group).

[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.

Principles and biomechanical response of normal gait cycle to measure gait parameters for the alignment of prosthetics limb: A technical report.

The limb amputations caused due to emergent incidents of trauma injuries and vascular diseases currently represent crucial global problems. The patients/amputees with limb amputation who lost the residual limb (knee-ankle foot system) must depend on the prosthetic limb. Prosthetic clinicians and technicians have attempted to develop optimal limb prosthetics that will enhance the ability and functional elements of the patients/users.

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.

Quantification of gait characteristics and muscle activation in patients with chronic ankle instability during walking on sand: A randomized crossover trial.

Background: Limited evidence exists regarding the movement control patterns of individuals with chronic ankle instability (CAI) during sand walking. This study aimed to analyze gait characteristics and muscle activation in patients with CAI while walking on sand.

Methods: This study recruited 30 participants, including 15 patients with CAI and 15 healthy controls.

The Effects of a 12-Week Training Multicomponent Exercise Program on Landing Mechanics in Recreational Athletes.

Background/objectives: This study investigated the impacts of a 12-week training program on kinetic parameters during landings in non-professional recreational athletes.

Methods: Fifty-seven non-elite recreational athletes performed three unilateral-landing trials from a 30 cm high structure on a force platform. The following outcome measures were analyzed: the ground reaction forces at initial ground contact (PF1) and the highest value (PF2), impulse (change in the moment of force during landing), stabilization time, and ankle and knee accelerations.

Comparison of the effects of exergaming and balance training on dynamic postural stability during jump-landing in recreational athletes with chronic ankle instability.

The primary inquiry of this study was to determine if exergaming is more effective than balance training in improving dynamic postural control during jump-landing movements among athletes with chronic ankle instability (CAI). Additionally, the study aimed to compare the effectiveness of these interventions on clinical and psychological outcomes. This study was a randomized, single-blinded, controlled trial in which participants were assigned to either an exergaming group or a balance training group.

Epidemiology of Musculoskeletal Injuries in Professional Ballet Dancers at the Opéra de Paris.

Objective: To describe the incidence, location, and type of musculoskeletal injuries in ballet dancers at the Opéra de Paris from 2018 to 2023 and to evaluate the effect of COVID-19 on injury incidence.

Design: Descriptive Retrospective Study.

Setting: Primary.

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.

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).

Survey of Utilization of Weightbearing Computed Tomography Within AOFAS Membership.

Background: Weightbearing computed tomography (WBCT) has been increasingly employed to evaluate and treat patients with varied pathologies such as progressive collapsing foot deformity (PCFD), posttraumatic deformity, hallux valgus, ankle arthritis, Charcot arthropathy, lisfranc, and syndesmosis injuries. However, little is known regarding its overall availability to foot and ankle providers and how it is being used in clinical practice. The goal of this study is to assess the utilization of WBCT among AOFAS members, identify the indications for use in clinical practice and potential barriers for implementation.

Arthroscopic Anatomic Reconstruction of the Interosseous Talocalcaneal Ligament Using a Gracilis Autograft for Subtalar Instability: 6- to 12-Year Retrospective Follow-up.

Background: Several surgical techniques have been reported of subtalar instability (STI), but it remains a controversial topic without long-term clinical evidence. This study aimed to report the all-inside arthroscopic anatomic interosseous talocalcaneal ligament (ITCL) reconstruction technique and its long-term outcomes in STI patients with confirmed ITCL rupture.

Methods: A retrospective study was conducted on consecutive series of STI patients who underwent all-inside arthroscopic anatomic reconstruction of the ITCL using a gracilis autograft between January 2010 and December 2016.

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.