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.

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.

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.

The Use of Nitinol Continuous Compression Implants in Orthopaedic Trauma.

Background: Continuous compression implants (CCIs) can provide continuous compression across a fracture site. They are mainly used in foot/ankle surgery, with very limited descriptions in the literature of their potential for trauma. The aim of this study was to describe the use and associated outcomes of CCIs in modern day trauma practice.

Fracture dislocation of the ankle joint in low energy trauma: Choosing between invasive damage control procedures and closed reduction in plaster.

Introduction: The purpose of this study is to identify significant differences in the clinical outcomes of patients who sustained a low energy trauma resulting into an ankle fracture-dislocation, treated with invasive (external fixation or skeletal traction) and conservative damage control procedures (closed reduction in plaster).

Materials And Methods: This is a retrospective comparative study including 52 patients with low energy ankle fracture-dislocation, surgically treated between January 2015 and January 2017. Patients included in this study had a minimum 24 months follow-up (range 24-36 months).

Managing ankle fracture-dislocation injury in the emergency department: a case study.

Ankle fracture-dislocation is a serious injury that requires prompt and appropriate management. The proximity of various neurovascular structures around the ankle joint means there is a risk of nerve or blood vessel damage. Initial management in the emergency department (ED), therefore, includes the realignment and repositioning of the dislocated joint to its normal anatomical position, referred to as reduction.

Total hip arthroplasty via the direct anterior approach using a conventional traction table and fluoroscopy: a safe and cost-effective technique.

Introduction: Precise implant positioning during total hip arthroplasty (THA) is an important factor affecting dislocation rate and long-term implant survival. Although a special carbon fiber traction table for THA improves the accuracy of implant positioning, it is too expensive. We aimed to report the accuracy of cup positioning and complication rate in patients undergoing THA using a conventional noncarbon fiber traction table, which is generally used for osteosynthesis of femoral fractures.

Treatment and rehabilitation of subtalar dislocations: A case series and a review of the literature.

Introduction: Subtalar dislocation is an uncommon orthopaedic pathology, representing 1 % of all traumatic injuries of the foot and 1-2 % of all dislocations, mostly affecting young male adults. While its urgent treatment consisting in reduction and immobilization of the dislocation has been well described, disagreement exists about post-operative management with specific regards to immobilization length and rehabilitation protocols.

Materials And Method: A case series of traumatic subtalar dislocations treated with urgent reduction, a mean of 4 weeks immobilization and subsequent rehabilitation is presented, with 1-year minimum clinical and subjective follow up.

Recurrent peroneal tendon dislocation-the current concept of management.

The peroneus muscles, consisting of the peroneus longus (PL) and peroneus brevis (PB) tendons, are vulnerable to injury at anatomically specific sites or within tendon sheaths. Peroneal tendon dislocation (PTD) is often misdiagnosed as a lateral ankle sprain as it occurs at a lower frequency than a lateral ankle sprain. Anatomical variations in the retromalleolar groove, soft tissue overstuffing, and presence of accessory peroneal muscles contribute to the etiology of PTD.

A Retrospective Case Series of Single-Screw vs Dual-Screw Fixation for Treatment of Medial Malleolus Fractures.

Background: Medial malleolus fractures (MMFs) are common across the world. Currently, there is a lack of consensus on the number of screws used in fixation of MMF. Our aim was to compare the radiographic outcomes of MMF with patients between fractures that have either undergone single-screw (SS) or dual-screw (DS) fixation.

Concomitant Factors Associated With Tillaux-Chaput Fractures in Adults: A Case-Control Study.

Background: Tillaux-Chaput fractures (TCFs) consist of fractures of the anterolateral distal tibia. They rarely occur in isolation in adults. When TCFs are missed, there is a risk of chronic pain, instability, and ankle osteoarthritis.

Predictive factors of hospital and nursing facility admission in the fixation of low-energy ankle fractures.

Introduction: Ankle fractures are increasingly common in frail patients, with hospitalization being the principal cost driver, particularly for the elderly who often need referral to nursing facilities. This study aims to identify factors affecting resource utilization per admission (hospital and nursing) in the fixation of low-energy ankle fractures.

Materials And Methods: This retrospective cohort study examined patients undergoing fixation for low-energy ankle fractures.

Principles of Lesser Toe and Metatarsophalangeal Joint Reconstruction for Complex and Revision Surgery of the Forefoot.

Successful lesser toes and metatarsophalangeal (MTP) joint reconstruction must withstand substantial biomechanical loads from standing, walking, and exercise. While complications following lesser toe and MTP reconstruction are common, limited literature addresses revision surgeries for complications including recurrence. Numerous complications of surgery for toes and lesser MTP joints can be managed or improved through revision surgery, but not all complications can be prevented or resolved.

Lesser Metatarsophalangeal Joint Instability: Minimally Invasive Surgery Treatment Alternatives.

Lesser metatarsophalangeal (MTP) joints instability is usually produced by the rupture of the plantar plate. The treatment algorithm may change in patients with advanced stages of the plantar plate rupture, and surgical treatment is proposed to avoid MTP dislocation. Palliative surgery with minimally invasive surgery (MIS) can offer a less aggressive approach and enable excellent clinical correction and a good function.

Metatarsophalangeal Joint Instability: Anatomy and Physiopathology.

Metatarsophalangeal (MTP) instability is a common cause of metatarsalgia of the lesser toes. Instability often presents as pain in the plantar forefoot, progressing to coronal and transverse plane malalignment. MTP joint dislocation can develop in some cases.

Rheumatoid Deformities of the Lesser Toes.

Rheumatoid arthritis is a chronic heterogeneous autoimmune disease characterized by painful joint inflammation and causes destructive bone erosions. Most common deformities in the rheumatoid forefoot are hallux valgus and claw toes. Radiographs are helpful to show the deformity and the associated pathologies.

Tibiotalocalcaneal Nail: A Novel Tool in the Management of Old Neglected Ankle Dislocation With Deformity.

Ankle dislocations, particularly those that are old and neglected, pose significant challenges in orthopedic management due to the development of arthritic changes and surgical difficulties of reduction. The optimal treatment often involves stabilization and realignment to ensure proper healing. The closed reduction is rarely achieved in old neglected dislocations.

Total Talus Allograft Transplantation With Subtalar Arthrodesis for Missing Talus: A Report of a Rare Case.

Post-traumatic missing talus is a rare and severe injury that often results in poor functional outcomes, with no consensus on the optimal treatment approach as strategies vary based on injury severity. We present the case of a 44-year-old male who sustained a missing talus following a high-energy motorcycle accident. After initial wound management and application of an external fixator, the patient underwent size-matched, fresh-frozen talus allograft transplantation combined with subtalar fusion.