Association of Pitch Timing and Throwing Arm Kinetics in High School and Professional Pitchers.

Background: Understanding the relationship between the temporal phases of the baseball pitch and subsequent joint loading may improve our understanding of optimal pitching mechanics and contribute to injury prevention in baseball pitchers.

Purpose: To investigate the temporal phases of the pitching motion and their associations with ball velocity and throwing arm kinetics in high school (HS) and professional (PRO) baseball pitchers.

Study Design: Descriptive laboratory study.

Single-Leg Squat Compensations Are Associated With Softball Pitching Pathomechanics in Adolescent Softball Pitchers.

Background: A lack of lumbopelvic-hip complex (LPHC) stability is often associated with altered pitching mechanics, thus increasing pain and injury susceptibility. The single-leg squat (SLS) is a simple diagnostic tool used to examine LPHC stability.

Purpose: To examine the relationship between trunk compensatory kinematics during the SLS and kinematics at foot contact during the windmill pitch.

The association of stride length to ball velocity and elbow varus torque in professional pitchers.

Professional basebal pitchers (n =315) were divided into quartiles based on increasing stride length and random intercept linear mixed-effect models were used to correlate stride length with ball velocity, pelvis and trunk rotation at foot contact, and throwing arm kinetics. Average stride length among all pitchers was 78.3±5.

The Financial Implications of Podiatric Foot and Ankle Fellowship: Is Another Year Worth It?

For prospective applicants many variables can factor into the decision to pursue fellowship level training. The purpose of the present study was to give prospective applicants an idea of the financial implications of podiatric foot and ankle fellowship. To calculate the net present value (NPV), weighted mean income data (clinical, general, research, associated research) from podiatric foot and ankle surgeon's (FAS's) with and without fellowship training was obtained.

Carrying Asymmetric Loads While Walking on a Treadmill Interferes with Lower Limb Coordination.

The purpose of this study was to investigate the effect of different load carriage modes on coordinative patterns in the lower extremities during walking. Twenty-five university students walked on a treadmill at their preferred pace under three different load conditions: symmetric load (5% of body mass in messenger bags on each shoulder hanging vertically and against the hips), asymmetric load 1 (10% of body mass in a messenger bag on one shoulder hanging vertically against the ipsilateral hip), and asymmetric load 2 (10% of body mass in a messenger bag on one shoulder with the bag draped across the trunk to the contralateral hip). Altered thigh-shank and shank-foot couplings were found for the loaded side during the stance of gait when comparing the asymmetric 1 and 2 to the symmetric load.

Endoscopic Haglund's Resection and Percutaneous Double-Row Insertional Achilles Repair.

Insertional Achilles tendinopathy can be a debilitating condition that often fails to improve with nonsurgical management such as bracing and physical therapy. Traditional surgical techniques include an open debridement of the diseased tendon and resection of calcaneal spurs. This is followed by repair of the tendon.

Treatment of chronic diabetic foot ulcers with adipose-derived stromal vascular fraction cell injections: Safety and evidence of efficacy at 1 year.

Diabetes affects multiple systems in complex manners. Diabetic foot ulcers (DFUs) are a result of diabetes-induced microarterial vessel disease and peripheral neuropathy. The presence of arteriosclerosis-induced macroarterial disease can further complicate DFU pathophysiology.

Impact of Bone Graft on Fusion Rates in Primary Open Ankle Arthrodesis Fixated With Cannulated Screws: A Systematic Review.

There is currently no consensus on the importance of bone graft use in ankle arthrodesis. Despite this, bone graft is widely used. We aimed to summarize the available literature on primary open ankle arthrodesis fixated with cannulated screws in order to assess the importance of bone graft in achieving more favorable rates of fusion.

Experience with negative-pressure wound therapy with instillation in complex infected orthopaedic wounds.

Chronic exudative wounds are frequently seen in hospitalised patients, consuming hospital resources and leading to increased morbidity. Negative-pressure therapy (NPWT) with topical instillation "NPWTi" may be used to improve the wound healing process, with the unique features (removal of wound exudate, edema reduction, promotion of tissue perfusion and granulation tissue formation, as well as drawing the edges of the wound to facilitate, in addition to the cyclic cleansing mechanism). This report is a descriptive study of our experience with NPWTi on complex infected orthopaedic wounds as a potential method to decrease the need for multiple surgical debridements required for the closure of such wounds.

Neglected Achilles Tendon Ruptures.

Achilles tendon ruptures are a common ailment and often missed in upwards of 25% of cases. Neglected Achilles injuries can be treated both conservatively and surgically. Physical therapy, bracing, and custom ankle-foot orthoses are some options to consider.

Risk Factors for Nonunion Following Ankle Arthrodesis: A Systematic Review and Meta-analysis.

Background: Nonunion is a postoperative complication after ankle arthrodesis (AA), which leads to increased morbidity and revision rates. Previous studies have identified risk factors for nonunion following AA, but no meta-analysis has been performed to stratify risk factors based on strength of evidence.

Methods: Abstracts and full-text articles were screened by 2 independent reviewers.

Pedal Musculovenous Pump Activation Effectively Counteracts Negative Impact of Knee Flexion on Human Popliteal Venous Flow.

Knee scooters are commonly used for mobility instead of other devices. However, passive popliteal venous flow impedance has been observed with knee scooter usage ostensibly as a result of deep knee flexion. This study aimed to characterize the magnitude of impact knee flexion has on popliteal venous flow in relation to the degree of knee flexion when walking boot immobilized.

The modified Shriners Hospitals for Children Greenville (mSHCG) multi-segment foot model provides clinically acceptable measurements of ankle and midfoot angles: A dual fluoroscopy study.

Background: Several multi-segment foot models have been developed to evaluate foot and ankle motion using skin-marker motion analysis. However, few multi-segment models have been evaluated against a reference standard to establish kinematic accuracy.

Research Question: How accurately do skin-markers estimate foot and ankle motion for the modified Shriners Hospitals for Children Greenville (mSHCG) multi-segment foot model when compared against the reference standard, dual fluoroscopy (DF), during gait, in asymptomatic participants?

Methods: Five participants walked overground as full-body skin-marker trajectory data and DF images of the foot and shank were simultaneously acquired.

In-Season Management of Acute and Subacute Sports Foot Injuries.

In athletes, foot injuries present with a variety of mechanisms, severity, and implications for return to play. Although potentially given less attention than knee and shoulder injuries by the team physician, foot injuries are common and thus require knowledgeable consideration. In this article, we review the anatomy, presentation, workup, and management of several of the most common athletic foot injuries, including turf toe, Lisfranc injuries, Jones fractures, and navicular stress fractures.

Epidemiology of Sports-Specific Foot and Ankle Injuries.

The epidemiology of any given topic sometimes is overlooked. This is true particularly with sports physicians and sports injuries. The identification of sports-specific injury patterns by collection and examination of data can help prevent injuries.

Musculoskeletal pain in lacrosse officials impacts function on the field.

This study determined the prevalence of joint pain among lacrosse officials and described the impact of pain thereof on current officiating duties on the field. Members of the US Lacrosse Officials Development Programme were provided with an electronic survey (a 15.7% response rate resulted in N = 1,441 of completed surveys).

Anterior Ankle Incision Wound Complications Between Total Ankle Replacement and Ankle Arthrodesis: A Matched Cohort Study.

The anterior incision is commonly used for total ankle replacement (TAR) and ankle arthrodesis. Historically, the anterior incision has demonstrated a high incidence of complications. The purpose of this study was to evaluate anterior incisional healing and soft tissue complications between TAR and ankle arthrodesis with anterior plate fixation.

Quality of Reduction of Displaced Intra-articular Calcaneal Fractures Using a Sinus Tarsi Versus Extensile Lateral Approach.

Objective: To evaluate the difference in the quality of fracture reduction between the sinus tarsi approach (STA) and extensile lateral approach (ELA) using postoperative Computed Tomography (CT) scans in displaced intra-articular calcaneal fractures (DIACFs).

Design: Retrospective.

Setting: Level 1 and level 2 academic centers.

Comparison of Ligament-Repair Techniques for the Syndesmosis: A Simulated Cadaveric Weight-Bearing Computed Tomography Analysis.

Although the literature describes a variety of reconstructive techniques for the syndesmosis, only few studies offer comparative data. Therefore, the authors compared 2 different ligament repair techniques for the syndesmosis. Sixteen paired fresh-frozen human cadaveric lower limbs were embedded in polymethyl methacrylate mid-calf and placed in a custom-made weightbearing simulation frame.

Multidisciplinary Application of an External Tissue Expander Device to Improve Patient Outcomes: A Critical Review.

Continuous external tissue expansion (CETE) is a versatile tool in soft tissue injury management, and could be an addition to the traditional reconstructive ladder. This critical review discusses the principles and application of CETE, covering a company-sponsored consensus meeting on this emerging technology and highlighting the DermaClose (Synovis Micro Companies Alliance, Inc., Birmingham, AL) device's unique approach to soft tissue injury management.

Patients With Opioid Use Disorder Have Increased Readmission Rates, Emergency Room Visits, and Costs Following a Hallux Valgus Procedure.

Background: Patients with a history of opioid use disorder (OUD) tend to have more complications, higher readmission rates, and increased costs following orthopaedic procedures. This study evaluated patients undergoing hallux valgus correction for their odds of increased (1) readmission rates, (2) emergency room (ER) visits, and (3) costs.

Methods: Patients undergoing hallux valgus corrections with OUD history were identified using a national Medicare administrative claims database of approximately 24 million orthopaedic surgery patients.

Treatment of Lisfranc Injuries Using Interosseous Suture Button: A Retrospective Review of 84 Cases With a Minimum 3-Year Follow-Up.

Lisfranc fracture dislocation is an injury often encountered by the foot and ankle surgeon. This injury, depending on the severity and level of energy, has been shown to lead to posttraumatic osteoarthritis and chronic pain if undiagnosed or improperly managed. The purpose of this study was to retrospectively evaluate the surgical repair with the use of an interosseous suture button for Lisfranc injuries with isolated ligamentous disruption.

Reliability of the "Clinical Tibiofibular Line" Technique for Open Syndesmosis Reduction Assessment.

Background: When intraoperative computed tomography (CT) is unavailable, open syndesmosis assessment is a universally available, safe alternative that is more accurate than radiographic assessment. However, it has a documented malreduction rate of up to 16%. This may be improved upon with a validated technique for assessing the accuracy of open syndesmosis reductions.