Rate of Subtalar Joint Arthrodesis After Retrograde Tibiotalocalcaneal Arthrodesis With Intramedullary Nail Fixation: Evaluation of the RAIN Database.

Background: Hindfoot arthritis or significant deformity involving the ankle and subtalar joint (STJ) is a disabling condition with few salvage options. Many surgeons note a decreased STJ fusion rate compared with ankle union when a retrograde nail construct is used. The purpose of this study was to report the STJ fusion rate of tibiotalocalcaneal (TTC) arthrodesis with retrograde nail.

First Metatarsal Head Osteochondral Defect Treatment With Particulated Juvenile Cartilage Allograft Transplantation: A Case Series.

Background: Focal damage to articular cartilage, also called an osteochondral defect (OCD), can be a cause of pain and decreased range of motion. Recent advancements have led to transplantation techniques using particulated juvenile articular cartilage allograft. This technique has been applied to the first metatarsal head to a very limited degree, with no published results to our knowledge.

A multicentre randomised controlled trial evaluating the efficacy of dehydrated human amnion/chorion membrane (EpiFix ) allograft for the treatment of venous leg ulcers.

A randomised, controlled, multicentre clinical trial was conducted to evaluate the efficacy of dehydrated human amnion/chorion membrane (EpiFix) allograft as an adjunct to multilayer compression therapy for the treatment of non-healing full-thickness venous leg ulcers. We randomly assigned 109 subjects to receive EpiFix and multilayer compression (n = 52) or dressings and multilayer compression therapy alone (n = 57). Patients were recruited from 15 centres around the USA and were followed up for 16 weeks.

Peri-talar re-alignment osteotomy for joint preservation in asymmetrical ankle osteoarthritis.

Various types of re-alignment surgery are used to preserve the ankle joint in cases of intermediate ankle arthritis with partial joint space narrowing.The short-term and mid-term results after re-alignment surgery are promising, with substantial post-operative pain relief and functional improvement that is reflected by high rates of patient satisfaction.In this context, re-alignment surgery can preserve the joint and reduce the pathological load that acts on the affected area.

Recurrence of Hallux Valgus Can Be Predicted from Immediate Postoperative Non-Weight-Bearing Radiographs.

Background: The aims of this study were to identify risk factors for the recurrence of hallux valgus deformity and to clarify whether recurrence after surgery to treat hallux valgus can be predicted using radiographic parameters assessed on immediate postoperative non-weight-bearing radiographs.

Methods: A proximal chevron osteotomy combined with a distal soft-tissue procedure was performed by a single surgeon to treat moderate to severe hallux valgus deformity in 93 patients (117 feet). The feet were grouped according to nonrecurrence or recurrence.

Beaming in Charcot Arthropathy-Intramedullary Fixation for Complicated Reconstructions: A Cadaveric Study.

In the modern treatment of Charcot neuroarthropathy, beam screw fixation is an alternative to plate and screw fixation. Exposure is minimized for implantation, and this technique supports the longitudinal columns of the foot as a rigid load-sharing construct. A published data review identified a paucity of data regarding metatarsal intramedullary canal morphology relevant to beam screw fixation.

Bioabsorbable Fixation Screw for Proximal Interphalangeal Arthrodesis of Lesser Toe Deformities.

Background: Although standard fixation of proximal interphalangeal (PIP) arthrodesis by K-wire is relatively inexpensive and well established, it does have some drawbacks, making newer fixation devices interesting. The aim of this study was to clinically and radiologically assess the operative correction of the lesser toe deformation in the form of a PIP arthrodesis using a bioabsorbable 2.7-mm fixation screw.

Anatomic Structures at Risk When Utilizing an Intramedullary Nail for Distal Fibular Fractures: A Cadaveric Study.

Background: Retrograde intramedullary fibular nail fixation is being utilized with increasing frequency, particularly in patients at higher risk of wound complications. The purpose of this anatomic study was to assess the relative risk to nearby anatomic structures when implanting a contemporary retrograde locked intramedullary fibular nail.

Methods: Ten human cadaveric lower extremities were instrumented with a fibular nail.

Experience with Navigation in Total Ankle Arthroplasty. Is It Worth the Cost?

Optimal placement of correctly sized total ankle replacement (TAR) implants is elemental to prolonging the working life. The negative mechanical effects of implant malalignment are well characterized. There is one FDA-approved navigated TAR system with limited but encouraging outcomes data.

Hallux valgus, ankle osteoarthrosis and adult acquired flatfoot deformity: a review of three common foot and ankle pathologies and their treatments.

The pathogenesis of hallux valgus deformity is multifactorial. Conservative treatment can alleviate pain but is unable to correct the deformity. Surgical treatment must be adapted to the type and severity of the deformity.

Weight-bearing computed tomography findings in varus ankle osteoarthritis: abnormal internal rotation of the talus in the axial plane.

Objectives: To assess the incidence of abnormal internal rotation of the talus in the axial plane in patients with varus ankle osteoarthritis, and to determine whether this incidence differs from the severity of varus ankle osteoarthritis (moderate versus severe).

Materials And Methods: We retrospectively evaluated weight-bearing computed tomography (CT) and plain radiographs of 52 ankles with no abnormalities (control group) and 96 ankles with varus osteoarthritis (varus-OA group), which were further stratified into a moderate-OA subgroup (50 ankles) and a severe-OA subgroup (46 ankles). A new radiographic parameter on weight-bearing CT, the talus rotation ratio, was used to assess the rotation of the talus in the axial plane.

Isolated Syndesmosis Diastasis: Computed Tomography Scan Assessment With Arthroscopic Correlation.

Purpose: To investigate which method can predict tibiofibular diastasis more accurately among the tibiofibular interval at the ankle joint level or previous parameters taken 1 cm above the joint line.

Methods: An arthroscopic examination was performed in 78 consecutive patients with anterolateral ankle pain. Four different methods were performed to take measurements of the tibiofibular interval using an axial computed tomography (CT) scan under existing arthroscopic diagnosis.

Union Rates and Complications of Lateral Column Lengthening Using the Interposition Plating Technique: A Radiographic and Medical Record Review.

Lateral column lengthening is a common procedure for correction of pes planovalgus. A tricortical bone graft has been a standard among foot and ankle surgeons. The purpose of the present study was to compare the union rates and complications between the 2 forms of fixation for lateral column lengthening.

Ankle Arthrodesis: A Retrospective Analysis Comparing Single Column, Locked Anterior Plating to Crossed Lag Screw Technique.

Ankle arthrodesis is performed to eliminate pain due to end-stage osteoarthritis, regardless of etiology. This procedure remains the reference standard treatment for end-stage ankle arthritis, despite recent advancements in total ankle replacement. The objective of the present study was to retrospectively evaluate the radiographic and clinical fusion rates and time to bony fusion for patients who underwent ankle arthrodesis using an anterior approach with a single column locked plate construct versus crossed lag screws.

Change in Talar Translation in the Coronal Plane After Mobile-Bearing Total Ankle Replacement and Its Association with Lower-Limb and Hindfoot Alignment.

Background: Mobile-bearing total ankle replacement (TAR) enables motion at the tibial implant-polyethylene insert interface. This motion could lead to coronal translation of the talus relative to the tibia and may affect radiographic outcome. We aimed to assess the translation of the talus before and after mobile-bearing TAR to determine whether translation of the talus after TAR is associated with coronal plane alignment of the lower limb and hindfoot as well as to investigate the complications associated with talar translation.

Plantar Plate Repair Using a Direct Plantar Approach: An Outcomes Analysis.

Direct plantar plate repair using a plantar approach has been described previously, but with few reports of the outcomes or clinical results. The purpose of the present study was to determine the outcomes of this technique. We performed a retrospective analysis of patients who had undergone direct plantar plate repair with or without concomitant Weil osteotomy and a prospective patient-reported subjective outcomes analysis.

Hawkins' type-II talar fracture with subtalar dislocation: A very unusual combination.

We report the unusual case of a 16-year-old young man who sustained a rare association of a Hawkins' type-II talar neck fracture with a complete medial subtalar dislocation (Hawkins type-IIB) that occurred as an isolated injury after indirect trauma during a soccer game. Following closed reduction of the subtalar dislocation, standard radiographs and computed tomography (CT) demonstrated a comminuted fracture of the talus involving the base of the talar neck. Open reduction was performed and the fracture was stabilized by ORIF.

Tibialis Anterior Tendon Reconstruction Using Augmented Half-Thickness Tendon Segment Transposition.

Unlabelled: Tibialis anterior tendon rupture causes substantial morbidity. The present study describes the outcomes of augmented, half-thickness tibialis anterior tendon segment transposition, a novel reconstruction technique. This was an institutional review board-approved retrospective review of 3 patients with surgically treated attritional distal rupture with 1-year follow-up.

Economic Analysis and Patient Satisfaction Associated With Outpatient Total Ankle Arthroplasty.

Background: Total ankle arthroplasty (TAA) is a rapidly growing treatment for end-stage ankle arthritis that is generally performed as an inpatient procedure. The feasibility of outpatient total ankle arthroplasty (OTAA) has not been reported in the literature. We sought to establish proof of concept for OTAA by comparing outpatient vs inpatient perioperative complications, postoperative emergency department (ED) visits, readmissions, patient satisfaction, and cost analysis.

Early Protected Weightbearing After Ankle Fractures in Patients With Diabetes Mellitus.

The traditional protocol for treatment after ankle fracture in the diabetic patient involves a period of prolonged non-weightbearing to reduce the incidence of complications. The goal of the present study was to identify the risk factors and complications associated with early protected weightbearing after closed ankle fractures in patients with diabetes. The data from 73 diabetic patients with operatively and nonoperatively treated ankle fractures were retrospectively reviewed.

A Review of 399 Total Ankle Replacements: Analysis of Ipsilateral Subtalar Joint Arthrodesis and Associated Talar Component Subsidence.

Total ankle replacement (TAR) is an accepted treatment for end-stage ankle arthritis. When concurrent subtalar joint pathologic features exist, ipsilateral subtalar joint arthrodesis (STJA) can be performed either simultaneous with TAR or as a staged procedure. Limited data exist on the effect of talar component subsidence and prosthesis survivorship.

Accuracy and Reproducibility Using Patient-Specific Instrumentation in Total Ankle Arthroplasty.

Background: Implant survivorship is dependent on accuracy of implantation and successful soft tissue balancing. System instrumentation for total ankle arthroplasty implantation has a key influence on surgeon accuracy and reproducibility. The purpose of this study was to determine the accuracy and reproducibility of implant position with patient-specific guides for total ankle arthroplasty across multiple surgeons at multiple facilities.

Modified Lambrinudi Arthrodesis for the Acute Treatment of Neurogenic Clubfoot: A Case Report.

Unlabelled: Neurogenic contracture often results in spastic, nonreducible equinovarus deformity. Rigid contracture leads to pain, instability, and bracing difficulties. This case report details the utilization of the modified Lambrinudi triple arthrodesis intended to create a plantigrade, functional limb that is amenable to an extremity brace in a case of an acquired neurologic clubfoot.

Donor Site Morbidity After Lateral Ankle Ligament Reconstruction Using the Anterior Half of the Peroneus Longus Tendon Autograft.

Background: The anterior half of the peroneus longus tendon (AHPLT) has been reported to be an effective autograft for ligament reconstruction with respect to strength and safety. However, there is little information regarding donor site morbidity after harvesting the AHPLT. Furthermore, to the best of our knowledge, there has not been a study on the isokinetic evaluation of ankle plantar flexion and eversion after AHPLT harvesting.

Surgical Planning for Flexor Digitorum Longus Tendon Transfers: An Anatomic Study.

Posterior tibial tendon dysfunction is often coupled with various degrees of hindfoot valgus and equinus. Preoperative planning is essential to appropriate procedure choice and surgical efficiency. The purpose of the present study was to assess the anatomy at the harvest site for flexor digitorum longus tendon transfer, specifically at the master knot of Henry.