Rehabilitation after surgical treatment of peroneal tendon tears and ruptures.

Purpose: The purpose of this study was to provide an overview of the available evidence on rehabilitation programmes after operatively treated patients with peroneal tendon tearsand ruptures.

Methods: A systematic review was performed, and PubMed and EMBASE were searched for relevant studies. Information regarding the rehabilitation programme after surgical management of peroneal tendon tears and ruptures was extracted from all included studies.

Midterm results of posterior arthroscopic ankle fusion.

Purpose: The presented study was performed to evaluate the midterm clinical and radiological results and complication rates of the first 40 patients with an ankle fusion through a posterior arthroscopic approach.

Methods: Forty consecutive patients with end-stage post-traumatic ankle osteoarthritis were treated with posterior arthroscopic ankle fusion. All patients were assessed clinically as well as radiologically with a minimum follow-up of 2 years.

Computed tomography analysis of osteochondral defects of the talus after arthroscopic debridement and microfracture.

Purpose: The primary surgical treatment of osteochondral defects (OCD) of the talus is arthroscopic debridement and microfracture. Healing of the subchondral bone is important because it affects cartilage repair and thus plays a role in pathogenesis of osteoarthritis. The purpose of this study was to evaluate the dimensional changes and bony healing of talar OCDs after arthroscopic debridement and microfracture.

Evaluation of the Dutch version of the Foot and Ankle Outcome Score (FAOS): Responsiveness and Minimally Important Change.

Purpose: The aim of this study was to evaluate the responsiveness of the Foot and Ankle Outcome Score (FAOS) and provide data on the Minimally Important Change (MIC) in patients 1 year after hindfoot and ankle surgery.

Methods: Prospective pre-operative and 1 year post-operative FAOS scores were collected from 145 patients. A patient's global assessment and a longitudinal derived Function Change Score were used as external anchors.

Diagnostic Accuracy of 2-Dimensional Computed Tomography for Articular Involvement and Fracture Pattern of Posterior Malleolar Fractures.

Background: Up to 44% of ankle fractures have involvement of the posterior tibial margin. Fracture size and morphology are important factors to guide treatment of these fragments, but reliability of plain radiography in estimating size is low. The aim of the current study was to evaluate the accuracy of 2-dimensional computed tomography (2DCT) in the assessment of posterior malleolar fractures.

Tibial Plateau Fracture Characteristics: Computed Tomography Mapping of Lateral, Medial, and Bicondylar Fractures.

Background: Computed tomography (CT) is seen as a useful diagnostic modality in preoperative planning for tibial plateau fractures. The purpose of this study was to characterize patterns of tibial plateau fractures with use of CT mapping. We hypothesized that CT mapping of fractures of the tibial plateau would reveal recurrent patterns of fragments and fracture lines, including patterns that do not fit into Schatzker's original classification.

The effect of concentrated bone marrow aspirate in operative treatment of fifth metatarsal stress fractures; a double-blind randomized controlled trial.

Background: Fifth metatarsal (MT-V) stress fractures often exhibit delayed union and are high-risk fractures for non-union. Surgical treatment, currently considered as the gold standard, does not give optimal results, with a mean time to fracture union of 12-18 weeks. In recent studies, the use of bone marrow cells has been introduced to accelerate healing of fractures with union problems.

Factors Associated With Reoperation After Fixation of Displaced Olecranon Fractures.

Background: Surgery for fixation of olecranon fractures is associated with reoperation, mostly for implant removal. A study of a large cohort of patients treated by many different surgeons allows us to determine if specific techniques or implants are associated with a higher rate of reoperation.

Questions/purposes: After open reduction and internal fixation of isolated olecranon fractures, what factors are associated with (1) reoperation and (2) implant removal?

Methods: Three hundred ninety-two adult patients who had operative treatment of a displaced olecranon fracture not associated with other fractures, dislocation, or subluxation at two area hospitals between January 2002 and May 2014 were analyzed to determine factors associated with reoperation.

Randomized comparison of tape versus semi-rigid and versus lace-up ankle support in the treatment of acute lateral ankle ligament injury.

Purpose: Functional treatment is the optimal non-surgical treatment for acute lateral ankle ligament injury (ALALI) in favour of immobilization treatment. There is no single most effective functional treatment (tape, semi-rigid brace or lace-up brace) based on currently available randomized trials.

Methods: This study is designed as a randomized controlled trial to evaluate the difference in functional outcome after treatment with tape versus semi-rigid versus lace-up ankle support (brace) for grades II and III ALALIs.

Osteochondritis dissecans of the humeral capitellum: reliability of four classification systems using radiographs and computed tomography.

Background: The radiographic appearance of osteochondritis dissecans (OCD) of the humeral capitellum varies according to the stage of the lesion. It is important to evaluate the stage of OCD lesion carefully to guide treatment. We compared the interobserver reliability of currently used classification systems for OCD of the humeral capitellum to identify the most reliable classification system.

Posterior Malleolar Fracture Patterns.

Objective: To characterize posterior malleolar fracture morphology using Cole fracture mapping and to study reliability of quantification of 3-dimensional computed tomography (CT)-modeling for posterior malleolar fractures with respect to quantification of fragment size (in cubic millimeter) and true articular involvement (in square millimeter).

Methods: CT scans of a consecutive series of 45 patients with an ankle fracture involving the posterior malleolus were reconstructed to calculate (1) fracture maps, (2) fragment volume, (3) articular surface of the posterior malleolar fragment, (4) articular surface of intact tibia, and (5) articular surface of the medial malleolus by 3 independent observers. Three-dimensional animation of this technique is shown on www.

Dynamic in vivo evaluation of radiocarpal contact after a 4-corner arthrodesis.

Purpose: To understand the mechanisms that preserve joint integrity after 4-corner arthrodesis (FCA).

Methods: We investigated the long-term changes of the radiolunate articulation after an FCA for different motions of the wrist in a cross-sectional study that included wrists of 10 healthy participants and both operated and nonoperated wrists of 8 individuals who had undergone FCA on 1 side. The average postoperative follow-up period of the FCA group was 5.

Pelvic and lower extremity injuries in Homer's Iliad: a review of the literature.

The Iliad, composed approximately in the middle of the eighth century bc, constitutes the leading and oldest known example of heroic epic. The Homeric epic presents the conflicts that took place during the last year of the 10-year lasting Trojan War, offering a realistic description of battle wounds. We studied the text of The Iliad in ancient Greek and in the translations in modern Greek and English and searched for all recorded injuries to the pelvis and lower extremities.

Quantitative 3-dimensional computed tomography measurements of coronoid fractures.

Purpose: Using quantitative 3-dimensional computed tomography (Q3DCT) modeling, we tested the null hypothesis that there was no difference in fracture fragment volume, articular surface involvement, and number of fracture fragments between coronoid fracture types and patterns of traumatic elbow instability.

Methods: We studied 82 patients with a computed tomography scan of a coronoid fracture using Q3DCT modeling. Fracture fragments were identified and fragment volume and articular surface involvement were measured within fracture types and injury patterns.

How valid are commercially available medical simulators?

Background: Since simulators offer important advantages, they are increasingly used in medical education and medical skills training that require physical actions. A wide variety of simulators have become commercially available. It is of high importance that evidence is provided that training on these simulators can actually improve clinical performance on live patients.

Validation of the PASSPORT V2 training environment for arthroscopic skills.

Purpose: Virtual reality simulators used in the education of orthopaedic residents often lack realistic haptic feedback. To solve this, the (Practice Arthroscopic Surgical Skills for Perfect Operative Real-life Treatment) PASSPORT simulator was developed, which was subjected to fundamental changes: improved realism and user interface. The purpose was to demonstrate its face and construct validity.

Distribution of coronoid fracture lines by specific patterns of traumatic elbow instability.

Purpose: To determine if specific coronoid fractures relate to specific overall traumatic elbow instability injury patterns and to depict any relationship on fracture maps and heat maps.

Methods: We collected 110 computed tomography (CT) studies from patients with coronoid fractures. Fracture types and pattern of injury were characterized based on anteroposterior and lateral radiographs, 2- and 3-dimensional CT scans, and intraoperative findings as described in operative reports.

Validation of the ArthroS virtual reality simulator for arthroscopic skills.

Purpose: Virtual reality simulator training has become important for acquiring arthroscopic skills. A new simulator for knee arthroscopy ArthroS™ has been developed. The purpose of this study was to demonstrate face and construct validity, executed according to a protocol used previously to validate arthroscopic simulators.

Feasibility of ultrasound imaging of osteochondral defects in the ankle: a clinical pilot study.

Talar osteochondral defects (OCDs) are imaged using magnetic resonance imaging (MRI) or computed tomography (CT). For extensive follow-up, ultrasound might be a fast, non-invasive alternative that images both bone and cartilage. In this study the potential of ultrasound, as compared with CT, in the imaging and grading of OCDs is explored.

Evaluation of a CT-based technique to measure the transfer accuracy of a virtually planned osteotomy.

Accurate transfer of a preoperatively planned osteotomy plane to the bone is of significance for corrective surgery, tumor resection, implant positioning and evaluation of new osteotomy techniques. Methods for comparing a preoperatively planned osteotomy plane with a surgical cut exist but the accuracy of these techniques are either limited or unknown. This paper proposes and evaluates a CT-based technique that enables comparing virtual with actual osteotomy planes.

Lift, drill, fill and fix (LDFF): a new arthroscopic treatment for talar osteochondral defects.

Purpose: The purpose of this study was to describe the short-term clinical outcome of a new arthroscopic fixation technique for primary osteochondral talar defects: lift, drill, fill and fix (LDFF).

Methods: Seven patients underwent an arthroscopic LDFF surgery for osteochondral talar defects, the mean follow-up was 12 months (SD 0.6).

Is the native ACL insertion site "completely restored" using an individualized approach to single-bundle ACL-R?

Purpose: The goal of individualized anatomic anterior cruciate ligament reconstruction (ACL-R) is to reproduce each patient's native insertion site as closely as possible. The amount of the native insertion site that is recreated by the tunnel aperture area is currently unknown, as are the implications of the degree of coverage. As such, the goals of this study are to determine whether individualized anatomic ACL-R techniques can maximally fill the native insertion site and to attempt to establish a crude measure to evaluate the percentage of reconstructed area as a first step towards elucidating the implications of complete footprint restoration.

Safety and efficiency of posterior arthroscopic ankle arthrodesis.

Purpose: To study the safety and efficiency of posterior arthroscopic ankle arthrodesis.

Methods: Ten fresh-frozen human lower leg specimens without evidence of previous surgery to the foot and ankle were selected. Arthroscopic debridement of the tibiotalar joint was performed in all specimens using a standardized protocol.