Fracture-Related Infections in the Foot and Ankle.

Fracture-related infection (FRI) poses significant challenges in the management of foot and ankle fractures, potentially leading to functional impairment and heightened health care expenses. This review addresses the diagnosis, risk factors, and management strategies for FRI. Surgical management involves multidisciplinary collaboration, emphasizing debridement, antimicrobial therapy, and implant removal when indicated.

Complications of Foot and Ankle Fractures in Diabetics.

Patients with diabetes have an increased risk of both foot and ankle fractures. Patients with mild disease may be managed similarly to the population with no diabetes, although patients with advanced diabetes are likely to require more robust fixation with prolonged periods of non-weight-bearing. All patients with diabetes should be screened for peripheral neuropathy, as this is a marker for poor outcomes following both surgical and nonsurgical management.

Posttraumatic Pathologies of the First Metatarsophalangeal Joint.

Injuries to the first metatarsophalangeal joint are often missed and not adequately treated, resulting in secondary deformities and degenerative arthritis. The particular anatomy of the joint puts mainly soft tissue structures at risk, which is why conditions such as turf toe injury and valgus or varus deformities can occur. Because the sesamoid bones are receiving high pressures, fractures should be considered.

Metatarsal Malunion.

Metatarsal fractures account for almost 50% of all foot fractures; the most frequent trauma mechanism for central metatarsal fractures is direct trauma. Care should be taken when evaluating patients with higher energy accidents, as they are often associated with serious soft-tissue damage and adjacent joint injuries, such as Lisfranc injuries. Malunions on the axial plane (varus/valgus) are usually better tolerated than the ones on the coronal plane, especially plantar flexion deformity.

Post Traumatic Complications After Navicular Fractures.

Navicular fractures are rare injuries. The navicular is a key part of normal hindfoot function and serves as the key link from the hindfoot to the midfoot in the medial column of the foot. Management of navicular fractures is complicated by the relatively poor soft tissue envelope, tenuous blood supply and high percentage of articular surface.

Chopart Joint Injuries.

Fractures and dislocations of the Chopart joints are injuries with a low incidence but a high rate of complication, especially if missed or inadequately treated. They often entail both trans-osseous and ligamentous components, and treatment must therefore entail reconstruction of articular congruency and realignment of foot to achieve mechanical stability in the lateral and medial columns. The types of fixation hardware can vary based on fracture types, location, and soft tissue envelope.

Fibular Malunion: Diagnosis, Treatment, and Prevention.

Malunions of the fibula are caused by malreduction during initial surgical management or the result of nonoperative treatment of an unstable ankle fracture. They can cause significant changes in loading of the ankle and subsequently lead to arthritic changes. Timely recognition of abnormal anatomy and corrective osteotomy yields favorable results.

Global epidemiology of lower limb fractures: Trends, burden, and projections from the GBD 2021 study.

Background: Lower limb fractures are a significant global public health issue, imposing considerable social and economic burdens. Despite their prevalence, comprehensive analyses of the global epidemiology of lower limb fractures remain scarce. This study aims to address this gap.

Outcomes in Treatment of Ankle and Pilon Fractures with Retrograde Tibiotalocalcaneal Nailing Without Articular Preparation in the Setting of Diabetes Mellitus.

Background: Treatment of ankle and pilon fractures in the setting of diabetes mellitus (DM) is challenging due to a propensity for postoperative complications. Limb salvage is a primary concern following these injuries, as below knee amputation (BKA) occurs at an unacceptably high rate. Primary retrograde tibiotalocalcaneal (TTC) joint nailing without articular preparation has emerged as a solution to treat diabetics with ankle and pilon fractures to mitigate surgical complications and prevent BKA.

Beyond support: exploring the dynamic and static biomechanical changes induced by preventive ankle taping: a novel cross-sectional study.

Introduction: In sports, 80% of all ankle injuries are sprains of the external compartment. Functional bandages are usually used preventively, specially in individuals with a history of lateral ankle injuries. To this day, the actual benefits of such taping remain unknown as important modifications are introduced in the ankle biomechanics.

Minimally invasive internal splinting technique for acute closed Achilles tendon rupture.

Background: Although non-surgical and surgical approaches have been developed to repair acute closed Achilles tendon ruptures, the medical community still lacks a definitive consensus on which approach is superior. This study describes a new minimally invasive internal splinting technique combined with knotless anchors for the treatment of 22 patients with acute closed Achilles tendon rupture.

Methods: A retrospective study was conducted involving 22 patients with acute closed Achilles tendon rupture who were treated with a minimally invasive internal splinting technique at Jingzhou Hospital of Yangtze University between January 2022 to October 2023.

Chronic Wounds and Dressings: An Overview of Management and Effectiveness.

Chronic wounds are complex conditions categorized into pressure injuries, diabetic foot ulcers, venous leg ulcers, and arterial ulcers. In managing these wounds, the selection of appropriate wound care products is of critical importance. Commonly used dressings include hydrocolloid, hydrogel, alginate, foam, and silver-containing dressings.

The effects of integrated traditional Chinese and western medicine rehabilitation programs on post-acute ankle sprain: A randomized controlled trial study protocol.

Background: Ankle sprain is a common clinical disease, which has the highest incidence rate among joint and ligament injuries. And acute ankle sprains can easily develop into chronic ankle instability, thereby increasing the difficulty of treatment. The current clinical guidelines for post-acute ankle sprains are still controversial.

The association between primary frozen shoulder and serum lipids may be overestimated: evidence based on retrospective observational studies and Mendelian randomization.

Background: Previous studies have shown that dyslipidemia is significantly associated with primary frozen shoulder and may be a risk factor for the development of primary frozen shoulder. However, these findings may be biased by a number of confounding factors. We investigated the association between serum lipids and primary frozen shoulder by retrospective analysis and two-sample Mendelian randomization (MR) methods.

Advancements in minimally invasive treatment of deltoid ligament injuries combined with distal tibiofibular syndesmosis injuries.

The deltoid ligament (medial collateral ligament) and the syndesmosis (a composite ligamentous structure at the distal tibiofibular junction) are critical for maintaining ankle stability. In cases of high-energy ankle fractures, these structures are often injured simultaneously, leading to instability and potential long-term complications such as post-traumatic arthritis. This review aims to explore advancements in minimally invasive techniques for the treatment of combined deltoid ligament and syndesmosis injuries, with a focus on optimizing surgical outcomes and reducing patient morbidity.

Arthroscopically Assisted Reduction and Fixation of Acute Tillaux, Pilon, Bosworth, Talar, and Calcaneal Fractures: A Systematic Review.

Increased use of arthroscopically assisted techniques for the treatment of ankle fractures has been reported. Despite their rapid development, there is only one systematic review regarding arthroscopically assisted treatment of ankle fractures, in which, however, only malleolar fracture studies are included. Various other types of ankle fractures have also been treated with arthroscopically assisted procedures.

Acute Achille Tendon Rupture After Treatment of Levofloxacin for Helicobacter pylori Eradication: A Case Report.

This case report aims to demonstrate a rare occurrence of tendon rupture attributable to levofloxacin use in Helicobacter pylori eradication. On the seventh day of treatment, the patient experienced severe foot pain and difficulty in walking, leading to a diagnosis of Achilles tendon rupture confirmed through magnetic resonance imaging. Levofloxacin-induced tendinopathy and/or rupture are rare complications that are often linked to age and sex.

Patients With Chronic Lateral Ankle Instability and Small Osteochondral Lesions of the Talus Obtain Good Postoperative Results: A Minimum 10-Year Follow-up With Radiographic Evidence.

Background: Few studies reported the long-term clinical outcomes and joint degeneration of patients with chronic lateral ankle instability (CLAI) and small osteochondral lesions of the talus (OLTs) following simultaneous open modified Broström-Gould (MBG) surgery and arthroscopic bone marrow stimulation (BMS). The purpose of this study was to study the long-term results of patients after BMS and BMG surgery, and to further evaluate the potential effect of OLT size on postoperative results.

Methods: In this retrospective study, 110 CLAI patients were divided into 57 patients with OLTs (including 24 patients having combined small osteochondral lesions of the tibial plafond) receiving simultaneous BMS and MBG surgeries (BMS+MBG group), and 53 patients without OLTs receiving isolated open MBG surgery (MBG group).

Impact of Earthquakes During COVID-19 Lockdown on the Pediatric Injury Pattern in the Zagreb Urban Area.

: Previous works on the epidemiology of pediatric trauma during the COVID-19 lockdown observed a decrease in pediatric surgical emergency consultations and fracture referrals. None of those works describes a unique situation in which there is the coexistence of another opposing factor, like an earthquake, that influences the number of injured children's referrals. Therefore, this study aimed to investigate the influence of earthquakes during the COVID-19 lockdown on pediatric injury pattern referrals at a tertiary care hospital in a urban setting.

Pattern of injury in polytrauma compared to single limb related Lisfranc joint fractures.

Background: Midfoot fractures in polytrauma patients are often an underappreciated injury relative to their other major injuries sustained. In this study, our aim was to explore the mechanisms and patterns of injury in polytrauma related midfoot fractures as compared to single limb injuries.

Setting: Multicentre observational study.

A case report of anaphylactic shock caused by lidocaine.

Rationale: Local anesthesia is a widely used technique for emergency wound closure, with lidocaine among the most commonly employed local anesthetics. Allergic reactions to lidocaine are rare, with anaphylaxis being even more uncommon.

Patient Concerns And Diagnosis: This report describes a 72-year-old male patient who presented with a right foot injury and underwent wound suturing under lidocaine local anesthesia.

Infection Rate and Antibiotic Administration for Urban Low-Energy Gunshot Wounds at an Academic Level 1 Trauma Center.

Introduction: The purpose of this study was to review rates of infection after civilian ballistic fractures and assess the effect of early antibiotic administration (EAA) on infection rates.

Methods: This was a retrospective cohort study done at an urban Level 1 Trauma Center. Patients ages 16 years and older with ballistic orthopaedic extremity injuries between May 2018 and December 2020 were enrolled.

Successful Healing After Minimally Invasive Subtalar Fusion Following Comminuted Open Calcaneus Fracture: A Case Report.

Case: A 51-year-old male polytrauma patient presented with bilateral calcaneus fractures after a fall. This report describes treatment of his right comminuted Sanders IV calcaneus fracture with percutaneous open reduction internal fixation (ORIF) and minimally invasive surgery (MIS) primary subtalar fusion to restore alignment and preserve soft tissue.

Conclusion: Unlike traditional open approaches, which are prone to wound complications due to larger incisions, our approach of maintaining fracture alignment during joint preparation using an MIS burr for acute posttrauma subtalar arthrodesis and percutaneous ORIF appears to have reduced these risks, resulting in successful radiological healing and functional recovery at 1-year follow-up.

Long-term results of staged management of complex lisfranc and chopart injury: a retrospective cohort study and systematic literature review.

Purpose: The aim was to assess the long-term functional outcome and quality of life after staged surgical treatment of complex Lisfranc and Chopart injuries in a patient cohort, and to perform a systematic review of the literature.

Methods: A retrospective cohort of all trauma patients with complex Lisfranc and/or Chopart injuries treated at our level 1 trauma center between July 1, 2010, and July 1, 2020 with ≥ 3 years follow-up was analyzed in terms of management, complications, and patient-reported outcomes (American Orthopaedic Foot & Ankle Society midfoot score, AOFAS and Foot Function Index, FFI). A systematic review of the literature (according to PRISMA 2020 guidelines) was performed of studies published between January 2000 to April 2024.

Severe Injuries of Former Portuguese Football Players: A Post-Career Burden?

Background/objectives: Football players have a high injury risk due to the physical demands of their profession, which can negatively affect their quality of life (QoL) in the long term. The aim of this study is to characterize the severe injuries that former Portuguese football players suffered throughout their professional careers and investigate the resulting impacts on the physical domain of QoL after retirement.

Methods: This study includes 84 former Portuguese football players (48.