A Comparison Between X-ray Imaging and an Innovative Computer-aided Design Method Based on Weightbearing CT Scan images for Assessing Hallux Valgus
With the development of recent technology, radiographs can be saved digitally, and angular measurements can be processed using various software packages. We developed an innovative computer-aided design method with Materialize Interactive Medical Image Control System software to measure hallux valgus angle (HVA), the intermetatarsal angle (IMA), and the distal metatarsal articular angle (DMAA) and assessed its concordance with traditional X-ray imaging methods. All measurements were carried out on 42 feet from 26 adult patients diagnosed with hallux valgus who were prospectively selected from July 2016 to April 2018. (Sour...
Source: Journal of Foot and Ankle Surgery - April 3, 2020 Category: Orthopaedics Authors: Zongyu Zhong, Peng Zhang, Hao Duan, Hao Yang, Qing Li, Fei He Tags: Original Research Source Type: research

Medial Plantar Artery Common Origin to Determine Incision Placement for the Fasciocutaneous Flap: A Cadaveric Study
This study examined the location of the origin of the medial plantar artery in 40 fresh cadavers. Results were obtained by dissection and macroscopic analysis to document the distance of the origin of the medial plantar art ery from the intercollicular groove of the medial malleolus in centimeters. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - April 3, 2020 Category: Orthopaedics Authors: Casie Blanton, Miguel Kercado, Thomas Nordquist, Suhail Masadeh, Pedro Rodriguez, Edgardo Rodriguez-Collazo Tags: Original Research Source Type: research

Posterior Tibial Tendinopathy and Osteopenia as Primary Symptoms of Celiac Disease: A Case Report
This case report describes posterior tibial tendon (PTT) tendinopathy, valgus deformity with tenosynovitis, and osteopenia at the medial malleolus as the primary symptoms of a young patient with celiac disease (CD) without gastrointestinal symptoms. CD is an autoimmune condition that is a chronic inflammatory disorder of the small intestine triggered by ingestion of gluten in individuals with a particular genetic background. Without typical gastrointestinal symptoms, CD patients are often misdiagnosed or undiagnosed. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - April 3, 2020 Category: Orthopaedics Authors: Masahiro Tada, Tyler Feltham, Stuart Michnic, Zheng-Yu Gao, Mark D Horowitz, Zijun Zhang, Lew C. Schon Tags: Case Reports and Series Source Type: research

Dimensional Changes of the Tarsal Tunnel During Foot and Ankle Positions – Anatomical Study
The tarsal tunnel is a fibrous osseous conduit for the tibial nerve and associated tendons. It is mechanically dynamic, and foot and ankle movements appear to move and change tunnel shape. However, the effect of foot and ankle movements is not clear. The aim of this study was to measure tarsal tunnel dimensions in anatomical position of the foot and ankle and quantify its changes at different positions in cadavers. A cross-sectional study with a total of 16 cryopreserved lower extremities from cadaveric specimens were used. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - April 3, 2020 Category: Orthopaedics Authors: Carlos L ópez-de-Celis, Santos Caudevilla Polo, Vanessa González-Rueda, Elena Bueno-Gracia, Albert Pérez-Bellmunt, Mathias Simon, Elena Estébanez-de-Miguel Tags: Original Research Source Type: research

Arthroscopic Ankle Arthrodesis for End-Stage Tuberculosis of the Ankle: A 2-Year Follow-Up
This study followed cases treated by arthroscopic arthrodesis for ankle joint TB to evaluate its efficacy and safety in the clinic. Patients who underwent arthroscopic ankle arthrodesis for ankle joint TB between April 11, 2010, and December 31, 2016, were followed. Their diagnoses were confirmed by bacterial culture or pathological examination. During arthroscopy, tissue samples were first obtained to further confirm the diagnosis. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - April 2, 2020 Category: Orthopaedics Authors: Changgui Zhang, Yangjing Lin, Chengchang Zhang, Jin Cao, Liu Yang, Xiaojun Duan Tags: Case Reports and Series Source Type: research

An Unusual Case Report of a Stage IV Osteochondral Defect Imitating a Medial Malleolar Avulsion Fracture
Osteochondral lesions of the talar dome are severely debilitating injuries that frequently can be missed on initial radiographic evaluation. In this case, we present the case of a 17-year-old male who injured his right ankle while skateboarding. Initial radiographic findings showed what appeared to be an avulsion fracture of the medial malleolus, and the patient was subsequently treated with immobilization. It was not until more advanced imaging of computed tomography was performed that the patient was appropriately diagnosed with a displaced talar dome fragment that was positioned in the medial gutter, requiring surgical ...
Source: Journal of Foot and Ankle Surgery - April 2, 2020 Category: Orthopaedics Authors: Tyler Claveau, Lawrence M. Fallat Tags: Case Reports and Series Source Type: research

Correction
In the February JADA For the Patient page titled “Helping Your Child Fight Tooth Decay” (Mark A. JADA. 2020;151[2]:154), a 6th bullet should be included under “What Can You Do?”: • as soon as 2 teeth come in next to each other, start cleaning between the teeth 1 time per day. Talk to your dentist or dental hygienist about how to do this. ” JADA regrets the error. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - April 2, 2020 Category: Orthopaedics Source Type: research

Posterior Tibial Tendon Allograft Reconstruction for Stage II Adult Acquired Flatfoot: A Case Series
Surgical treatment for a stage II adult acquired flatfoot has consisted of reconstruction of the diseased posterior tibial tendon with flexor digitorum longus tendon transfer, combined with osteotomies to address the underlying deformity. This case series presents an alternative to tendon transfer using allograft tendon for posterior tibial tendon reconstruction. Four patients who underwent stage II flatfoot reconstruction with posterior tibial tendon allograft transplantation were included. All patients had preoperative radiographs demonstrating flatfoot deformity and magnetic resonance imaging showing advanced tendinopat...
Source: Journal of Foot and Ankle Surgery - April 1, 2020 Category: Orthopaedics Authors: Darrick R. Dominick, Alan R. Catanzariti Tags: Case Reports and Series Source Type: research

Fusion of the Tarsometatarsal Joints: A Focus on Lateral Column Fusion Nonunion Rates
The literature has previously criticized lateral column arthrodesis, stating this procedure should be avoided to preserve biomechanical function. For patients with recurrent pain secondary to posttraumatic degenerative joint disease (PT-DJD) or dysfunction secondary to Charcot tarsometatarsal collapse, however, this procedure could provide a positive alternative to conservative measures. In our study, 37 patients underwent fourth and/or fifth metatarsal to cuboid arthrodesis, either in isolation or in combination with other tarsometatarsal arthrodeses, with an average follow-up of 27.7 ± 28.5 months. (Source: Journa...
Source: Journal of Foot and Ankle Surgery - March 31, 2020 Category: Orthopaedics Authors: Richard Derner, Brian S. Derner, Ansgar Olsen Tags: Original Research Source Type: research

Clinical and Functional Results of Brostr öm–Gould Procedure With Suture Tape Augmentation: An Evaluation Using Three Scales
This study aimed to describe functional results using the visual analog scale (VAS), American Orthopedic Foot& Ankle Society (AOFAS) scale, and Short Form of Quality of Life Survey (SF-36) in patients with ankle lateral instability who underwent the modified Brostr öm–Gould repair and suture tape augmentation and to determine the recurrence of injury and the impact on the perception of its stability. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - March 31, 2020 Category: Orthopaedics Authors: V. Jonathan Ram írez-Gómez, Luis A. Gómez-Carlín, Rafael Ortega-Orozco, Carlos A. Zazueta-Arnaud, Juan P. Patiño-Fernández Tags: Original Research Source Type: research

Posteroanterior Lag Screws Versus Posterior Buttress Plate Fixation of Posterior Malleolar Fragments in Spiral Tibial Shaft Fracture
The aim of this study is to compare the clinical outcomes of posteroanterior (PA) lag screws versus posterior buttress plate fixation in treatment of posterior malleolar fragments (PMFs) in spiral tibial shaft fracture, and provide guidance for surgeons selecting a treatment strategy. A total of 48 eligible patients with PMFs associated with spiral tibial shaft fracture surgically treated from March 2009 to January 2016 were included in the study. They were divided into the screw group (n  = 24) and the plate group (n = 24). (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - March 29, 2020 Category: Orthopaedics Authors: Kaibin Zhang, Rongfei Cui, Yanqing Gu, Dalin Wang, Junwei Yan, Zhaowei Yin, Chenyang Xu Tags: Original Research Source Type: research

Patient Requests for Burial of Amputated Limbs
Patient requests that amputated limbs be preserved for private burial, although infrequent, are regular occurrences in the United States. No formal data exist on the incidence, but the practice is encouraged within several major religious traditions and supported by some strains of folk culture. Podiatric surgeons may find that addressing the issue proactively with patients who are anticipating amputation could help the process of grieving and adjustment necessary for healing after loss. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - March 29, 2020 Category: Orthopaedics Authors: John W. Ehman Tags: Commentary Source Type: research

Editor's Introduction to Chaplain Ehman's Comments on Amputation and Limb Burial
One of the most common and difficult tasks that foot and ankle surgeons have to conduct is explaining to a patient, and the patient's family, that amputation is the indicated course of treatment. As such, it behooves us all to consider the possibility that our patient may have certain religious or personal beliefs that are specifically related to amputation, and to discuss with the patient how they would like to proceed with regard to the care and handling of the amputated portion of their body. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - March 28, 2020 Category: Orthopaedics Authors: D. Scot Malay Tags: Commentary Source Type: research

American Orthopedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Joint Scale: A Cross-Cultural Adaptation and Validation Study in the Persian Language
We evaluated the reliability and validity of the Persian translation of the American Orthopedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal joint scale (AOFAS Hallux MTP-IP). The translated AOFAS Hallux MTP-IP scale form was completed for 101 patients with hallux deformities; the subjective questions were answered by the patients, whereas the orthopedic foot and ankle surgeon and his assistant answered the objective questions. The validated Persian version of the 36-Item Short Form Survey Instrument (SF-36) was used for validity assessment. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - March 20, 2020 Category: Orthopaedics Authors: Hamideh Mahdaviazad, Bahareh Kardeh, Amir Reza Vosoughi Tags: Original Research Source Type: research

Effect of Lower-Extremity Angular Imbalance on Foot and Ankle Pain in Patients With Genu Varus Deformity
When there is a varus knee deformity, the ankle and foot compensate. However, the association between pain and angular change in the compensatory mechanism is not well understood. Therefore, we investigated the relationship between pain and angular change of the lower extremity in genu varus patients. Standing whole-lower-leg plain radiographs of 127 legs (77 patients) with>4 ° of genu varum were evaluated. Pain was assessed separately at the ankle, forefoot, and hindfoot. Knee, ankle, and subtalar joint angles were measured. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - March 14, 2020 Category: Orthopaedics Authors: Joo-Yul Bae, Dong-Kyo Seo, Hyung-Kwon Cho, Suk Kyu Lee Tags: Original Research Source Type: research

Patient-Reported Outcome Measures (PROMs): Influence of Motor Tasks and Psychosocial Factors on FAAM Scores in Foot and Ankle Trauma Patients
Patient-reported outcome measures (PROMS) are being increasingly used as a quality of care metric. However, the validity and consistency of PROMS remain undefined. The study sought to determine whether Foot and Ankle Ability Measure (FAAM) scores improve after patients complete motor tasks evaluated on the survey and to examine the relationship between depression and self-efficacy and FAAM scores or change in scores. We conducted a prospective comparison study of adults with isolated foot, ankle, or distal tibia fractures treated operatively at level I trauma center. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - March 12, 2020 Category: Orthopaedics Authors: Blake J. Schultz, Natalie Tanner, Lauren M. Shapiro, Nicole A. Segovia, Robin N. Kamal, Julius A. Bishop, Michael J. Gardner Tags: Original Research Source Type: research

The Use of Percutaneous Screw Fixation Without Fracture Site Preparation in the Treatment of Fifth Metatarsal Base Nonunion
Nonunion after a proximal fifth metatarsal fracture can cause considerable pain, with high morbidity and loss of work. Although many authors advocate early surgical management of zone 3 injuries (Jones fractures), zone 1 and 2 fractures are generally expected to heal with conservative management. Uncommonly, zone 1 and 2 fractures can develop nonunions. The aim of this study was to evaluate the efficacy of closed intramedullary screw fixation for nonunions of the fifth metatarsal base. We performed a prospective study involving all fifth metatarsal base nonunions treated in our department over 2 years. (Source: Journal of ...
Source: Journal of Foot and Ankle Surgery - March 12, 2020 Category: Orthopaedics Authors: Michael J. Grant, Andy P. Molloy, Lyndon W. Mason Tags: Original Research Source Type: research

Relationship Between pH Shifts and Rate of Healing in Chronic Nonhealing Venous Stasis Lower-Extremity Wounds
Venous stasis ulcers represent the majority of lower-extremity ulcers and place a considerable financial burden on the American health care system. Current standard of care therapies remain sub-optimal with 50% of venous stasis ulcers remaining unhealed after 4 months. Sixteen consecutive wounds were enrolled across 8 participants at a single center and underwent pH-driven therapy in addition to standard care as dictated by physicians. Following wound debridement, the pH of the wound bed was measured using pH strips. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - March 6, 2020 Category: Orthopaedics Authors: Arthur Tarricone, Karla De La Mata, Simon Chen, Prakash Krishnan, Samantha Landau, Ronald Soave Tags: Original Research Source Type: research

Computer-Assisted Gradual Correction of Charcot Foot Deformities: An In-Depth Evaluation of Stage One of a Planned Two-Stage Approach to Charcot Reconstruction
The surgical treatment of Charcot foot is a widely debated topic, with issues ranging from when to operate to how to properly correct a deformity. Historically, correction of a severe deformity was attempted in 1 acute surgical procedure that frequently required open reduction and internal fixation through large incisions. This 1-time procedure would often result in complications including under- or overcorrection of the deformity, neurovascular injury, or incision dehiscence leading to possible soft-tissue infection or osteomyelitis. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - March 4, 2020 Category: Orthopaedics Authors: Philip Wrotslavsky, Stephen J. Kriger, Samuel M. Hammer-Nahman, James G. Kwok Tags: Case Reports and Series Source Type: research

TEMPORARY REMOVAL: Is the Denis Browne Splint a Myth? A Long-Term Prospective Cohort Study in Clubfoot Management using Denis Browne Splint Versus Daily Exercise Protocol
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - March 1, 2020 Category: Orthopaedics Authors: Reda Ali Sheta, Mohamed El-Sayed Source Type: research

Histopathological Evaluation of Mechanoreceptors in the Metatarsophalangeal Joint Capsule in Hallux Valgus
To date, we could find no study concerning the relationship between mechanoreceptors in the joint capsule of the first metatarsophalangeal joint and hallux valgus deformity. We aimed to investigate the presence of mechanoreceptors in samples obtained from the first metatarsophalangeal joint capsules of patients with hallux valgus deformity to improve our understanding of the clinical and histopathological features of the disease. Samples were taken from the first metatarsophalangeal joint capsules of 13 fresh-frozen cadavers with normal anatomy (controls) and 29 patients undergoing surgery for hallux valgus (cases). (Sourc...
Source: Journal of Foot and Ankle Surgery - February 26, 2020 Category: Orthopaedics Authors: Evrim Şirin, Cansu Kandemir, Barış Yılmaz, Güzelali Özdemir, Dilek Akakın, Hasan Hilmi Muratlı Tags: Original Research Source Type: research

Syndesmotic Ligament Allograft Reconstruction for Treatment of Chronic Diastasis
Chronic diastasis after a syndesmotic injury can lead to ankle joint instability and loss of joint congruence. Failure to restore the fibula into the proper anatomic position within the incisura increases the focal stress on the talus and can accelerate degenerative joint destruction. In the case of failed syndesmotic repair, fixation options are limited. If promptly diagnosed, the syndesmosis may be amenable to open debridement and subsequent fixation with 2 interosseous screws. If latent diastasis is found, however, syndesmotic fusion by bone block arthrodesis is recommended. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 26, 2020 Category: Orthopaedics Authors: James C. Connors, Jordan P. Grossman, Emily E. Zulauf, Michael A. Coyer Tags: Case Reports and Series Source Type: research

Age-Related Outcomes in Total Ankle Arthroplasty: An Analysis of 112 Patients
Traditionally, total ankle replacement has been reserved for elderly patients with low physical demands. With nearly 80% of end-stage ankle arthritis being secondary to prior trauma, patients may require a replacement at a much younger rate than primary hip and knee arthritis. Historical accounts of implant failure and high revision rates in younger patients have been reported in the literature. With increasing technology and surgeon experience, implants are being used in younger patients with significantly fewer complications than early reports. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 26, 2020 Category: Orthopaedics Authors: James M. Cottom, Colin T. Graney, Steven M. Douthett, Charles Sisovsky, Kelly K. McConnell, Britton S. Plemmons Tags: Original Research Source Type: research

All-Inside Arthroscopic Anterior Talofibular Ligament Anatomic Reconstruction With a Gracilis Tendon Autograft for Chronic Ankle Instability in High-Demand Patients
The goal of this study was to evaluate the surgical technique and clinical outcome of all-inside arthroscopic anterior talofibular ligament anatomic reconstruction with a gracilis tendon autograft for chronic ankle instability in high-demand patients. Fifteen consecutive patients (14 [93.3%] males and 1 [6.7%] female, mean age 31.9 ± 7.8 [range 21 to 48] years) with chronic ankle instability were enrolled in this study. Under direct arthroscopic visualization, bone tunnels were created in the fibula and talus by a 4.5-mm cannulated drill system. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Shenghui Lan, Wenbo Zeng, Gongwu Yuan, Feng Xu, Xianhua Cai, Ming Tang, Shijun Wei Tags: Original Research Source Type: research

One-Bone Tarsus: A Case Report
In this report, we describe a case of multiple tarsal coalitions in a 24-year-old male who experienced progressively worsening pain for 3 to 4 months before presenting for care. This case was unique in that all the tarsal and tarsometatarsal bones in the foot were fused and formed 1 integrated tarsal. All of the metatarsals were fused as well, and the patient had no joints or ranges of motion in the hindfoot or midfoot. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Ali Yeganeh, Mikaiel Hajializade, Seyed Mani Mahdavi, Amir Sobhani Eraghi, Mehdi Moghtadaei Source Type: research

Risk Factors for Short-Term Complication After Open Reduction and Internal Fixation of Ankle Fractures: Analysis of a Large Insurance Claims Database
Although fractures of the ankle are common injuries treated by surgical podiatrists and orthopaedic surgeons specializing in foot and ankle surgery, postoperative complications can occur, often imposing an economic burden on the patient. As health care in the United States moves toward value-based care, cost reduction has primarily focused on reducing complications and unplanned episodes of care. We used a large modern database of insurance claims to examine patterns of complications after open reduction internal fixation of ankle fractures, identifying diabetes mellitus and history of myocardial infarction as risk factors...
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Daniel C. Jupiter, En Shuo Hsu, George Tye Liu, John G. Reilly, Naohiro Shibuya Source Type: research

Effectiveness of the Cadaver Lab in Podiatric Surgery Residency Programs
Since the inception of the first surgical training system by Sir William Stewart Halsted, resident surgical skill development has been promulgated in teaching hospitals. Currently, the Council on Podiatric Medical Education does not mandate the availability of a cadaver lab as a residency curriculum requirement. The purpose of the present study is to assess the structure of the cadaver lab and availability in the current podiatric surgical training programs. A survey was sent electronically to 229 American Association of Colleges of Podiatric Medicine –approved residency programs, excluding OhioHealth, across all res...
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Anson K. Chu, Rona W. Law, Joseph M. Greschner, Christopher F. Hyer Source Type: research

Diffuse-Type Giant Cell Tumor of the Paratenon of Achilles Tendon Requiring Reconstruction Using Bilateral Autografts: A Case Report
In this study, we report the case of a 41-year-old male patient who was diagnosed with diffuse-type paratenon giant cell tumor involving the Achilles tendon. The duration of the bilateral tumors was 8 years. He visited first affiliated Hospital of Wenzhou Medical University for medical attention. Both his Achilles tendons required removal. The reconstructed Achilles tendon was replaced using tissue derived from the knee and foot. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Haibo Zhou, Chao Zhang, Chuicong Lin, Guangjian Jin, Lei Chen, Chun Chen Source Type: research

Common Pitfalls in Subtalar Joint Preparation for Arthrodesis via Sinus Tarsi Approach
This cadaveric study assessed factors that could lead to nonunions in subtalar joint arthrodesis. The purpose of this study was to assist surgeons in achieving sufficient joint preparation in hopes to achieve more frequent arthrodesis of the subtalar joint. We evaluated the influence of experience in regard to cartilage preparation of the joint. We also assessed which quadrants of the subtalar joint were more likely to have unprepared cartilage. The subtalar joints in 17 cadaveric limbs were prepared by 17 participants with differing levels of experience. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Neil B. Patel, Cody Blazek, Rick Scanlan, Jeffrey M. Manway, Patrick R. Burns Source Type: research

Weightbearing Cone-Beam Computed Tomography of Acute Ankle Syndesmosis Injuries
Syndesmotic injuries are common, but only a subset of these injuries are unstable. A noninvasive tool for identifying instability would aid in the selection of patients for surgery. Weightbearing computed tomography (CT) data have been reported for healthy patients, but there are limited data on unstable syndesmoses. We evaluated the syndesmotic area of arthroscopically proven unstable ankles after acute injury. This is a prospective comparative study of consecutive patients recruited to a weightbearing CT database. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Andres del Rio, Samuel M. Bewsher, Sasha Roshan-Zamir, Julie Tate, Maggie Eden, Robert Gotmaker, Otis Wang, Harvinder S. Bedi, Andrew H. Rotstein Source Type: research

Lateral Extensile Approach Versus Minimal Incision Approach for Open Reduction and Internal Fixation of Displaced Intra-articular Calcaneal Fractures: A Meta-analysis
Treatment of displaced intra-articular calcaneal fractures remains controversial. Therefore, the purpose of this large meta-analysis was to report the outcomes of the lateral extensile approach versus the minimal incision approach including complications, anatomic reduction, functional outcomes, and timing and to report results when only randomized control trials were compared. Five electronic databases were searched for articles directly comparing the 2 above approaches. Inclusion criteria included articles published from January 2007 to April 2017, adults (>18 years old) with closed, Sanders type II or III fractures, ...
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Andrea Seat, Christopher Seat Tags: Review Articles Source Type: research

Open Versus Closed Operative Treatment for Tongue-Type Calcaneal Fractures: Case Series and Literature Review
Because consensus on the optimal surgical treatment of tongue-type calcaneal fractures is lacking, this study aimed to compare outcomes and postoperative complications of open and closed surgical treatment of these fractures. For this cases series, all patients 18 years or older who underwent operative fixation of tongue-type calcaneal fractures at 2 level I trauma centers between 2004 and 2015 were considered eligible for participation. Data on explanatory and outcome variables were collected from medical records based on available follow-up. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Quirine M.J. van der Vliet, Jeffrey M. Potter, Thirza A. Esselink, Roderick M. Houwert, Falco Hietbrink, Luke P.H. Leenen, Marilyn Heng Source Type: research

Two Cases of Periprosthetic Fracture After Surgery for Acute Midfoot Charcot
Charcot neuroarthropathy is a rare condition that often results in deformity of the foot and ankle, with a high incidence of ulceration and a high risk of amputation. Traditionally, treatment of the acute stages of Charcot foot has been nonoperative until consolidation. Still, a large number of patients develop deformities, and early operative treatment of unstable Charcot feet has been suggested. To overcome some of the inherent challenges when operating on acute-stage Charcot feet, the superconstruct technique has been proposed. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Fredrik Andr è Nilsen, Marius Molund, Kjetil H. Hvaal Source Type: research

Operative Management of a Pediatric Talar Body and Neck Fracture: A Case Report
Pediatric talus fractures are rare injuries that generally result from high-energy trauma. The relative elasticity of pediatric bone is thought to contribute to the lower rate of fracture in children. Although these injuries are rare, complications of talar body fractures, including avascular necrosis, collapse of the talar dome, and tibiotalar arthrosis, are well described. In the pediatric patient, these complications can result in poor outcomes and a disabling position for the patient. There is a relative paucity of data given the low incidence of these injuries and lack of consensus on operative versus nonoperative man...
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Andrew D. Wohler, J Kent Ellington Source Type: research

Surgical Treatment and Management for Chronic Dislocated Subtalar Joint
This study aims to describe this “sidecar” deformity, etiologies of the deformity, and the surgical options for correction. This study was performed by reviewing medical records of a single foot and ankle surgeon for patients who met inclusion criteria and underwent surgical correction. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Daniel R. Elbert, Travis M. Langan, Patrick R. Burns Tags: Case Reports and Series Source Type: research

Kaposi Sarcoma Inflammatory Cytokine Syndrome Presenting as Infection: A Case Report
Kaposi sarcoma inflammatory cytokine syndrome is a rare and fatal malignancy that is challenging to treat. The syndrome appears in individuals who are both human immunodeficiency virus and human herpesvirus 8 positive. The diagnosis of disease is challenging because its presentation mimics sepsis and it has a high mortality rate. A bone marrow biopsy is necessary for definitive diagnosis. This case report discusses a 40-year-old human immunodeficiency virus infection –positive African American male who presented to the emergency department with a chief complaint of left hallux pain in January 2018 after a trip to a n...
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Tommy Tally, Robin Dretler, Tom Cain, Kelly Brennan Source Type: research

The Epidemiology of Metatarsal Fractures Among Older Females With Bisphosphonate Exposure
We examined the epidemiology of metatarsal fractures among 48,390 females aged ≥50 years who initiated oral BP and were followed for a median 7.7 years, including 68 females who experienced an atypical femur fracture. Incident metatarsal fractures after BP initiation were identified by clinical diagnoses and validated by record review. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Tenaya A. West, Jason D. Pollard, Malini Chandra, Rita L. Hui, Miranda Ritterman Weintraub, Christy M. King, Christopher D. Grimsrud, Joan C. Lo Source Type: research

Total Ankle Arthroplasty and Ankle Arthrodesis Use: An American Board of Orthopaedic Surgery Part II Database Study
Total ankle arthroplasty (TAA) use has increased during the past 20 years, whereas ankle arthrodesis (AAD) use has remained constant. The purpose of this study was to examine trends in TAA and AAD use in American Board of Orthopedic Surgery Part II candidates while considering the influence of fellowship training status on treatment of end-stage ankle arthritis. The American Board of Orthopedic Surgery Part II database was queried to identify all candidates who performed ≥1 TAA or AAD from examination years 2009 through 2018. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Christopher N. Carender, Natalie A. Glass, Alan G. Shamrock, Annunziato Amendola, Kyle R. Duchman Source Type: research

The Clinical Efficacy of Two Endoscopic Surgical Approaches for Intractable Plantar Fasciitis
In this randomized retrospective study, 2 different endoscopic approaches were used to treat intractable plantar fasciitis with the aim to reduce complications and improve therapeutic effects. The lateral double incisions group included 23 feet in 22 patients, and the medial and lateral incisions group included 21 feet in 19 patients. Both groups were treated with endoscopy through the suprafascial approach. Patients were evaluated using the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale (AOFAS-AHS) and visual analog scale (VAS) preoperatively and 3, 6, 12, and 24 months postoperatively. (Source: Journal ...
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Yong Tang, Pan Deng, Gang Wang, Yourong Yao, Zhengli Luo, Yunqin Xu Source Type: research

Tibial Nail Combined with Vacuum Sealing Drainage for Gustilo Grade IIIB Open Tibial Fractures: A Patient Series
Gustilo grade IIIB open tibial fractures are relatively difficult to treat. We investigated the treatment effects of tibial intramedullary nails combined with vacuum sealing drainage (VSD) for Gustilo grade IIIB open tibial fractures. From March 2015 to March 2017, 13 cases of Gustilo grade IIIB open tibial fractures were treated with Expert Tibial Nails combined with VSD. Causes of injury included falls from a height (n  = 9, 69.2%) and road accidents (n = 4, 30.8%). The duration from time of injury to hospital intake was 7.3 hours (range 5 to 9.5), and the time between injury and operation was 6.7 days (range 3 t...
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Zhenhai Wang, Tong Liu, Yiheng Cheng, Dajiang Xin, Wenqing Qu, Yugui Jiang, Dan Wang Source Type: research

Infectious Tenosynovitis of the Tibialis Anterior Due to Mycobacterium chelonae After Intravenous Heroin Injection
This report is of a 65-year-old male patient who was found to have an M. chelonae infection along the tibialis anterior tendon after injecting himself with heroin into the dorsal foot veins. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Danae L. Lowell, Jessie M. Jean-Claude, Lisa Fuchs Source Type: research

Clinical Effectiveness of Treatment Strategies for Prosthetic Joint Infection Following Total Ankle Replacement: A Systematic Review and Meta-analysis
Prosthetic joint infection (PJI) after total ankle replacement (TAR) is a challenging complication, which often requires debridement and implant retention (DAIR) with or without polyethylene exchange, revision surgery, implantation of a cement spacer, conversion to arthrodesis, or even amputation. The optimum treatment for ankle PJI is not well established. We conducted a systematic review and meta-analysis to compare the clinical effectiveness of various treatment strategies for infected ankle prostheses. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Setor K. Kunutsor, Matthew C. Barrett, Michael R. Whitehouse, Ashley W. Blom Source Type: research

Utility of Ottawa Ankle Rules in an Aging Population: Evidence for Addition of an Age Criterion
The Ottawa ankle rules (OAR) indicate that any patient with the inability to ambulate up to four steps or with tenderness at either malleoli should receive diagnostic imaging for an acute ankle injury. Current trends indicate that health care providers tend to order more images in practice than necessary according to OAR. The purpose of this study is to analyze OAR in geriatric versus nongeriatric patients. Secondarily, we hope to refine these guidelines for ankle imaging in the hopes that health care providers will be comfortable in adhering to these guidelines more strictly. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Jordan Murphy, David A Weiner, Joshua Kotler, Brian McCormick, Douglass Johnson, Jacob Wisbeck, David Milzman Source Type: research

Anterior Distal Hemiepiphysiodesis of Tibia for Treatment of Recurrent Equinus Deformity Due to Flat-Top Talus in Surgically Treated Clubfoot
Treatment of persistent or recurrent equinus after repeated surgical releases can be challenging in patients with clubfoot. Anterior distal tibial epiphysiodesis has recently been used in patients with recurrent progressive equinus deformity, with inconsistent outcomes. Herein, we used this technique in a carefully selected subgroup (8 children, 9 feet) of patients with a severe equinus deformity and a flat-top talus. The patients were followed up with radiological and clinical measures for 12 to 18 months. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Ramin Zargarbashi, Reza Abdi, Mohammadreza Bozorgmanesh, Behnam Panjavi Source Type: research

Poroid Hidradenocarcinoma of the Ankle: Case Report of a Rare Malignant Cutaneous Adnexal Neoplasm
We present a case of an exceptionally rare malignant cutaneous adnexal tumor, highlighting the importance of adherence to fundamental biopsy principles for diagnosing and managing musculoskeletal lesions. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Keith T. Aziz, Adam S. Levin, Jonathan D. Cuda, James R. Ficke Source Type: research

Comparison of Radiographic Measurements Before and After Triplane Tarsometatarsal Arthrodesis for Hallux Valgus
We present a comparison of preoperative and final postoperative first ray measurements in 109 feet after triplane tarsometatarsal arthrodesis at a mean follow-up time of 17.4 months. Preoperative and final postoperative first ray variables including intermetatarsal angle (IMA), hallux valgus angle (HVA), tibial sesamoid position (TSP), distal metatarsal articular angle (DMAA), Seiberg index, metatarsal rotation angle (MRA), sesamoid subluxation, osseous union, and hardware failure were evaluated. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Paul Dayton, Stefany Carvalho, Rachel Egdorf, Mindi Dayton Source Type: research

New Perspectives on a Common Deformity, Resurrection of Historical Techniques
Surgical management of hallux valgus deformity remains an ongoing topic of consideration and research in the global foot and ankle community. Over the past several years, there has been a resurgence of interest looking at both early modern medicine and more contemporary approaches in light of improved appreciation for etiology of deformity and instrumentation available to execute repair. With this renewed interest, there have been challenges to dogmas held fast by many treating surgeons. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Michael H. Theodoulou Tags: Editorial Source Type: research

The Influence of Gender, Age, and Body Mass Index on Arch Height and Arch Stiffness
Arch structure and arch function play an important role in maintaining balance, bearing body weight, and absorbing ground reaction forces. However, arch structure and arch function are known to vary extensively and may be affected by factors such as gender, age, and obesity. Therefore, the purpose of this study was to examine the influence of gender, age, and body mass index (BMI) on arch height and arch stiffness. A total of 173 participants (aged 57.60 ± 11.19 years, mean BMI 25.12 ± 3.93 kg/m2) participated in this cross-sectional study. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Xiaoguang Zhao, Yaodong Gu, Jiabin Yu, Ye Ma, Zhexiao Zhou Source Type: research

Comparison of Combination Weil Metatarsal Osteotomy and Direct Plantar Plate Repair Versus Weil Metatarsal Osteotomy Alone for Forefoot Metatarsalgia
Although many surgeons believe that shortening osteotomies are appropriate in patients with metatarsalgia and long second metatarsals, there remains ambiguity regarding when to repair the injured plantar plate and when to leave it alone. We prospectively assessed consecutive adult subjects who underwent an isolated second Weil metatarsal osteotomy (WMO) or a WMO plus plantar plate repair (WMO  + PPR) for sub–second metatarsophalangeal joint pain during a 3.5-year period at our practice. Eighty-six patients (86 feet: 21 WMO only and 65 WMO + PPR) with a mean age of 61 ± 11 years were followed for 1 year...
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Adam E. Fleischer, Erin E. Klein, Michael Bowen, Timothy P. McConn, Matthew D. Sorensen, Lowell Weil Source Type: research

Successful Lower Limb Replantation of Knee-Level Amputation in a Child: A Case Report
We present a case of a 3-year-old child with his right leg totally severed from the knee joint in a traumatic accident. After 5 hours of cold ischemia time, together with antishock therapies, the child underwent leg replantation under stable conditions. The replanted lower limb finally survived after several surgical procedures. The patient was discharged 4 weeks after admission and had restored partial motor and sensory functions 6 months after surgery. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - February 25, 2020 Category: Orthopaedics Authors: Xiao-Lin Li, Wei Wang, Fei Liu, Wei Hu, Ding-Shun Liang Source Type: research