Foot & Ankle Orthopaedics最新文献

{"title":"Traumatic Tibialis Anterior Rupture Reconstruction Using Iliotibial Band Autograft.","authors":"Natalie Kuhn, Susanna Gebhardt, Michelle Zhifeng Chiu, Brian Freniere, Naveen Pattisapu","doi":"10.1177/24730114251337076","DOIUrl":"https://doi.org/10.1177/24730114251337076","url":null,"abstract":"","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 2","pages":"24730114251337076"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to Sport or Military Duty After Lower Extremity Open Fracture: Systematic Review of Athletes and Active Military.","authors":"Jake H Goldfarb, Zachary D Randall, Daniel E Pereira, Lauren Yaeger, Marschall B Berkes","doi":"10.1177/24730114251337078","DOIUrl":"https://doi.org/10.1177/24730114251337078","url":null,"abstract":"<p><strong>Background: </strong>Open fractures are complex injuries with high complication rates and infection risks, often resulting in prolonged recovery and limited return to physical activities. Despite this, data on return to sport (RTS) or return to military duty (RTD) are limited. This study evaluates RTS or RTD in individuals with lower extremity open fractures, hypothesizing extended recovery times and limited return rates, particularly for amateur athletes and military personnel compared with professional athletes.</p><p><strong>Methods: </strong>A systematic review of studies from 1990 to 2024 was conducted using Embase, Ovid MEDLINE, Clinicaltrials.gov, Cochrane databases, SPORTDiscus, and Scopus. Studies investigating lower extremity open fractures with RTS or RTD outcomes were included. Data extracted included patient demographics, Gustilo-Anderson classifications, recovery timelines, and return rates.</p><p><strong>Results: </strong>Eleven studies were included, with 10 involving adults and 1 including pediatric patients. The analysis covered 722 open fractures. Two studies reported an average return to sport time of 44.0 weeks (17 individuals) in amateur athletes, whereas 3 studies reported an average return to sport time of 61.8 weeks (26 individuals) in professional athletes. Five studies reported 27.3% of amateur athletes had returned to sports at final follow-up (mean = 19.5 months), and 1 study reported that 18.3% of military members returned to full duty at final follow-up. In the 3 studies reporting on professional athletes, 80.8% returned to playing at the professional level.</p><p><strong>Conclusions: </strong>Lower extremity open fractures often result in prolonged recovery times and significantly limit RTS or RTD. Although professional athletes demonstrated higher return rates, the outcomes for the general amateur athlete and military populations were substantially poorer. Further research with discrete fracture and treatment details is needed to better understand recovery trajectories for open fractures, disparity in outcomes between professional and amateur athletes, and the influence of resources and motivation on returning to activity.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 2","pages":"24730114251337078"},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of Surgical Costs Associated With Tibiotalar Fusion.","authors":"Kade Wagers, Chong Zhang, Angela Presson, Devon Nixon","doi":"10.1177/24730114251332941","DOIUrl":"https://doi.org/10.1177/24730114251332941","url":null,"abstract":"<p><strong>Background: </strong>There is growing focus on surgical costs related to common orthopaedic procedures. In this investigation, we studied surgical costs associated with tibiotalar arthrodesis.</p><p><strong>Methods: </strong>Patients were retrospectively identified who had undergone primary fusion of the tibiotalar joint based on <i>Current Procedural Terminology</i> (<i>CPT</i>) codes from 2014 to 2020. Using the Value Driven Outcome (VDO) tool, we conducted an evaluation of both total direct costs and facility-related expenses. The VDO tool encompasses a comprehensive item-level database capable of capturing detailed cost information, which is subsequently presented as relative mean data. Adjustments were made to cost variables to reflect 2022 US dollars, and comparative multivariable analysis of costs in relation to treatment groups adjusting for demographic variables was performed using generalized linear models to yield cost ratios along with 95% CIs.</p><p><strong>Results: </strong>Our cohort consisted of 262 patients who underwent primary ankle fusion procedures done by one of 4 fellowship-trained orthopaedic foot and ankle surgeons. There were no differences in demographic data or total operating room (OR) time based on surgical construct (screws-alone n = 228 vs anterior plate-screws n = 34). Total direct costs for anterior plate-screw constructs were 78% higher than screws alone (ratio in cost = 1.78, 95% CI 1.55-2.08, <i>P</i> < .001), adjusting for other variables. For all fusion constructs, every 1-hour increase in total OR time increased total direct costs by 29% (ratio in cost = 1.29, 95% CI 1.18-1.40, <i>P</i> < .001).</p><p><strong>Conclusion: </strong>Enhancing cost-effectiveness of orthopaedic care remains an important objective. Our investigation found that anterior plate-screw constructs for tibiotalar arthrodesis have notably higher total costs compared with screw-only constructs. Many variables are considered when selecting surgical constructs for ankle arthrodesis. When clinically appropriate, screw-only ankle arthrodesis constructs could be considered if there is a need to reduce costs.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 2","pages":"24730114251332941"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PROMIS Minimal Clinically Important Differences Across Foot and Ankle Surgeries.","authors":"Nathaniel E Zona, Michael A Hewitt, Carson Keeter, Sara E Buckley, Kenneth J Hunt","doi":"10.1177/24730114251334055","DOIUrl":"https://doi.org/10.1177/24730114251334055","url":null,"abstract":"<p><strong>Background: </strong>Minimal clinically important differences (MCIDs) increase patient-reported outcome measure (PROM) utility by defining benchmarks of meaningful improvement. The threshold for appreciable improvement may be unique to specific patient characteristics. To help establish benchmarks and improve evaluation of patient progress, this study investigates whether surgery type and demographic characteristics impact MCID.</p><p><strong>Methods: </strong>All foot and ankle patients within a single institution's PRO registry were screened. Patients without preoperative or ≥ 180-day follow-up in PROMIS physical function (PF) Computer Adaptive Test (CAT) (v2.0) and pain interference (PI) CAT (v1.1) were excluded. Foot and Ankle Single Assessment Numeric Evaluation (FA SANE) was used as an anchor for MCID calculations. MCID was compared across 11 foot and ankle surgical categories, reported sex, body mass index (BMI), and social deprivation index (SDI).</p><p><strong>Results: </strong>We included 1243 patients with an average follow-up of 456 ± 176 days. Patients significantly improved in PF by 8.2 ± 10.9 (<i>P</i> < .001) and PI by -8.1 ± 9.5 (<i>P</i> < .001). Global MCID estimates for PF and PI were 5.5 (95% CI 4.9, 6.0) and -5.8 (95% CI -5.3, -6.3), respectively, when anchored against FA SANE. The MCIDs using a ½ SD distribution-based method were 5.5 and -4.8, respectively. Surgery type greatly affected MCID, ranging from 2.3 and -3.8 for hardware removals to 15.7 and -9.8 for small soft tissue surgeries. MCID differences across reported sex, BMI, and SDI never exceeded 1.9 points.</p><p><strong>Conclusion: </strong>A 6-month postoperative improvement of ≥ 5.5 and ≤ -4.8 in PROMIS PF and PI suggest meaningful clinical differences from baseline. However, MCID values for PROMIS scales vary across foot and ankle surgeries and patient characteristics, suggesting a global MCID for patient populations may not reflect the true threshold of meaningful change for each individual patient. Anchoring to FA SANE allows physicians to more objectively gauge appreciable change in patient-specific contexts.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 2","pages":"24730114251334055"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Factors for Tillaux-Chaput Tubercle Fracture: A Case-Control Study.","authors":"Cédric Dongmo Mayopa, David Ancelin, Pauline Despontin, Julie Manon, Gaspary Fodjeu, Randy Buzisa Mbuku, Maxime Masscheleyn, Olivier Cornu, Karim Tribak, Dan Putineanu","doi":"10.1177/24730114251332940","DOIUrl":"https://doi.org/10.1177/24730114251332940","url":null,"abstract":"<p><strong>Background: </strong>Tillaux-Chaput tubercle fractures in adults often go unnoticed on standard radiographs in the setting of other malleolar fractures. This study aimed to identify clinical and radiologic factors associated with these fractures to develop a decision aid for computed tomographic (CT) diagnosis.</p><p><strong>Methods: </strong>This case-control study included 72 patients with bimalleolar fractures who underwent both radiography and CT scans. The case group consisted of 28 patients with Tillaux-Chaput fractures, and 44 served as control. Sociodemographic, clinical data, and injury mechanisms were compared using univariate and multivariate analysis to identify predictive factors.</p><p><strong>Results: </strong>Tillaux-Chaput fractures were undetected on standard radiographs in 60% of cases. In multivariate analysis, only age >60 years and injury mechanisms with Lauge-Hansen pronation-external rotation stage III or IV injuries were found to be highly associated with Tillaux-Chaput tubercle fractures.</p><p><strong>Conclusion: </strong>We recommend routine CT scan evaluation for patients >60 years old with stage III or IV pronation-external rotation ankle fractures.</p><p><strong>Level of evidence: </strong>Level III, case-control study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 2","pages":"24730114251332940"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achilles Tendon Rupture Treatment Systematic Review and Meta-analysis.","authors":"Sara España Fernández de Valderrama, Beatriz García Martínez, Laura Ezquerra Herrando","doi":"10.1177/24730114251327219","DOIUrl":"https://doi.org/10.1177/24730114251327219","url":null,"abstract":"<p><strong>Background: </strong>Acute Achilles tendon rupture (ATR) has increased in recent decades, reflecting the longer life expectancy and higher levels of activity. Surgical intervention has been the main treatment, but recently there has been growing interest in nonoperative approaches. Study compares surgical and conservative treatment of acute ATR, examining demographic data, rerupture rate, complications, and functional scale Achilles Total Tendon Rupture Score (ATRS).</p><p><strong>Methods: </strong>A literature review was conducted including randomized clinical trials and prospective cohorts. RevMan software was employed to ascertain the <i>I</i>² heterogeneity, with a view to determining whether a fixed or random effects model should be used for meta-analysis. The results were expressed as either the mean difference or relative risk (RR), as appropriate, with 95% CI.</p><p><strong>Results: </strong>Ten studies, published after 2010, were included in the analysis. Of the total 1327 participants, 57.8% received surgical treatment and 42.2% nonsurgical treatment. The follow-up was between 12-24 months. The rerupture rate was lower in surgical treatment (RR 0.28, 95% CI 0.15-0.50; <i>P</i> < .0001), although this was accompanied by a higher risk of complications (RR 2.39, 95% CI 1.57-3.63; <i>P</i> < .0001). The patient satisfaction was comparable between the 2 treatment groups, with no statistically significant difference on the ATRS scale (MD 0.87, 95% CI -1.18 to 2.92; <i>P</i> = .40).</p><p><strong>Conclusion: </strong>Surgical repair of acute ATR significantly reduces the risk of rerupture but it is associated with a higher rate of complications. Furthermore, there are no significant differences in the various functional scales in terms of patient satisfaction between the 2 treatments.</p><p><strong>Level of evidence: </strong>II, meta-analysis.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 2","pages":"24730114251327219"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking the Glass Ceiling: Female Speaker Representation at the American Orthopaedic Foot & Ankle Society Annual Meetings Over Time.","authors":"Katherine M Kutzer, Rochelle Bitolas, Raquel S Garcia, Alexandra Hunter Aitchison, Julia E Ralph, Sally J Kuehn, Andrew E Hanselman, Albert T Anastasio, Samuel B Adams","doi":"10.1177/24730114251328691","DOIUrl":"https://doi.org/10.1177/24730114251328691","url":null,"abstract":"<p><strong>Background: </strong>Female representation among residents and practicing surgeons in orthopaedics remains disproportionately low at 19.3% and 7.4%, respectively. This study investigates female representation in speaker roles at American Orthopaedic Foot & Ankle Society (AOFAS) meetings over time.</p><p><strong>Methods: </strong>The annual AOFAS meeting programs for 2012 to 2024 were reviewed by 3 independent raters. Each speaker, moderator, and panelist was classified based on gender and role; data were cross-checked using Fleiss multirater κ validation. Sessions discussing surgical or biomedical topics were categorized as \"technical,\" and all other sessions were categorized as \"nontechnical.\" Yearly odds ratios (ORs) and CIs evaluating gender vs session status, as well as gender vs speaker role, are provided.</p><p><strong>Results: </strong>A total of 2396 speaking sessions were analyzed; 11.5% of sessions were led by female speakers. Over time, female speaker representation ranged from 5.61% in 2014 to 18.75% in 2022. Female speakers led only 10.8% of the 2088 technical sessions. On average, female speakers were significantly more likely than males to assume nontechnical speaking roles across all years combined (OR 1.5111, 95% CI 1.0792-2.1158, <i>P</i> = .0162). For individual year ORs, female speakers were significantly more likely to assume nontechnical speaking roles in 2020 (OR 12.24, 95% CI 4.082-36.67, <i>P</i> < .001); however, the differences were not statistically significant for other years. Females also comprised 10.10% and 12.00% of moderator and panelist roles, respectively.</p><p><strong>Conclusion: </strong>Female speaker involvement was representative of AOFAS female membership and the national population of female orthopaedic surgeons. Additionally, our study revealed an increasing trend in female speakers, panelists, and moderators from 2012 to 2024. However, there is a need for a shift in the distribution of speaker roles to prevent professional marginalization. Continued efforts to support female representation as role models at national conferences increases visibility and may help to address the lack of women within orthopaedics.</p><p><strong>Level of evidence: </strong>Level III, retrospective cross-sectional study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 2","pages":"24730114251328691"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Deltoid Ligament Repair Reduce Complications and Improve Functional Outcomes Measured by PROMIS Scores Following Ankle Fracture Surgery?","authors":"Steven M Hadley, Rachel Bergman, John J Peabody, Sarah J Westvold, Ryan Filler, Milap Patel, Anish R Kadakia","doi":"10.1177/24730114251330879","DOIUrl":"https://doi.org/10.1177/24730114251330879","url":null,"abstract":"<p><strong>Background: </strong>Deltoid repair (DR) in ankle fracture surgery remains controversial. This study aims to determine whether DR reduces complications and improves outcomes measured by Patient Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests (CATs) of physical function (PF) and pain interference (PI). We hypothesized that DR would reduce complications and improve PROMIS scores.</p><p><strong>Methods: </strong>This was a retrospective study of 782 patients at a single institution who underwent ankle fracture surgery between January 2016 and December 2021. Two fellowship-trained foot and ankle orthopaedic surgeons independently reviewed all radiographs and assessed reduction quality and complications at final follow-up. Multiple extremity injuries, open fractures, and pilon variants were excluded. A total of 345 patients with deltoid ruptures were sent PROMIS CATs. Of those, 265 patients with minimum 1-year follow-up were analyzed for complications. Finally, 112 patients who completed CATs were analyzed for PROMIS. Wilcoxon rank-sum test compared PROMIS between groups. Linear regression modeled DR effect on PROMIS adjusted for relevant covariates and propensity scores.</p><p><strong>Results: </strong>Fifty of the 265 patients (18.9%) underwent DR. The incidence of radiographic evident complications among 215 patients (81.1%) without repair (NDR) was 14.42%: 7 (3.26%) degenerative joint disease, 3 (1.40%) ankle joint malreduction, 4 (1.86%) syndesmotic malreduction, and 8 (3.72%) malleolar malunion. The DR group had no radiographic complications. Among patients who completed CATs (n = 112), DR (n = 21) was not significantly different for mean PF (54.31±9.83 vs 52.79±10.42, <i>P</i> = .71) or mean PI (47.21±7.82 vs 48.53±8.37, <i>P</i> = .59) than NDR (n=91). Adjusted regression models estimated a 1.89-point increase in PF and a 1.67-point decrease in PI for DR vs NDR. When adjusted for propensity scores, DR had PF 2.17 higher and PI 1.73 lower compared to NDR. Neither of these reach minimal clinically important difference criteria.</p><p><strong>Conclusion: </strong>DR was associated with reduced radiographically evident complications following ankle fracture surgery. This study was underpowered to detect small effect sizes in PROMIS, and we remain uncertain if DR meaningfully improved patient-reported outcomes.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 2","pages":"24730114251330879"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Bilateral Scandinavian Total Ankle Replacement: A Detailed Analysis of Implant Survivability and Patient-Reported Outcomes.","authors":"Alexandra Hunter Aitchison, Albert T Anastasio, Kevin A Wu, Emily Poehlein, Cynthia Green, Samuel B Adams, James K DeOrio, Mark E Easley, James A Nunley","doi":"10.1177/24730114251329349","DOIUrl":"https://doi.org/10.1177/24730114251329349","url":null,"abstract":"<p><strong>Background: </strong>Total ankle replacement (TAR) is an established treatment for end-stage ankle arthritis, offering pain relief and improved functionality. The Scandinavian Total Ankle Replacement (STAR) was first used in the United States in 1998 and although unilateral STAR has been extensively studied, there is limited documentation on the outcomes of simultaneous bilateral STAR procedures. This study aimed to evaluate the survivability and patient-reported outcomes of simultaneous bilateral STAR, focusing on implant survival rates and improvements in quality of life, function, and pain relief.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on all patients managed with primary TAR performed simultaneously with bilateral STAR prostheses at our institution from July 1998 to February 2008. Demographics and perioperative characteristics were collected. Poisson regression was used for analyzing implant survivability, and generalized linear mixed models were applied to assess patient-reported outcomes, including the visual analog scale (VAS), Short Musculoskeletal Function Assessment (SMFA), 36-Item Short Form Health Survey (SF-36), and American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot, at multiple follow-up time points.</p><p><strong>Results: </strong>Twenty-one patients were included for a total of 42 implants. The average length of follow up was 4.9 ± 2.7 years. The implant failure rate at 5 years was 12.0% (95% CI 4.5%-32.0%). The last recorded failure occurred at 8 years postimplant, with an implant failure rate of 19.2% (95% CI 17.2%-51.1%). Statistically significant improvements were observed in all patient-reported outcome measures from baseline to the 5-year follow-up (<i>P</i> < .05) except SMFA bother because of high variability and small sample size.</p><p><strong>Conclusion: </strong>At midterm follow-up, patients who underwent bilateral simultaneous TAR with the STAR prosthesis experienced a significant and durable improvement in patient-reported outcome scores across multiple functional indices. Failure rates were within range to those reported in previous studies evaluating unilateral STAR, with an estimated average survivorship of 80.8% at 8 years.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 2","pages":"24730114251329349"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Clinical and Radiographic Outcomes of Supination External Rotation Type IV Equivalent Ankle Fractures With and Without Deltoid Repair.","authors":"Saanchi Kukadia, David Cho, Stephanie Eble, Prashanth Kumar, Alan Shamrock, Mark Drakos","doi":"10.1177/24730114251329333","DOIUrl":"https://doi.org/10.1177/24730114251329333","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of consensus on how deltoid injuries should be addressed in the setting of acute ankle fractures. This study aims to evaluate whether deltoid repair during lateral malleolar fracture fixation leads to improved clinical outcomes compared to fixation without deltoid repair.</p><p><strong>Methods: </strong>This was a single-center retrospective study involving 13 surgeons. Inclusion criteria were patients aged 18 years or older who underwent open fixation for a supination external rotation type IV (SER IV) equivalent ankle fracture. SER IV fractures were confirmed with stress radiographs. Deltoid injury was confirmed with an intraoperative external rotation stress test. A total of 146 patients were included. Eighty patients received a deltoid repair (DR), and 66 patients did not receive a deltoid repair (NDR). Patient-reported outcomes via PROMIS scores were collected preoperatively and at least 1 year postoperatively for all patients. Preoperative and postoperative medial clear space (MCS) were reviewed for all patients.</p><p><strong>Results: </strong>There were no significant differences in preoperative and postoperative PROMIS domains between the 2 cohorts. There were also no significant differences in preoperative MCS and postoperative MCS between the 2 cohorts. There were no significant differences in the incidence of subsequent procedures for removal of painful hardware, revisions, infections, progression to arthritis, and persistent pain.</p><p><strong>Conclusion: </strong>This study compares short- to medium-term outcomes and complications of SER IV-equivalent ankle fractures with and without deltoid repair. No significant differences between PROMIS scores, postoperative MCS, and complication rates were observed between groups.</p><p><strong>Level of evidence: </strong>Level III, retrospective case control study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 2","pages":"24730114251329333"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}