Journal of Foot & Ankle Surgery最新文献_第10页

Radiographic soft tissue thickness is not a risk factor for infection after primary total ankle arthroplasty. 影像学软组织厚度不是初次全踝关节置换术后感染的危险因素。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-01-25 DOI: 10.1053/j.jfas.2025.01.012

Kevin A Wu, Albert T Anastasio, Katherine M Kutzer, Alexandra N Krez, James K DeOrio, James A Nunley, Mark E Easley, Samuel B Adams

{"title":"Radiographic soft tissue thickness is not a risk factor for infection after primary total ankle arthroplasty.","authors":"Kevin A Wu, Albert T Anastasio, Katherine M Kutzer, Alexandra N Krez, James K DeOrio, James A Nunley, Mark E Easley, Samuel B Adams","doi":"10.1053/j.jfas.2025.01.012","DOIUrl":"10.1053/j.jfas.2025.01.012","url":null,"abstract":"As the incidence of total ankle arthroplasty (TAA) for the management of end-stage arthritis is on the rise, identification of risk factors for periprosthetic joint infection (PJI) is essential. There has been limited research exploring the use of radiographic soft tissue thickness in TAA despite its predictive value in other forms of arthroplasty. This study evaluated the predictive capabilities of radiographic soft-tissue thickness for PJI following TAA. A retrospective analysis of 323 patients at a single institution who underwent primary TAA from 2003 to 2019 was conducted. Patient demographics, comorbidities, indication for surgery, prosthesis type and tourniquet time were recorded. Tibial-Tissue and Talus-Tissue distances were measured on preoperative lateral radiographic imaging. Logistic regression was utilized to determine the Odds Ratio (OR) of risk factors for the occurrence of PJI. Of the 323 patients, 6 patients (1.86 %) developed a PJI. Average duration of follow-up was 8.42 ± 2.52 years. Neither Tibial-Tissue (OR = 0.975; 95 % CI [0.947 - 1.004]; p = 0.09) nor Talus-Tissue thickness (OR = 0.976; 95 % CI [0.940 - 1.012]; p = 0.18) were significant predictors of PJI. Although not statistically significant, the infected cohort had smaller average Tibial-Tissue (2.20 vs. 2.53 cm; p = 0.05) and Talus-Tissue thickness (2.19 vs. 2.44 cm; p = 0.36) compared to the non-infected cohort. Measurements such as Tibial-Tissue length and Talus-Tissue length were not significant predictors of PJI following primary TAA. These findings underscore the necessity for additional research to identify modifiable risk factors aimed at reducing PJI rates and enhancing patient outcomes.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rescue of interfragmentary compression in screw stripping failures: The efficacy of NiTiNOL. 螺钉剥离失败后碎片间压缩的抢救：镍钛醇的疗效。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-01-24 DOI: 10.1053/j.jfas.2025.01.006

Shannon King, Claudia Vitale, Rachel Grosswald, Taylor Filicette, James Johnson, Akhilesh Gokhale, Gregory Berlet, David L Safranski

{"title":"Rescue of interfragmentary compression in screw stripping failures: The efficacy of NiTiNOL.","authors":"Shannon King, Claudia Vitale, Rachel Grosswald, Taylor Filicette, James Johnson, Akhilesh Gokhale, Gregory Berlet, David L Safranski","doi":"10.1053/j.jfas.2025.01.006","DOIUrl":"10.1053/j.jfas.2025.01.006","url":null,"abstract":"Orthopedic screws are widely used to achieve bone reduction, compression, and construct stability. However, the relationship between insertion torque, interfragmentary compression, and fixation strength, especially when comparing standard screws with NiTiNOL/sustained dynamic compression (SDC), has not been thoroughly investigated. This study measured insertion torque, interfragmentary compression, and fixation strength for two types of headed orthopedic devices-standard and SDC-using solid foam bone replicates and cadaver validation. The study also assessed the interfragmentary compression produced by these devices in the context of simulated bone resorption. Results showed that compression force increased with insertion torque until thread stripping occurred, resulting in a 91.9 % loss of compression in the standard screw group. In contrast, the SDC device maintained significantly higher compression, even beyond the point of stripping. These findings suggest that SDC devices offer increased safety by continuing to apply interfragmentary compression after stripping. The SDC device's ability to generate internal compression allows it to re-engage threads into undamaged bone, potentially compensating for compression loss due to stripping. Clinically, these results indicate that surgeons might benefit from deliberately undershooting peak insertion torque, regardless of the device type, and may prefer NiTiNOL-based SDC devices for their resilience to stripping and bone resorption, ultimately optimizing patient outcomes in foot and ankle surgery.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk factors for postoperative infection in patients after pilon fracture fixation. 皮隆骨折固定术后感染的危险因素分析。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-01-23 DOI: 10.1053/j.jfas.2025.01.009

Nave Cohen, Cynthia Kyin, Doron Norman, Bezalel Peskin, Nabil Ghrayeb, Itay Perets, Ofer Sachs, Bana Awad, Itay Ron, Jacob Shapira

{"title":"Risk factors for postoperative infection in patients after pilon fracture fixation.","authors":"Nave Cohen, Cynthia Kyin, Doron Norman, Bezalel Peskin, Nabil Ghrayeb, Itay Perets, Ofer Sachs, Bana Awad, Itay Ron, Jacob Shapira","doi":"10.1053/j.jfas.2025.01.009","DOIUrl":"10.1053/j.jfas.2025.01.009","url":null,"abstract":"The combination of high energy fractures, extensive soft tissue trauma, and high infection rates in pilon fractures of the distal tibia have long challenged surgeons. Despite the ample evidence, there is no consensus regarding the factors that may influence postoperative infections following surgical management of these fractures. This study aimed to investigate the risk factors for postoperative infections in patients undergoing surgical management for pilon fractures. This retrospective cohort study evaluated demographic variables, smoking status, nutritional status (i.e., pre-and postoperative albumin, pre-and postoperative white blood cell count, use of antibiotics, time to external fixation and ORIF, and hospital length of stay. A multivariate logistic regression model was used to predict risk factors associated with postoperative infection after fixation of a pilon fracture for several independent parameters. A receiver operator characteristic (ROC) curve was constructed, and a threshold was found for the investigated continuous variables, which were significant in the regression analysis. Overall, 416 patients following surgical management for a pilon fracture were identified. A multivariate logistic regression analysis revealed that preoperative albumin, preoperative WBC, and hospital length of stay were associated with postoperative infection following surgical management of pilon fractures. Thresholds determined by the Youden index were 3.05 for preoperative albumin levels, 12.65 for preoperative WBC levels, and 7.1 days for hospital length of stay. Furthermore, older patients were less prone to develop postoperative infection than younger patients. Lower preoperative albumin levels (< 3.05 mg/dL), higher preoperative WBC levels (>12.65 mg/dL), and a longer duration of hospitalization (>7.1 days) were related to an increased risk for postoperative infection after fixation of a pilon fracture.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes following modified chevron osteotomy combined with akin osteotomy for severe hallux valgus: A prospective study. 改良的Chevron截骨联合Akin截骨治疗严重拇外翻的结果：一项前瞻性研究。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-01-23 DOI: 10.1053/j.jfas.2025.01.007

Liu Jun, Shi Xuefeng, Zhang Chao, Hu Hongpeng, Du Huyu

{"title":"Outcomes following modified chevron osteotomy combined with akin osteotomy for severe hallux valgus: A prospective study.","authors":"Liu Jun, Shi Xuefeng, Zhang Chao, Hu Hongpeng, Du Huyu","doi":"10.1053/j.jfas.2025.01.007","DOIUrl":"10.1053/j.jfas.2025.01.007","url":null,"abstract":"The definitive guideline for the osteotomy technique or the superiority of a particular surgical approach for severe hallux valgus correction remains elusive. Here, we investigated the clinical and radiographic outcomes following modified distal chevron osteotomy coupled with proximal Akin osteotomy to correct severe hallux valgus. A prospective cohort study was performed on 45 patients (62 feet) diagnosed with severe hallux valgus, undergoing the modified distal chevron osteotomy technique described in this study, combined with proximal Akin osteotomy. The radiographic variables: hallux valgus angle and intermetatarsal angle, were measured, and the American Orthopaedic Foot and Ankle Association scoring system was used to assess the clinical curative effect at six weeks and one-year intervals following surgery. Compared to the preoperative assessments, the hallux valgus and intermetatarsal angles were significantly decreased, and the American Orthopaedic Foot and Ankle Association score was increased markedly in both postoperative follow-ups. The difference between the variables was comparable at the six-week and one-year postoperative reassessments. No severe surgical complications or recurrences were observed. The combined use of modified distal chevron osteotomy and proximal Akin osteotomy demonstrated favorable therapeutic outcomes and satisfactory surgical correction. The above-mentioned surgical technique can be, therefore, recommended to correct the severe hallux valgus deformity.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early weight bearing is not associated with short-term complications in ankle fractures. 早期负重与踝关节骨折的短期并发症无关。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-01-18 DOI: 10.1053/j.jfas.2025.01.008

Warren G Haralson, Clayton Brinkley, Jacob Cebulko, Sam Hawkins, Emily Leary, James P Stannard, Gregory J Della Rocca, Brett Crist, Kyle Schweser

{"title":"Early weight bearing is not associated with short-term complications in ankle fractures.","authors":"Warren G Haralson, Clayton Brinkley, Jacob Cebulko, Sam Hawkins, Emily Leary, James P Stannard, Gregory J Della Rocca, Brett Crist, Kyle Schweser","doi":"10.1053/j.jfas.2025.01.008","DOIUrl":"10.1053/j.jfas.2025.01.008","url":null,"abstract":"Ankle fractures are common injuries and post-operative protocols continue to vary. We aim to compare postoperative complications between early weight bearing (EWB), intermediate weight bearing (IWB), and delayed weight bearing (DWB) in adult patients with isolated ankle fractures treated with open reduction internal fixation (ORIF). This retrospective cohort study includes 233 adult patients with isolated (medial malleolar, lateral malleolar, posterior malleolar, bimalleolar equivalent) or complex (trimalleolar, trimalleolar equivalent, bimalleolar, and Maisonneuve) ankle fractures treated with ORIF between 2020 and 2022 at a level I trauma center. Patients were weight bearing postoperatively at < 3 weeks (EWB), 3-6 weeks (IWB), or > 6 weeks (DWB). Main outcome measurements include rates of complications requiring reoperation and minor complications. Thirty-one and eight tenths percent (74/233) were EWB, 25.8 % (60/233) were IWB, and 42.5 % (99/233) were DWB. 73.0 % of patients (170/233) had complex fractures, and 27.0 % (63/233) had isolated malleolar fractures. 16.3 % of patients (38/233) developed complications, with 7.7 % (18/233) requiring reoperation. We found no differences in overall complications (14.86 % vs. 11.67 % vs. 20.20 %; p = 0.3396) or complications requiring reoperation (9.46 % vs. 3.33 % vs. 9.09 %; p = 0.3337) among the weight bearing groups for all fractures. Between the complex fracture group and the isolated malleolar fracture group, there were no differences in overall complications (7.94 % vs. 19.41 %; p = 0.0566) or complications requiring reoperation (9.41 % vs. 3.17 %; p = 0.1664). There is not statistical significance between timing to weight bear and complications in ankle fractures treated with ORIF.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effects of intercalary fragments at the posterior malleolus on ankle joint pressure distribution - a biomechanical cadaveric study. 后踝骨间碎片对踝关节压力分布的影响——生物力学尸体研究。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-01-15 DOI: 10.1053/j.jfas.2025.01.004

Lionel Llano, Christian Peez, Ivan Zderic, R Geoff Richards, Boyko Gueorguiev, Jorge Barla, Stefan Rammelt

{"title":"The effects of intercalary fragments at the posterior malleolus on ankle joint pressure distribution - a biomechanical cadaveric study.","authors":"Lionel Llano, Christian Peez, Ivan Zderic, R Geoff Richards, Boyko Gueorguiev, Jorge Barla, Stefan Rammelt","doi":"10.1053/j.jfas.2025.01.004","DOIUrl":"10.1053/j.jfas.2025.01.004","url":null,"abstract":"Introduction: With the increased use of computed tomography scans in cases with trimalleolar ankle fractures, bone fragments between the posterior malleolus and the rest of the articular surface tibial plafond surface - described as intercalary fragments (ICFs) - can be recognized. The aim of this study was to determine the ICF size threshold for a significant change in the pressure distribution at the ankle joint, having a considerable impact on the remaining cartilage of the joint.Design and methods: Eight human cadaveric lower legs were used, and a posterior malleolus Bartoniček/Rammelt II fracture was created with sequential 2 mm, 4 mm, 6 mm, and 8 mm ICFs. The posterior malleolus was fixed with a 3.5 mm one-third tube buttress plate and each specimen was mounted in a custom-made frame for axial loading under 700 N in neutral position, 30° plantar flexion, and 30° dorsiflexion of the foot. Using electronic foil sensors, pressure measurements were performed to define the contact area, centre of force, and peak pressure at the ankle joint in loaded condition.Results: Compared to the situation without ICF, contact area decreased significantly after 4 mm, 6 mm and 8 mm ICFs. Anteroposterior center of force shift was significant after 6 mm and 8 mm ICFs. Mediolateral center of force shift was significant after 2 mm, 4 mm, 6 mm and 8 mm ICFs.Conclusion: Posterolateral defects of the tibial plafond alter ankle joint pressure characteristics. Regardless of the direction of ankle joint flexion, increasing the ICF defect size results in decreased contact area, increased mediolateral center of force migration and higher peak joint forces. Malreduction or removal of ICFs larger than 2 mm should be avoided to preserve physiological ankle pressure characteristics.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mini Fragment and Small Fragment Screws are Comparable in Acute Syndesmotic Injury. 小碎片螺钉和小碎片螺钉在急性韧带联合损伤中的可比较性。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-01-11 DOI: 10.1053/j.jfas.2025.01.003

Stein B M van den Heuvel, Diederick Penning, Jens A Halm, Tim Schepers

{"title":"Mini Fragment and Small Fragment Screws are Comparable in Acute Syndesmotic Injury.","authors":"Stein B M van den Heuvel, Diederick Penning, Jens A Halm, Tim Schepers","doi":"10.1053/j.jfas.2025.01.003","DOIUrl":"10.1053/j.jfas.2025.01.003","url":null,"abstract":"Ankle fractures are often accompanied by syndesmotic injuries, contributing to instability and potential long term complications. Syndesmotic injuries are traditionally fixed with either small fragment (3.5-mm diameter) or large fragment (4.5-mm diameter) syndesmotic screws. With regards to the recent emergence of less prominent implants for ankle fracture, this study was set out to compare the outcomes of mini fragment screws (2.7-mm or 2.8-mm diameter) and small fragment screws in syndesmotic fixation. Eighty-seven patients with traumatic syndesmotic injuries were retrospectively included for this study. Forty-four patients underwent mini fragment fixation and 43 patients underwent standard small fragment fixation. After-treatment was similar in both groups. Primary outcome consisted of the incidence of malreduction and secondary dislocation within three months. Secondary objectives were the incidence of the overall complication rate and implant removal rate. In total, malreduction was observed in three patients (3.4 %) and secondary dislocation in two patients (2.3 %), with no significant differences between the mini fragment and small fragment groups. Mini fragment fixation demonstrated a significantly lower overall complication rate (2.3 %) compared to the small fragment group (16.3 %)(p = .030). Implant removal rates were similar between the groups (27.3 % for mini fragment and 27.9 % for small fragment screws). This study suggests that both screw types are effective for fixation of acute syndesmotic injuries, with comparable malreduction and secondary dislocation rates. Prospective studies with longer follow-up, including functional outcome, are needed for comprehensive insights into optimal syndesmotic screw selection.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient-reported outcomes using PROMIS after tarsal tunnel release surgery. 患者报告的跗骨隧道松解手术后使用PROMIS的结果。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-01-10 DOI: 10.1053/j.jfas.2025.01.005

Zein S El-Zein, Samuel A Florentino, Mina Botros, Judith F Baumhauer

{"title":"Patient-reported outcomes using PROMIS after tarsal tunnel release surgery.","authors":"Zein S El-Zein, Samuel A Florentino, Mina Botros, Judith F Baumhauer","doi":"10.1053/j.jfas.2025.01.005","DOIUrl":"10.1053/j.jfas.2025.01.005","url":null,"abstract":"Tarsal tunnel syndrome is an entrapment neuropathy of the tibial nerve and its branches in the tarsal tunnel. The literature on surgical release of the tarsal tunnel shows variable outcomes with no studies reporting validated patient reported outcomes. We aim to determine clinical response after tarsal tunnel release using the Patient-Reported Outcomes Measurement Information System (PROMIS). CPT code 28035 was used to identify patients who underwent isolated tarsal tunnel release (TTR) between 1/1/2015 and 12/15/2022 at a single institution. Patient demographic data and PROMIS physical function (PF), pain interference (PI), and depression scores were prospectively collected at the initial pre-operative clinic visit and in follow-up throughout the episode of care after TTR. The validated distribution-based method (1/2 sd) was used to assess minimal clinically important difference (MCID) and bivariate analysis was used to determine postoperative recovery. A total of 39 patients who underwent TTR were included. The mean t-score change (pre- to post-operation) was 7.2 for PF, -6.1 for PI, and -5.93 for depression. MCID thresholds were calculated as PF increase of 4.7, PI decrease of 3.9, and depression decrease of 5.1. Fourteen (35 %), 24(62 %), and 27 (69 %) patients reached MCID for PF, PI, and depression, respectively. No relationship was observed between space-occupying lesions and patient outcomes. This study provides validated outcomes after TTR. Though there is significant improvement after surgery, the patients still experience some pain and physical limitations.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Union rates following power rasp joint preparation for foot and ankle arthrodesis: A retrospective study of 418 fusions. 418例足踝关节融合术中强力钳预备关节的愈合率回顾性研究。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-01-10 DOI: 10.1053/j.jfas.2024.12.006

Jay S Badell, James M Cottom, Josh Ekladios

{"title":"Union rates following power rasp joint preparation for foot and ankle arthrodesis: A retrospective study of 418 fusions.","authors":"Jay S Badell, James M Cottom, Josh Ekladios","doi":"10.1053/j.jfas.2024.12.006","DOIUrl":"10.1053/j.jfas.2024.12.006","url":null,"abstract":"Joint arthrodesis is a very common surgical approach in foot and ankle surgery at various anatomic levels. Several techniques have demonstrated the ability to provide successful fusion with appropriate preparation of the joint in question. With that in mind, the joint preparation, regardless of approach or instrumentation, is consistently the most time-consuming. Additionally, this step is prone to eventual complications like shortening with saw cuts or inadequate preparation with curettes and osteotomes alone, not to mention the persistent threat of non-union as is the case with any osteotomy or arthrodesis. Power rasp instrumentation presents a potential alternative for the surgeon to not only improve operating room efficiency, but also provide fast, reproducible, and adequate joint preparation thereby yielding excellent union rates. This study retrospectively analyzed 418 total arthrodesis attempts performed on 198 patients. Procedures included Lapidus bunionectomy/1st tarsometatarsal joint (TMTJ) fusion, midfoot fusions involving more than one TMTJ, isolated subtalar joint fusions (STJ), isolated talonavicular fusions (TNJ), and triple arthrodesis (STJ, TNJ, CCJ). The procedures were performed at a single institution with power rasp joint preparation (PJRP) as the primary tool for debridement of all cartilage from the articular surfaces of the joint in question. Minimum follow-up was 12 months. Radiographic union was defined on X-rays with osseous bridging and trabeculation across the fusion site using standard weightbearing foot radiographs taken at 3-, 6-, and 12-month intervals postoperatively. Four- and one-half percent of all arthrodesis attempts went on to develop a radiographic non-union after 12 months (19/418). This study demonstrates excellent overall union rates using a simple device that provides ease of surgeon use, minimal risk of non-union, and time-cost efficiency for providers, patients, and facilities alike.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relationship between controlling nutritional status (CONUT) and surgical site infection (SSI) following elective foot and ankle surgery. 选择性足踝手术后控制营养状况（CONUT）与手术部位感染（SSI）的关系。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-01-08 DOI: 10.1053/j.jfas.2025.01.001

Yansen Li, Zixuan Luo, Shiji Qin, Fengqi Zhang, Haitao Zhao

{"title":"Relationship between controlling nutritional status (CONUT) and surgical site infection (SSI) following elective foot and ankle surgery.","authors":"Yansen Li, Zixuan Luo, Shiji Qin, Fengqi Zhang, Haitao Zhao","doi":"10.1053/j.jfas.2025.01.001","DOIUrl":"10.1053/j.jfas.2025.01.001","url":null,"abstract":"This study aims to examine whether the preoperative controlling nutritional status (CONUT) score was associated with SSI following elective foot and ankle surgeries. This study retrospectively reviewed adult undergoing elective foot and ankle surgeries in a tertiary university-affiliated hospital between January 2019 and May 2023, and identified who subsequently developed an SSI within 12 months postoperative. CONUT score was calculated from serum albumin, lymphocyte count, and toral cholesterol concentration, and its optimal cut-off value for differentiating SSI risk was determined by the receiver operating characteristic curve. Three independent hierarchical multivariable logistic regression models, adjusting demographics, confounders or covariates were constructed to examine the association. Among 1,424 surgical procedures performed in 1,221 patients, 36 (2.5 %) SSIs were identified, with 21 (1.5 %) superficial cases and 15 (1.1 %) deep cases, respectively. The optimal cut-off for CONUT was 3, and significant differences were observed between patients with CONUT ≥ 3 and those <3, in terms of age, BMI, anesthesia, procedure, bleeding, preoperative prophylactic antibiotics, and admission sodium. Multivariate analyses showed consistent significant results (OR 4.66 and 95 % CI 2.32 to 9.37 after adjustment for demographics; OR 4.72 and 95 % CI 2.22 to 10.02 for adjustment for confounders, and OR 3.80 and 95 % CI 1.68 to 8.59 for further covariates). This finding may aid clinicians in conducting individualized assessments of SSI and developing a more tailored SSI risk profile for patients undergoing such procedures.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0