Journal of Foot & Ankle Surgery最新文献_第6页

Can early treatment of lisfranc injuries without planned re-intervention be safely performed. 能否安全地进行无计划再介入的 Lisfranc 损伤早期治疗？

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-10-09 DOI: 10.1053/j.jfas.2024.09.015

Daniel T DeGenova, James L Iandoli, Anthony J Melaragno, Scott S Hyland, Sara E Dickinson, Brett Hoffman, Benjamin C Taylor

{"title":"Can early treatment of lisfranc injuries without planned re-intervention be safely performed.","authors":"Daniel T DeGenova, James L Iandoli, Anthony J Melaragno, Scott S Hyland, Sara E Dickinson, Brett Hoffman, Benjamin C Taylor","doi":"10.1053/j.jfas.2024.09.015","DOIUrl":"10.1053/j.jfas.2024.09.015","url":null,"abstract":"The Lisfranc complex is a unique combination of ligamentous and osseous relationships between the medial cuneiform and second metatarsal base that is often injured by high energy mechanisms. Fixation for these injuries is often operative; however, the optimal timing of surgical treatment has been debated. All patients who underwent operative fixation of a Lisfranc injury at a single urban tertiary care center were reviewed. Patient were split into two groups based on timing to fixation with one group being less than 24 h from presentation and a second group being greater than 24 h. There were 58 patients who underwent what was planned as final operative stabilization of their Lisfranc injury in less than 24 h and 41 patients who underwent fixation after more than 24 h. The early treatment of Lisfranc injuries did not lead to significant increases in follow up time, infections, time to weight bearing, union rates, or time to union compared patients treated with delayed fixation. There was a higher rate of superficial infection in the early intervention group, but it did not reach statistical significance. We believe our findings demonstrate that delayed fixation is not superior to early treatment of Lisfranc injuries. LEVEL OF EVIDENCE: Level 3 Therapeutic retrospective comparative study.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401812","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

Midterm functional outcomes of synthetic cartilage implant (SCI) arthroplasty for hallux rigidus. 合成软骨植入（SCI）关节置换术治疗硬下疳的中期功能效果。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-10-04 DOI: 10.1053/j.jfas.2024.09.006

Aysha Rajeev, William Yallop, George Koshy, Kailash Devalia

{"title":"Midterm functional outcomes of synthetic cartilage implant (SCI) arthroplasty for hallux rigidus.","authors":"Aysha Rajeev, William Yallop, George Koshy, Kailash Devalia","doi":"10.1053/j.jfas.2024.09.006","DOIUrl":"10.1053/j.jfas.2024.09.006","url":null,"abstract":"Hallux rigidus is a common degenerative condition of first metatarso-phalangeal joint most commonly affecting patients above 50 years of age. The aim of our study is to evaluate the five-year results of synthetic cartilage implant (Cartiva) arthroplasty for hallux rigidus. A retrospective study of 70 patients who underwent synthetic cartilage implant interpositional arthroplasty were collected and analysed. Patients with Grade 3 to 4 hallux rigidus and who had failed conservative management were included. Patients who had previous forefoot surgery, hallux varus or valgus deformity of more than 250 and neuromuscular disease were excluded. Mean age at the time of operation was 63.4 years (range 42-84 years). The mean follow-up was 62.6 months. The functional evaluation was done using Manchester-Oxford Foot Questionnaire (MOxFQ). EQ-5D and EQVAS. 86 patients were matriculated in the study with 70 patients being assessed at five years. The average preoperative MOxFQ score improved from 35.74 (31.44-40.04) to 19.11 (11.31- 26.91) at one year after surgery. The EQ-5D scores improved from preoperative average of 9.40 (8.14-10.66) to 4.26 (2.09-6.43) at one year. The preoperative EQVAS was 61.66 (51.25-72.07) to 71.45 (60.87-82.03 at one year. At five years follow up the average MOxFQ score was 17.6 (9.92-24.38), EQ-5D - 4.8 (2.26- 6.45) and EQVAS - 72.48 (62.40-82.56). Three patients had revision to first MTP fusion due to ongoing pain. Synthetic cartilage implant has demonstrated clinical efficacy and good functional outcomes at the end of five years for the treatment of Hallux rigidus. Level of Clinical Evidence: 4.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382219","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

Weight-bearing timing after the operative management of ankle fractures: Single center audit and critical appraisal of literature. 踝关节骨折手术治疗后的负重时机：单中心审计和文献批判性评估。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-10-02 DOI: 10.1053/j.jfas.2024.09.014

Olivier Vinckier, Giovanni Matricali, Manou Overstijns, Sander Wuite, Harm Hoekstra

{"title":"Weight-bearing timing after the operative management of ankle fractures: Single center audit and critical appraisal of literature.","authors":"Olivier Vinckier, Giovanni Matricali, Manou Overstijns, Sander Wuite, Harm Hoekstra","doi":"10.1053/j.jfas.2024.09.014","DOIUrl":"10.1053/j.jfas.2024.09.014","url":null,"abstract":"The postoperative weight-bearing policy following internal fixation of unstable ankle fractures varies greatly and is largely surgeon-dependent. While early weight-bearing is favoured for its superior functional and economic outcomes, late weight-bearing may be safer initially. However, consensus on the preferred treatment protocol is lacking. We audited practices at University Hospitals Leuven, Belgium, comparing them to existing literature to establish an updated protocol. In a retrospective study of 236 patients with unstable ankle fractures, we compared outcomes between early (EWB) and late weight-bearing (LWB) strategies, with or without braces and/or vacuum casts. Most patients followed a LWB protocol, while EWB was reserved for younger, lower BMI individuals. The difference in brace or vacuum cast usage was insignificant. All open fractures followed a LWB protocol. No disparities in union rates, complications, or length of stay were found between EWB and LWB. Surgical management cost €6,419 (6,921 US $) on average, with length of stay being the main cost driver. Total healthcare costs did not differ significantly between EWB and LWB. FRI was revealed in 6 cases, (1 [4%] vs. 5 [2.5%], EWB vs. LWB respectively, P=0.922) In conclusion, while no significant differences in outcomes were observed between EWB and LWB rehabilitation, differences in group characteristics may have influenced these findings. Despite limited EWB cases, it appears safe for younger patients with low BMI. Vacuum casts and braces aid in EWB. Reducing length of stay, rather than restricting orthotic use, may help control healthcare costs.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376264","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

An analysis of radiologic and anatomical parameters associated with medial osteochondral lesions of the talus in non-traumatic cases. 非创伤性病例中与距骨内侧骨软骨损伤相关的放射学和解剖学参数分析》（An Analysis of Radiologic and Anatomical Parameters associated with Medial Osteochondral Lesions of Talus in Non-Traumatic Cases）。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-10-02 DOI: 10.1053/j.jfas.2024.09.016

Gokhan Sayer, Fatih Golgelioglu, Erdal Uzun, Yasin Semih Guvercin, Tuba Akdag, Sinan Oguzkaya

{"title":"An analysis of radiologic and anatomical parameters associated with medial osteochondral lesions of the talus in non-traumatic cases.","authors":"Gokhan Sayer, Fatih Golgelioglu, Erdal Uzun, Yasin Semih Guvercin, Tuba Akdag, Sinan Oguzkaya","doi":"10.1053/j.jfas.2024.09.016","DOIUrl":"10.1053/j.jfas.2024.09.016","url":null,"abstract":"The study aimed to provide a comprehensive analysis of radiological and anatomical measurements in patients with medial osteochondral lesions of the talus (OLT), particularly those without a history of trauma. The retrospective cross sectional study evaluated 23 medial OLT individuals aged 18-45 with no history of trauma who were identified by magnetic resonance imaging (MRI) between 2016 and 2020. The control group consisted of 27 individuals between the ages of 18 and 45 who did not have OLT and applied for other reasons. Measurements were performed with 16 parameters from anteroposterior (AP) and lateral weight-bearing ankle conventional radiographs (CR). All individuals' demographic data were assessed. A total of 50 patients aged 18-45 years, including 26 males and 24 females with a mean age of 30.28±4.46 years, were evaluated in the study. No significant differences in age or gender were found between the groups (P>0.05). Analysis of both the OLT and control groups revealed a significant association of decreased talar declination angle (P<0.001) and Meary-Tomeno's angle (P = 0.003) with medial OLT. There was no relationship between other radiological parameters and medial OLT development. In conclusion, a decreased talar declination angle and a decreased Meary-Tomeno's angle appear to have significant relationship with development of medial OLT in individuals without a history of trauma. These findings also indicate that a possible cause of medial OLT is a lower-angled positioning of the talus relative to the ground and the first metatarsus in the sagittal plane. Level of Clinical Evidence: Level 3 cross sectional study.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373421","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

Operative management of Charcot neuropathy of the foot and ankle: A retrospective cohort study of long-term outcomes. 足踝夏科神经病的手术治疗：长期疗效回顾性队列研究

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-09-25 DOI: 10.1053/j.jfas.2024.09.012

Naveen Pattisapu, William C Skinner, Ryan G Rogero, Jane Yeoh, Benjamin J Grear, David R Richardson, Garnett A Murphy, Clayton C Bettin

{"title":"Operative management of Charcot neuropathy of the foot and ankle: A retrospective cohort study of long-term outcomes.","authors":"Naveen Pattisapu, William C Skinner, Ryan G Rogero, Jane Yeoh, Benjamin J Grear, David R Richardson, Garnett A Murphy, Clayton C Bettin","doi":"10.1053/j.jfas.2024.09.012","DOIUrl":"10.1053/j.jfas.2024.09.012","url":null,"abstract":"Treatment of Charcot neuroarthropathy (CN) of the foot and ankle remains challenging for both patients and surgeons. Nonoperative treatment with cast/orthosis immobilization has long been the main treatment, but surgical intervention has gained interest to improve poor long-term outcomes. Few long-term outcome studies exist on operative management of CN. A retrospective chart review was performed to analyze demographics, comorbidities, complications, and outcomes of operative management of CN. Patients were divided into two cohorts for analysis: limited surgical intervention (LSI) and reconstructive surgery (RS). Fifty-eight patients with CN treated surgically over 11 years were identified. Average follow-up was 46 months (range, 1 to 173 months). The mean age was 60.2 (range, 29 to 81) years, and the average body mass index was 34.3. Diabetes caused CN in 72.4 % (42/58) of patients. The LSI cohort (n = 32) had significantly higher rates of presenting infection (59.4 %; 19/32) and ulceration (87.5 %; 28/32) compared with the RS cohort (n = 26; 23.1 % [6/26] and 50 % [13/26], respectively). Rates of postoperative infection and ulceration were lower in the LSI group (25 % [8/32] and 34.4 % [11/32], respectively) than the RS group (42.3 % [11/26] and 42.3 % [11/26], respectively). The amputation rate for the LSI cohort was 21.9 % (7/32) compared with 23.1 % (6/26) for RS. This large, single-center study of operatively treated CN patients showed no significant difference between LSI and RS. This study provides data to help surgeons counsel patients on expected outcomes.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331475","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

Short term temporal outcomes after intramedullary fixation of lateral malleolus fractures. 髓内固定外侧耳骨骨折后的短期疗效。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-09-25 DOI: 10.1053/j.jfas.2024.09.011

Stephanie E Dal Porto-Kujanpaa, Ramez Sakkab, Samantha R Spierling Bagsic, Leah Puglisi, Michael L Collins, Brittany M Rice

{"title":"Short term temporal outcomes after intramedullary fixation of lateral malleolus fractures.","authors":"Stephanie E Dal Porto-Kujanpaa, Ramez Sakkab, Samantha R Spierling Bagsic, Leah Puglisi, Michael L Collins, Brittany M Rice","doi":"10.1053/j.jfas.2024.09.011","DOIUrl":"10.1053/j.jfas.2024.09.011","url":null,"abstract":"Ankle fractures are a common intra-articular trauma. The gold standard treatment for unstable ankle fractures has been Open Reduction Internal Fixation with plating and lag screw(s). Advocates for intramedullary nailing of the fibula note decreased wound complications and greater biomechanical strength. We hypothesized that time to union and time to weight bearing would be decreased with a fibular intramedullary nail compared to prior ankle ORIF literature. A retrospective cohort study was conducted of 65 consecutive ankle fracture patients treated with a fibular nail. The median follow-up time was 18.3 months (IQR: 55.4 - 97.6 days). All patients (100%) achieved clinical and radiographic union at a median of 9.6 (IQR: 54 - 78 days) and 10.8 weeks (IQR: 58 - 95 days), respectively. Post-operatively patients bore weight in walking boot and athletic shoe at a median 6.1 and 9.4 weeks, respectively. Fifteen patients suffered complications (23.1%). Patients with history of prior or active smoking were significantly correlated to longer time to union (p=0.016). Time to union also took 0.43 days longer for each additional year of age (t-value 2.13, p-value = 0.038). Nineteen out of 65 patients (29.2%) participated in the Olerud-Molander Ankle Scoring and the median functional outcome score was 71 (IQR: 56 - 93). While fibular nailing has advanced passive range of motion and weight bearing in our institution, time to weight bearing is clouded by surgeon comfort. Further study comparing fibular fracture healing and weight bearing status in regards to intramedullary and plate fixation in needed. LEVEL OF EVIDENCE: IV.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331489","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

How has acute syndesmotic injury management evolved over the last decade? Results from a national survey. 过去十年间，急性巩膜损伤的处理发生了怎样的变化？一项全国性调查的结果。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-09-25 DOI: 10.1053/j.jfas.2024.09.010

D Penning, R C M Vermeulen, S B M van den Heuvel, J A Halm, T Schepers

{"title":"How has acute syndesmotic injury management evolved over the last decade? Results from a national survey.","authors":"D Penning, R C M Vermeulen, S B M van den Heuvel, J A Halm, T Schepers","doi":"10.1053/j.jfas.2024.09.010","DOIUrl":"https://doi.org/10.1053/j.jfas.2024.09.010","url":null,"abstract":"The management of acute distal tibiofibular syndesmotic injuries has evolved over time and therefore, the aim of this study was to evaluate the use of different methods and the changes regarding management of distal tibiofibular syndesmotic injury among Dutch trauma- and orthopedic surgeons. A digital survey based on a previous survey conducted in 2012 was sent to (orthopedic) trauma surgeons from all different hospitals in the Netherlands. Sixty out of the 68 invited hospitals completed at least one survey (88.2 %). For Weber B or low Weber C fractures, there was a preference for the use of a single syndesmotic screw (SS)(73.6 %), while two screws were mainly used in Maisonneuve fractures (89.3 %). Furthermore, there was a clear preference for 3.5-mm screws, engaging three cortices, 2 to 4-cm above the tibiotalar joint. There is a significant decrease in routine removal of SSs (23.2 % compared to 87.0 % in 2012, p < 0.01). The percentage of hospitals in this survey that used the suture button (SB) was relatively low: 8.3 % for low fibular fractures and 5.0 % in high fibular fractures. In conclusion, the most striking difference compared to 2012 is the large decline in routine removal of the SS, which is in line with current literature. The SS is mainly implanted engaging three cortices, placed 2-4 cm above the tibiotalar joint and 3.5 mm in size and for the treatment of Maisonneuve fractures, two screws are preferred over a single SS. LEVEL OF EVIDENCE: Level III.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331474","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

Efficacy, safety, and pharmacokinetics of CPL-01, an investigational long-acting ropivacaine, in bunionectomy: Results of a phase 2b study. CPL-01（一种研究性长效罗哌卡因）在拇趾外翻切除术中的疗效、安全性和药代动力学：2b 期研究结果。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-09-19 DOI: 10.1053/j.jfas.2024.09.007

Hanghang Tommy Xu, John Zimmerman, Todd Bertoch, Lee Chen, P J Chen, Erol Onel

{"title":"Efficacy, safety, and pharmacokinetics of CPL-01, an investigational long-acting ropivacaine, in bunionectomy: Results of a phase 2b study.","authors":"Hanghang Tommy Xu, John Zimmerman, Todd Bertoch, Lee Chen, P J Chen, Erol Onel","doi":"10.1053/j.jfas.2024.09.007","DOIUrl":"https://doi.org/10.1053/j.jfas.2024.09.007","url":null,"abstract":"CPL-01 (ropivacaine extended-release injection) is formulated to safely provide postoperative analgesia and reduce opioid use. Participants undergoing unilateral distal first metatarsal bunionectomy with osteotomy were randomized to receive either CPL-01 (200 mg in Cohort 1, 300 mg in Cohort 2), ropivacaine HCl (50 mg in Cohort 1, 75 mg in Cohort 2), or volume-matched placebo into the surgical site prior to closure. Participants remained in an inpatient setting for 72 h to assess efficacy (Numeric Rating Scale [NRS] scores for pain with activity adjusted for opioid usage, and rescue medication usage), safety and pharmacokinetics. Seventy-three participants were randomized and treated, and 71 participants completed the study. Participants who received 300 mg CPL-01 had a mean (SD) area under the curve from 0 to 72 h (AUC0-72) of the NRS score with activity of 356.9 (132.82), which was lower than placebo, indicating less pain. Participants who received CPL-01 300 mg also had numerically lower mean total opioid consumption. CPL-01 was safe and well-tolerated, with no evidence of increased AEs in one group versus another. Infiltration of CPL-01 had no impact on wound or bone healing. CPL-01 showed predictable and consistent extended-release pharmacokinetics, with no indication of \"dose-dumping.\" Ropivacaine HCl delivered 94.3-99.7 % of its ropivacaine dose in the first 24 h; the 300 mg CPL-01 dose delivered 38.5 %. While this Phase 2b study was small, results demonstrated the safety, efficacy, and extended-release characteristics of this long-acting ropivacaine formulation in this surgical model, supporting further development of CPL-01 in Phase 3 clinical studies. LEVEL OF CLINICAL EVIDENCE: 1.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299838","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

Treatment of distal third tibial fractures with anterior soft tissue compromise through the posterolateral approach: Distal Third Tibial Fractures via the Posterolateral Approach. 通过后外侧入路治疗胫骨第三远端骨折伴前软组织损伤：通过后外侧入路治疗胫骨第三远端骨折。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-09-06 DOI: 10.1053/j.jfas.2024.09.002

Xiaoliang Yang, Xu Zhang, Caixia Liu, Liming Zhang, Fan Wu, Qiang Shen, Yadong Yu

{"title":"Treatment of distal third tibial fractures with anterior soft tissue compromise through the posterolateral approach: Distal Third Tibial Fractures via the Posterolateral Approach.","authors":"Xiaoliang Yang, Xu Zhang, Caixia Liu, Liming Zhang, Fan Wu, Qiang Shen, Yadong Yu","doi":"10.1053/j.jfas.2024.09.002","DOIUrl":"10.1053/j.jfas.2024.09.002","url":null,"abstract":"Distal third tibial fractures associated with anterior soft tissue compromise are a predictor of more complications and poor prognosis. The study aimed to introduce the treatment of such fractures through the posterolateral approach. From March 2020 and January 2022, 32 patients with distal third tibial fractures were plated through the posterolateral approach due to concurrent closed anterior soft tissue compromise. There were 30 male and 2 female patients with the mean age of 33 years (range, 20-53 years). The reduction quality of diaphyseal fractures was good (n=30) and acceptable (n=2). The reduction quality of articular fragments was anatomic (n=21), good (n=6), and fair (n=1). All anterior soft tissue injuries healed without surgical intervention. Follow-ups lasted 28 months (range, 25-34 months). The mean dorsiflexion of the injured and uninjured ankles were 17.8°±5.4° and 24.5°±6.6°, respectively (P<0.05). The mean plantar flexion of the ankles were 42°±8.8° and 46°±12.9°, respectively (P>0.05). The mean inversion of the injured and uninjured ankles were 15°±13.3° and 19°±12.4°, respectively (P<0.05). The mean eversion of the injured and uninjured ankles were 27.8°±16.9° and 32.9°±14.3°, respectively (P>0.05). The mean American Orthopaedic Foot and Ankle score was 90 (range, 68-100). Distal third tibial fractures with anterior soft tissue compromise can be plated through the posterolateral approach, resulting in good functional outcomes and minimum complications. LEVEL OF EVIDENCE: Therapeutic study, Level IV.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156524","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

Effect of patient age on fifth metatarsal fracture pattern, management, and outcomes. 患者年龄对第五跖骨骨折模式、处理和疗效的影响

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-09-06 DOI: 10.1053/j.jfas.2024.09.001

Manasa L Kadiyala, Matthew T Kingery, Raymond Walls, Abhishek Ganta, Sanjit R Konda, Kenneth A Egol

{"title":"Effect of patient age on fifth metatarsal fracture pattern, management, and outcomes.","authors":"Manasa L Kadiyala, Matthew T Kingery, Raymond Walls, Abhishek Ganta, Sanjit R Konda, Kenneth A Egol","doi":"10.1053/j.jfas.2024.09.001","DOIUrl":"10.1053/j.jfas.2024.09.001","url":null,"abstract":"Patients with 5th metatarsal (MT) fractures encompass a broad age distribution. This study evaluated the impact of age on the differences in clinical outcomes and management of these fractures. This was a retrospective cohort study of patients presenting to a single large, urban, academic hospital system with a 5th MT fracture over a 10-year period. Patients were stratified into groups of younger than 65 years old and equal to or greater than 65 years old. Initial and successive radiographs were reviewed, and fractures were categorized as Zone 1, Zone 2, Zone 3, Shaft, Neck, or Head fractures. 2,461 patients with 5th MT fractures were evaluated. Patients who did not follow up after initial evaluation in the emergency department or urgent care were excluded. Among 2,020 patients with mean follow-up of 1.03 years who met inclusion criteria, 76.2% were younger than 65 years and 23.8% were greater than or equal to 65 years. There was a significant difference in fracture type between groups as older patients were more likely to sustain metatarsal neck fractures but less likely to sustain Zone 1 base fractures (p < 0.05). There was no difference in time to clinical healing (p = 0.108) or time to radiographic union (p = 0.367) for all fractures between age groups. In conclusion, older patients sustain different 5th metatarsal fracture patterns compared to younger patients. However, despite the differences in age, there was no evidence for any difference in clinical and radiographic outcomes between groups.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156523","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