Journal of Foot & Ankle Surgery最新文献_第7页

Total Ankle Arthroplasty Templating: Preoperative Computer Templating Correlates Highly with Intraoperative Component Selection. 全踝关节成形术模板制作：术前计算机模板与术中组件选择高度相关。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-08-19 DOI: 10.1053/j.jfas.2024.08.006

Robert J Teasdall, Bryanna D Vesely, Taylor R Wood, Jennifer A Kipp, Kyle A Lynch, Samuel Rosas, Aaron T Scott

{"title":"Total Ankle Arthroplasty Templating: Preoperative Computer Templating Correlates Highly with Intraoperative Component Selection.","authors":"Robert J Teasdall, Bryanna D Vesely, Taylor R Wood, Jennifer A Kipp, Kyle A Lynch, Samuel Rosas, Aaron T Scott","doi":"10.1053/j.jfas.2024.08.006","DOIUrl":"10.1053/j.jfas.2024.08.006","url":null,"abstract":"<p><p>Proper alignment and sizing are critical to the performance of a successful total ankle arthroplasty. While it is common practice in preoperative planning prior to total knee and total hip arthroplasty, preoperative computer templating has not been well established in the setting of total ankle arthroplasty. A retrospective review of all total ankle arthroplasties performed during a 10-year period by a single fellowship-trained orthopaedic surgeon was conducted. Computer templating was utilized for all preoperative Anterior to Posterior (AP) and lateral standing radiographs, and templated component sizes were compared to the operative reports and postoperative radiographs to determine the precision of the available templates. Statistical analysis was performed with Interclass Correlation Coefficients (ICC) and descriptive statistical tests. Seventy patients with a mean age of 64.8 years (range, 48-87) and mean BMI of 30.34 (range, 19.1-55.6) were included. The ICC demonstrated that both the AP (ICC 0.80 - 95% CI 0.679-0.876) and lateral (ICC 0.786 - 95% CI 0.655-0.867) radiographs provided accurate tibial total ankle arthroplasty component templating. Similarly, the AP (ICC 0.842 - 95% CI 0.745-0.902) and lateral (ICC 0.809 - 95% CI 0.692-0.881) radiographs provided accurate talar templating. No differences were observed when comparing AP to lateral radiographs in percentage of correct component templating: tibial AP 61.4% vs lateral 58.6%, p = .119 and talar component AP 57.1% vs lateral 45.7%, p = .176. These study findings demonstrate that preoperative templating for total ankle arthroplasties is accurate in determining appropriate implant sizing. Accurate templating is an absolute necessity for future templating studies.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019435","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

Safety and Efficacy of One vs Two Incision Broström Gould with Calcaneal Osteotomy and Peroneal Tendon Debridement Surgery 单切口与双切口布罗斯特罗姆古尔德钙骨截骨术和腓肠肌肌腱清创手术的安全性和有效性对比。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-08-14 DOI: 10.1053/j.jfas.2024.08.003

Mila Scheinberg MD, MS , Travis Fortin MD , Matthew McCrosson MD , Ting Dan Zhang BS , Juan Campos MS, BS , Marc Bernstein MS , Ashish Shah MD

{"title":"Safety and Efficacy of One vs Two Incision Broström Gould with Calcaneal Osteotomy and Peroneal Tendon Debridement Surgery","authors":"Mila Scheinberg MD, MS , Travis Fortin MD , Matthew McCrosson MD , Ting Dan Zhang BS , Juan Campos MS, BS , Marc Bernstein MS , Ashish Shah MD","doi":"10.1053/j.jfas.2024.08.003","DOIUrl":"10.1053/j.jfas.2024.08.003","url":null,"abstract":"<div><div>Surgical intervention, such as the Broström-Gould procedure, is typically indicated for patients with chronic lateral ankle instability. In this study, we are comparing the safety and efficacy of the Broström-Gould procedure with peroneal tendon debridement, a sliding lateralizing calcaneal osteotomy, and adjuvant procedures performed with a single- versus double-incision approach. Our retrospective analysis included patients who underwent the procedure of interest between 2011 and 2020. Patients were divided into 2 groups: undergoing either a 1-incision (n = 53) or a 2-incision approach (n = 47), both with a lateralizing calcaneal osteotomy. A significant difference in skin bridge breakdown was observed between the 2-incision (n = 6 [13%]) and 1-incision groups (n = 0 [0%]). There were no significant differences in infection, deep wound dehiscence, nerve palsy, or neuroma between patients in the 2 groups. Furthermore, no statistically significant differences in mean PROMIS scores existed between the cohorts. The described Broström-Gould procedure shows promise for treating chronic ankle instability. While patients in both single- and double-incision groups had similar rates of postoperative complications, the decreased incidence of skin bridge breakdown in the 1incision group highlights the approach's safety and potential benefits in reducing wound-related complications.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"63 6","pages":"Pages 747-751"},"PeriodicalIF":1.3,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996800","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

PA Screw Versus Plate Fixation for Posterior Malleolar Fracture, Systematic Review and Meta-analysis of Complications and Functional Results. PA螺钉与钢板固定治疗耳后臼骨骨折，并发症和功能结果的系统回顾和荟萃分析。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-08-14 DOI: 10.1053/j.jfas.2024.08.001

Carlos A Sánchez, Natalia Correal, Daniela Caro

{"title":"PA Screw Versus Plate Fixation for Posterior Malleolar Fracture, Systematic Review and Meta-analysis of Complications and Functional Results.","authors":"Carlos A Sánchez, Natalia Correal, Daniela Caro","doi":"10.1053/j.jfas.2024.08.001","DOIUrl":"10.1053/j.jfas.2024.08.001","url":null,"abstract":"<p><p>Fixation methods for posterior malleolar fracture (PMF) are a source of great controversy. This study aims to compare complications, clinical, and radiological outcomes between PA screws and posterior plate in PMF using current literature. A systematic search strategy was conducted following the PRISMA protocol. Medline (PubMed), Embase (Elsevier), and Lilacs databases were used to identify complication rates (infection, nonunion, loss of reduction, osteoarthrosis, and sural nerve injury) and to compare reported functional outcomes. The level of evidence in the articles was assessed using the GRADE tool. The studies eligible for meta-analysis were processed using The Review Manager version 5.4.1 software. Twelve articles met the inclusion criteria; 5 articles were included for subgroup meta-analysis. Overall infection rate, loss of reduction and sural nerve injury were each 2%. Osteoarthritis rate was 10%. There was no difference in risk reduction for infection rate (RD = 0.01; 95% CI: -0.03 to 0.06; p = .50), loss of reduction (RD = -0.00; 95% CI: -0.03 to 0.03; p = .88), sural nerve injury (RD = 0.01; 95% CI: -0.03 to 0.04; p = .70), osteoarthrosis (RD = -0.00; 95% CI: -0.09 to 0.09; p = .97), functional (MD = 0.70; 95% CI: -1.06 to 2.45; p = .44) or pain scores (MD = 0.12; 95% CI: -0.31 to 0.55; p = .58), nor deficit in dorsiflexion (MD= -0.26; 95% CI: -1.64 to 1.12; p = .71). There were no clinical nor radiological significant differences when comparing fixation of PMF with plates or PA screws. With current literature it is not possible to establish the superiority of either fixation.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989405","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 Prevalence of Persistent Toe Walking in Children With and Without Autism Spectrum Disorder and the Odds of Subsequent Surgery. 自闭症谱系障碍儿童和非自闭症谱系障碍儿童持续性足趾行走的患病率及后续手术的几率。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-08-13 DOI: 10.1053/j.jfas.2024.08.005

Michael Chapek, Jeffrey Kessler

{"title":"The Prevalence of Persistent Toe Walking in Children With and Without Autism Spectrum Disorder and the Odds of Subsequent Surgery.","authors":"Michael Chapek, Jeffrey Kessler","doi":"10.1053/j.jfas.2024.08.005","DOIUrl":"10.1053/j.jfas.2024.08.005","url":null,"abstract":"<p><p>Persistent toe walking is associated with autism spectrum disorder. The true prevalence of persistent toe walking and odds of progression to surgery in children with and without autism remains unclear. This retrospective descriptive study identified patients ages 3 to 17 years who were enrolled in our healthcare system over a 2-year period. Using international classification of disease codes, we identified all children with autism and persistent toe walking, and excluded children with conditions that may independently cause toe walking. Data on Achilles lengthening surgeries, sex, race and body mass index was gathered. The toe walking prevalence amongst children with and without autism was calculated. Multivariable logistic regression analysis controlling for sex, race and body mass index was used to determine independent risk factors for persistent toe walking and surgery. Of the children who met inclusion criteria (N = 284,925), 4622 (1.6%) had persistent toe walking. Prevalence of persistent toe walking was higher amongst children with autism (6.3% vs 1.5%, p < .01), as were odds of persistent toe walking (OR 4.13, 95% CI 3.74 to 4.56, p < .01). Males and White patients had higher odds of persistent toe walking compared to females and patients of any other race, respectively (p < .01 for all). Although children with autism and toe walking had higher rates of surgery than their counterparts without autism (4.3% vs 2.6%, p = .04), this difference was not significant after controlling for sex, race and BMI (OR 1.59, 95% CI 0.95 to 2.69, p > .05).</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989406","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

What is the Total Ankle Arthroplasty Experience of Podiatric Foot and Ankle Surgery Fellows? A National Survey. 足踝外科研究员的全踝关节置换术经验如何？全国调查。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-08-10 DOI: 10.1053/j.jfas.2024.08.004

Ramez Sakkab, Jeffrey E McAlister, Joshua M Ekladios, James M Cottom

{"title":"What is the Total Ankle Arthroplasty Experience of Podiatric Foot and Ankle Surgery Fellows? A National Survey.","authors":"Ramez Sakkab, Jeffrey E McAlister, Joshua M Ekladios, James M Cottom","doi":"10.1053/j.jfas.2024.08.004","DOIUrl":"10.1053/j.jfas.2024.08.004","url":null,"abstract":"<p><p>In 2011, the Council of Podiatric Medical Education, the accrediting body of the American Podiatric Medical Association, approved the conversion of all Podiatric Residencies to 3-year surgical programs. In 2012, there were 12 podiatric fellowships recognized by the American College of Foot and Ankle Surgeons. To date, there are 53 programs listed under the college's website. As podiatric fellowships expand, further research is needed to identify advantages and pitfalls of fellowship training. Our primary aim was to obtain current fellow survey data to enhance our understanding of podiatric reconstructive foot and ankle surgery fellowship training programs. In doing so, we decided to use one of the most salient topics in fellowship training- Total Ankle Replacement. Invitation was administered by email and 73.6% of active reconstructive 2023-24 American College of Foot and Ankle Surgeons postgraduate fellows responded. Fellowship total ankle replacement case volume was significantly greater than residency (p = 0.037). Completion of 0-5 total ankle replacement(s) was 30.8%, and greater than 30 in 17.9% of fellows. Fifty nine percent reported feeling \"comfortable\" or \"very comfortable\" with total ankle arthroplasty. Patient specific instrumentation was used in a majority of cases (66.7%). Over three fourths (79.8%) of fellows stated they planned on performing TAR as an attending surgeon after their fellowship. Despite its limitations, we hope our survey data can aid graduating and previous fellows and add to the body of knowledge for future TAR educational programs and industry involvement. As podiatric fellowships continue to transform, so too must our research efforts to track progress.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972230","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

Publication Rates for Oral Manuscript and Poster Presentations From the American College of Foot and Ankle Surgeons: 2015 to 2019 美国足踝外科医生学会口述手稿和海报发表率：2015-2019 年。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-08-06 DOI: 10.1053/j.jfas.2024.07.007

Calvin J. Rushing DPM, FACFAS , Kristen L. Paege

{"title":"Publication Rates for Oral Manuscript and Poster Presentations From the American College of Foot and Ankle Surgeons: 2015 to 2019","authors":"Calvin J. Rushing DPM, FACFAS , Kristen L. Paege","doi":"10.1053/j.jfas.2024.07.007","DOIUrl":"10.1053/j.jfas.2024.07.007","url":null,"abstract":"<div><div>The quality of national society conferences is often assessed indirectly by analyzing the journal publication rate of the abstracts presented. The conversion rate of abstracts presented at the annual American College of Foot and Ankle Surgeons conference is currently the highest reported (76.9%) for any foot and ankle society to date. The purpose of the present retrospective study was to re-assess the journal publication rate for abstracts (oral manuscript, poster) accepted for presentation at the annual meeting, this time from 2015 to 2019. All accepted abstracts from this period were compiled in a database. PubMed, Google Scholar, and Scopus searches were performed using abstract titles, and author names. The journal publication rate was 80.7% (92/114) for oral manuscripts, and 23.1% (287/1240) for poster abstracts. The mean time to publication was 18.7 months (0 to 75), and 19.1 months (0 to 88) for oral manuscript and posters, respectively. The most common journal for abstract publication was The Journal of Foot and Ankle Surgery. The American College of Foot and Ankle Surgeons oral manuscript publication rate from 2015 to 2019 (80.7%) exceeded the previous reported rate from 2010 to 2014 (76.9%), and is now the highest reported for any national foot and ankle society to date. Attendees of the oral presentations, and readers of the Journal of Foot and Ankle Surgery may remain confident in the quality, and clinical significance of the research presented.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"63 6","pages":"Pages 713-716"},"PeriodicalIF":1.3,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908194","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

Age Influence on Total Ankle Arthroplasty Outcomes: A Systematic Review 年龄对全踝关节置换术结果的影响：系统回顾

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-08-03 DOI: 10.1053/j.jfas.2024.07.013

Jennifer A. Kipp DPM , Bryanna D. Vesely DPM, MPH , Thea A. Lance BS , Brian N. White MA , Ashleigh W. Medda DPM, FACFAS , Aaron T. Scott MD

{"title":"Age Influence on Total Ankle Arthroplasty Outcomes: A Systematic Review","authors":"Jennifer A. Kipp DPM , Bryanna D. Vesely DPM, MPH , Thea A. Lance BS , Brian N. White MA , Ashleigh W. Medda DPM, FACFAS , Aaron T. Scott MD","doi":"10.1053/j.jfas.2024.07.013","DOIUrl":"10.1053/j.jfas.2024.07.013","url":null,"abstract":"<div><div>Total ankle arthroplasty has gained popularity as advancing technology has resulted in higher survivorship and lower complication rates. In the past, total ankle replacement candidates have been reserved for patients greater than 50 years old with low physical demands and minimal deformity. However, with newer designs, surgeons have begun to expand their patient inclusion criteria. The purpose of this study was to analyze current literature comparing patient outcomes among total ankle replacement patients over and under age 50. A systematic review of the literature was performed comparing the impact of age to total ankle replacement outcomes. 159 articles were reviewed. Seven studies met our inclusion criteria and therefore were included in the synthesis. No statistically significant difference in outcomes was determined for the younger and older age groups in regard to reoperation, complications, and implant survivorship (<em>p</em> = .412, .955, .155, respectively). However, the statistical model is underpowered given the limited number of studies. While the findings of this study infer that total ankle replacement outcomes are not significantly different among older and younger age groups, further research in this area is needed.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"63 6","pages":"Pages 765-768"},"PeriodicalIF":1.3,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894796","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

Experience With Immediate Internal Fixation Combined With Primary Wound Closure in Gustilo–Anderson Type IIIA Open Ankle Fractures 古斯蒂洛-安德森 IIIA 型开放性踝关节骨折即刻内固定联合原位伤口闭合术的经验。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-08-02 DOI: 10.1053/j.jfas.2024.07.010

Jijian Gao MD , Wencan Fan MD , Weijiang Zhang MD , Yong Fan MD , Hongyu Xu MD

{"title":"Experience With Immediate Internal Fixation Combined With Primary Wound Closure in Gustilo–Anderson Type IIIA Open Ankle Fractures","authors":"Jijian Gao MD , Wencan Fan MD , Weijiang Zhang MD , Yong Fan MD , Hongyu Xu MD","doi":"10.1053/j.jfas.2024.07.010","DOIUrl":"10.1053/j.jfas.2024.07.010","url":null,"abstract":"<div><div>Open ankle fractures, especially Gustilo–Anderson type III fractures are challenging to manage with controversy over the “best” or “superior” treatment strategy. This study aimed to evaluate the treatment outcome of immediate internal fixation combined with primary wound closure in the management of Gustilo–Anderson type IIIA open ankle fractures. We retrospectively assessed the outcomes of thirty-two patients treated using immediate internal fixation combined with primary wound closure with a minimum follow-up of twenty-four months. At the median follow-up of 38 months, the mean American Orthopaedic Foot and Ankle Society scale score was 87.22 ± 4.05. The physical component summary score of Short-Form 36 Health Status Survey was 66.63 ± 11.42 and the mental component summary score was 67.31 ± 7.20. Range of motion of Ankle/Foot injured side was 64.56 ± 4.30 degrees, and range of motion of Ankle/Foot uninjured side was 72.31 ± 3.12 degrees. Visual analog pain scale score was 1.5 ± 0.88 at rest and 3.09 ± 1.17 during activity. According to American Orthopaedic Foot and Ankle Society scale score, the rate of excellent and good outcomes was 90.6%. Postoperative complications were documented, comprising 2 (6.4%) cases of infection, 5 (15.6%) cases of wound skin necrosis, 1 (3.2%) case of postoperative ankle traumatic arthritis, and 1 (3.2%) case requiring reoperation due to suboptimal fibula fracture reduction. The study results demonstrated that immediate internal fixation combined with primary wound closure for Gustilo–Anderson type IIIA open ankle fractures achieve good functional outcomes and lower complication rates.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"63 6","pages":"Pages 731-734"},"PeriodicalIF":1.3,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of Preoperative Coronal Plane Alignment on Actual Versus Predicted Alignment Using Patient Specific Instrumentation in Total Ankle Replacement 在全踝关节置换术中使用患者专用器械，术前冠状面对齐对实际对齐与预测对齐的影响。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-08-02 DOI: 10.1053/j.jfas.2024.07.009

Andrew Regal DPM, AACFAS , Tisileli S. Tuifua MD , Brandon M. Scharer DPM, FACFAS , Jason George DeVries DPM, FACFAS

{"title":"Effect of Preoperative Coronal Plane Alignment on Actual Versus Predicted Alignment Using Patient Specific Instrumentation in Total Ankle Replacement","authors":"Andrew Regal DPM, AACFAS , Tisileli S. Tuifua MD , Brandon M. Scharer DPM, FACFAS , Jason George DeVries DPM, FACFAS","doi":"10.1053/j.jfas.2024.07.009","DOIUrl":"10.1053/j.jfas.2024.07.009","url":null,"abstract":"<div><div>Alignment in total ankle replacement is important for success and implant survival. Recently there has been the introduction and adoption of patient specific instrumentation for implantation in total ankle replacement. Current literature does not evaluate the effect of preoperative deformity on accuracy of patient specific instrumentation. A retrospective radiographic analysis was performed on 97 consecutive patients receiving total ankle replacement with patient specific instrumentation to assess the accuracy and reproducibility of the instrumentation. Subgroup analysis evaluated the effect of preoperative deformity. All surgeries were performed by fellowship trained foot and ankle surgeons without industry ties to the implants used. Preoperative and postoperative films were compared to plans based on computerized tomography scans to assess how closely the plan would be implemented in patients. Overall postoperative coronal plane alignment was within 2° of predicted in 87.6% (85 patients). Similarly, overall postoperative sagittal plane alignment was within 2° of predicted in 88.7% (86 patients). Tibial implant size was accurately predicted in 81.4% (79 patients), and talus implant size was correct in 75.3% (73 patients). Patients with preoperative varus deformity had a higher difference between predicted and actual postoperative alignment compared to valgus deformity (1.1° compared to 0.3°, <em>p</em> = .02). A higher average procedure time was found in varus patients, and more adjunctive procedures were needed in patients with varus or valgus deformity, but these were not significant, p > .5. Surgeons can expect a high degree of accuracy when using patient specific instrumentation overall, but less accurate in varus deformity.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"63 6","pages":"Pages 724-730"},"PeriodicalIF":1.3,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890765","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

Posterior Malleolus Fracture Fixation In Lateral Decubitus Position: Surgical Technique and Results in 60 Patients 侧卧位下踝后骨折固定术。60例患者的手术技巧和效果。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-08-02 DOI: 10.1053/j.jfas.2024.07.012

Nikolaos Gougoulias MD, PhD, Panagiotis Christidis MD, MSc, Georgios Christidis MD, Panagiotis Markopoulos MD, Georgios Biniaris MD

{"title":"Posterior Malleolus Fracture Fixation In Lateral Decubitus Position: Surgical Technique and Results in 60 Patients","authors":"Nikolaos Gougoulias MD, PhD, Panagiotis Christidis MD, MSc, Georgios Christidis MD, Panagiotis Markopoulos MD, Georgios Biniaris MD","doi":"10.1053/j.jfas.2024.07.012","DOIUrl":"10.1053/j.jfas.2024.07.012","url":null,"abstract":"<div><div>The present study shows how posterior malleolus fractures (PMFs) and distal fibular fractures were fixed using the posterolateral approach with the patient in lateral decubitus position, not previously described in the literature. This technique has been used in 60 consecutive patients (42 women and 18 men; mean age 54.7; range 21-92 years), 33 of which presented as fracture dislocations from March, 2021 to December, 2023. After PMFs fixation in lateral decubitus position, release of the sacral support allowed patients to be placed supine (without de-sterilizing the operative field), in order to proceed with medial malleolus or posteromedial fragment fixation. Fractures were classified according to the Lauge Hansen classification as SER4 (n = 50), PER4 (n = 7), SAD (n = 1), and PAB (n = 2). Fractures were classified according to Rammelt & Bartonicek, as type B (n = 40), C (n = 13), and D (n = 7). During the same period of time 14 fractures involving the PM, classified as type A, were treated with indirect fixation, whilst 6 geriatric and/or poor mobility patients with fracture dislocations were treated with retrograde hindfoot nail fixation. Follow-up period ranged from 4-36 months (mean = 14.4; SD = 8.8). Complications occurred in 5 patients (8.3%; 3 had delayed (medial) wound healing, one developed CRPS and one required implants removal and arthroscopy because of metal irritation and stiffness). No deep infections, thromboembolic events, fracture malreductions or malunions were recorded and all patients returned to the preinjury mobilization status. In conclusion, PM fracture fixation was feasible and safely performed with patients in lateral decubitus position.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"63 6","pages":"Pages 742-746"},"PeriodicalIF":1.3,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890767","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