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

Takedown of Ankle Arthrodesis and Conversion to Total Ankle Arthroplasty: A Systematic Review 踝关节切除术后转为全踝关节置换术：系统回顾。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-07-19 DOI: 10.1053/j.jfas.2024.07.002

Freideriki Poutoglidou MD, MSc, PhD, Sohail Yousaf MBBS, MSc, FCPS, FRCS

{"title":"Takedown of Ankle Arthrodesis and Conversion to Total Ankle Arthroplasty: A Systematic Review","authors":"Freideriki Poutoglidou MD, MSc, PhD, Sohail Yousaf MBBS, MSc, FCPS, FRCS","doi":"10.1053/j.jfas.2024.07.002","DOIUrl":"10.1053/j.jfas.2024.07.002","url":null,"abstract":"<div><div>Management of the nonunited or painful ankle arthrodesis remains a difficult challenge. The aim of this systematic review was to investigate the clinical outcomes and complications of conversion of an ankle fusion to a total ankle replacement (TAR). The PRISMA statement guidelines were followed. A literature search was performed in PubMed, Science Direct and Cochrane Central Register of Controlled Trails (CENTRAL) from their inception up to October 10th, 2023. The quality of the included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal tool and the Methodological Index for NonRandomized Studies (MINORS). Seven studies with 220 patients (223 ankles) with a mean follow-up of 64.9 months were included. Takedown of an ankle fusion and conversion to a TAR led to a significant improvement in all functional and clinical scores and with an acceptable range of motion. Most common complications were malleolar fractures (12.8%) and arthrofibrosis (5.6%). The revision rate was 8% and 4 cases resulted in a below-knee amputation. Cases with an insufficient fibula had a good outcome when a fibular reconstruction was performed. In conclusion, takedown of an ankle fusion and conversion to a TAR has satisfactory clinical outcomes and with a limited number of complications. Future well-designed studies are needed to validate the results of the present study.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735550","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 Value of Routine Radiography in the Nonoperative Treatment of Metatarsal Fractures: A Retrospective Cohort Study 常规 X 射线照相术在跖骨骨折非手术治疗中的价值：一项回顾性队列研究。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-07-19 DOI: 10.1053/j.jfas.2024.07.003

Gijs J.A. Willinge MD, Dries Boulidam MSc, Dorien A. Salentijn MD, Bas A. Twigt MD, PhD, J. Carel Goslings MD, PhD, Ruben N. van Veen MD, PhD

{"title":"The Value of Routine Radiography in the Nonoperative Treatment of Metatarsal Fractures: A Retrospective Cohort Study","authors":"Gijs J.A. Willinge MD, Dries Boulidam MSc, Dorien A. Salentijn MD, Bas A. Twigt MD, PhD, J. Carel Goslings MD, PhD, Ruben N. van Veen MD, PhD","doi":"10.1053/j.jfas.2024.07.003","DOIUrl":"10.1053/j.jfas.2024.07.003","url":null,"abstract":"<div><div>Although widely used in follow-up treatment protocols, the added value of routine radiographs to clinical decision-making in nonoperative treatment of patients with metatarsal fractures is unclear. This retrospective cohort study aimed to determine whether routine follow-up radiographs contributed to changes in treatment strategies in nonoperative treatment of patients with a metatarsal fracture. Adult (aged ≥ 18 years) patients who received nonoperative follow-up treatment for a metatarsal fracture between May first, 2020 and May second, 2022 were included. All relevant data were extracted from patient records. Radiographs without a documented clinical indication were classified as routine. Outcomes included changes in treatment strategies based on routine radiographs during follow-up treatment and secondarily, changes in treatment strategy based on clinically indicated radiographs. A total of 168 patients were included, with 135 single and 33 multiple metatarsal fractures. During follow-up, 223 radiographs were performed, of which 154 (69%) were routine and 69 (31%) were on clinical indication. Of routine radiographs, 9 (6%) led to a change in treatment which only included additional imaging. No switch to operative treatment or prolonging of immobilization was observed based on routine radiographs. Of clinically indicated radiographs, 16 (23%) led to a change of treatment, including prolonged immobilization (n = 2), additional follow-up appointments (n = 1) and additional imaging (n = 12). Our results show routinely performed radiographs seldom affect treatment strategies in nonoperative treatment of metatarsal fractures, indicating minimal added value to clinical decision-making. Omitting routine radiographs from treatment protocols may contribute to the reduction of unnecessary healthcare resource utilization in clinical practice.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735551","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

Racial Disparities in Outcomes After Foot and Ankle Surgery: A Systematic Review and Meta-Analysis 足踝手术后结果的种族差异：系统回顾与元分析》。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-07-14 DOI: 10.1053/j.jfas.2024.06.011

Scott Buchanan BS , Emily Luo BS , Kian Bagheri DO , Kevin A. Wu BS , Albert T. Anastasio MD , Samantha Kaplan PhD , Samuel Adams MD

{"title":"Racial Disparities in Outcomes After Foot and Ankle Surgery: A Systematic Review and Meta-Analysis","authors":"Scott Buchanan BS , Emily Luo BS , Kian Bagheri DO , Kevin A. Wu BS , Albert T. Anastasio MD , Samantha Kaplan PhD , Samuel Adams MD","doi":"10.1053/j.jfas.2024.06.011","DOIUrl":"10.1053/j.jfas.2024.06.011","url":null,"abstract":"<div><div>This systematic review and meta-analysis delved into the impact of race and ethnicity on outcomes following foot and ankle surgery, an area garnering increasing attention within the medical community. Despite significant literature on postsurgical clinical and functional outcomes, limited research has explored the influence of racial and ethnic factors on postoperative outcomes. In this study, data from 33 relevant studies, involving a total of 557,734 patients, were analyzed to assess outcomes across different racial and ethnic groups. Notably, only 6 studies met the criteria for inclusion in the final meta-analysis due to variations in outcome reporting. Findings revealed disparities in functional scores, pain levels, and resource utilization among different racial and ethnic cohorts. Specifically, non-White and minority patients exhibited higher rates of foot and ankle fractures and lower extremity surgeries, worse functional outcomes, increased pain, longer hospital stays, and a greater incidence of complications compared to their White counterparts. However, some studies presented contradictory results, emphasizing the necessity for further investigation to elucidate these discrepancies fully. This research underscores the importance of considering racial and ethnic factors in foot and ankle surgery outcomes and highlights the need for targeted interventions to address existing disparities.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621626","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

New Insight into the Effects of Different Types of Midfoot and Hindfoot Deformities on the Functional Outcomes of Rheumatoid Arthritis Patients 不同类型的中足和后足畸形对类风湿关节炎患者功能预后影响的新见解。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-07-10 DOI: 10.1053/j.jfas.2024.07.001

{"title":"New Insight into the Effects of Different Types of Midfoot and Hindfoot Deformities on the Functional Outcomes of Rheumatoid Arthritis Patients","authors":"","doi":"10.1053/j.jfas.2024.07.001","DOIUrl":"10.1053/j.jfas.2024.07.001","url":null,"abstract":"<div><div><span>In advanced stages of rheumatoid arthritis<span> (RA), the pattern of joint involvement leads to varied types of foot deformities<span><span> such as forefoot, midfoot, and hindfoot deformities. We aim to evaluate midfoot and hindfoot deformities and their effect on functional outcomes in RA patients. In this prospective cross-sectional study clinical and radiological evaluations of 100 adult RA patients were studied for midfoot and hindfoot deformities. The RA </span>disease activity, functional disability level, specific foot and ankle assessments, gait speed, and balance tests were assessed. </span></span></span>Radiological examinations<span><span> of the weight-bearing feet in a standing position were done. We found that the most frequent deformity type was the planovalgus foot (24%). There were statistically significant differences between the types of foot deformities<span><span> and disease duration, disease activity, falls, Tinetti and Berg balance Test, and health assessment questionnaire-disability index. The multivariate regression analysis of independent correlates of falling detected that patients with equinovarus deformity were 2.5 times more liable for falling with 63.5% predictive power. According to the predictive criteria of deformity type for falling, the equinocavovarus type had accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 91%, 84.5%, 98.5%, 99%, and 84%, respectively. We found in RA patients, midfoot and hindfoot deformities cause a significant reduction of functional ability and </span>quality of life. The early detection of foot deformities requires a good awareness of the clinical and radiographic diagnosis of different types of deformities thus reducing the possible functional disabilities via early management by combined </span></span>orthotic, physiotherapy, and surgical treatments.</span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602069","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

Hyperuricemia May Increase Risk of Achilles Tendon Rupture: A Case Control Study 高尿酸血症可能增加跟腱断裂的风险：病例对照研究

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-07-06 DOI: 10.1053/j.jfas.2024.06.005

{"title":"Hyperuricemia May Increase Risk of Achilles Tendon Rupture: A Case Control Study","authors":"","doi":"10.1053/j.jfas.2024.06.005","DOIUrl":"10.1053/j.jfas.2024.06.005","url":null,"abstract":"<div><div>It has been demonstrated in a number of studies that high levels of uric acid can cause crystal deposition in the tendons of the lower extremities, which in turn can impair the Achilles tendon. This study aimed to interpret whether hyperuricemia is relevant with Achilles tendon rupture. Patients diagnosed with Achilles tendon rupture at the same institution between 2013 and 2022 were included in the case group. Healthy subjects who had physical examinations during the same period were included in the control group. Propensity score matching was used to match in a 1:1 ratio. Demographic and clinical characteristics of patients in both groups were compared. Five hundred and fourteen patients were included in the study (ATR=257; Control group=257). The proportion of individuals with hyperuricemia varied significantly between the 2 groups (Achilles tendon rupture group=43.6%; control group=27.6%; <em>p</em><0.001). The Achilles tendon rupture and hyperuricemia were linked by conditional logistic regression (<em>p</em><0.001; OR=2.036; 95CI%=1.400-2.961). Compared with healthy subjects, patients with hyperuricemia have a higher risk of Achilles tendon rupture. Further studies are required to verify the effects of hyperuricemia and monosodium urate crystals on Achilles tendon structure.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555837","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

Evaluation of Online AI-Generated Foot and Ankle Surgery Information 评估在线人工智能生成的足踝手术信息。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-07-03 DOI: 10.1053/j.jfas.2024.06.009

{"title":"Evaluation of Online AI-Generated Foot and Ankle Surgery Information","authors":"","doi":"10.1053/j.jfas.2024.06.009","DOIUrl":"10.1053/j.jfas.2024.06.009","url":null,"abstract":"<div><div><span>As a natural progression from educational pamphlets to the worldwide web, and now artificial intelligence (AI), OpenAI chatbots provide a simple way of obtaining pathology-specific patient information, however, little is known concerning the readability and quality of foot and ankle surgery information. This investigation compares such information using the commercially available OpenAI ChatGPT Chatbot and FootCareMD®. A list of common foot and ankle pathologies from FootCareMD® were queried and compared with similar results using ChatGPT. From both resources, the Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL) scores were calculated for each condition. Qualitative analysis of each query was performed using the JAMA Benchmark Criteria Score and the DISCERN Score.The overall ChatGPT and FootCareMD® FRES scores were 31.12 ± 7.86 and 55.18 ± 7.27, respectively (</span><em>p</em> < .0001). The overall ChatGPT and FootCareMD® FKGL scores were 13.79 ± 1.22 and 9.60 ± 1.24 respectively (<em>p</em> < .0001), except for the pilon fracture FKGL scores (<em>p</em> = .09). The average JAMA Benchmark for all information obtained through ChatGPT and FootCareMD® were 0 ± 0 and 1.95 ± 0.15 (<em>p</em> < .001), respectively. The DISCERN Score for all information obtained through ChatGPT and FootCareMD® were 52.53 ± 5.39 and 66.93 ± 4.57 (<em>p</em> < .001), respectively. AI-assisted queries concerning common foot and ankle pathologies are written at a higher grade level and with less reliability and accuracy compared to similar information available on FootCareMD®. With the ease of use and increase in AI technology, consideration should be given to the nature and quality of information being shared with respect to the diagnosis and treatment of foot and ankle conditions.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538849","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 in Patients With Heel Ulcerations that Underwent Below the Knee Amputations Versus Vertical Contour Calcanectomy: Importance of Selection Criteria 接受膝下截肢术与垂直轮廓钙化切除术的足跟溃疡患者的疗效：选择标准的重要性。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-07-02 DOI: 10.1053/j.jfas.2024.06.010

{"title":"Outcomes in Patients With Heel Ulcerations that Underwent Below the Knee Amputations Versus Vertical Contour Calcanectomy: Importance of Selection Criteria","authors":"","doi":"10.1053/j.jfas.2024.06.010","DOIUrl":"10.1053/j.jfas.2024.06.010","url":null,"abstract":"<div><div>The aim of the study was to compare preoperative factors and postoperative outcomes in patients with heel ulcerations that primarily had a transtibial (below the knee) amputation (N = 38) versus vertical contour calcanectomy (n = 62). The groups had no statistical difference between their Charlson Comorbidity Index Score, a prognostic score of 10-year survival in patients with multiple comorbidities. The odds of primary closure were 21.1 times higher in patients that underwent below knee amputation compared to patients that underwent vertical contour calcanectomy (OR 21.1 [95% CI 3.89-114.21]). The odds of positive soft tissue culture at time of closure were 17.1 times higher for patients that underwent vertical contour calcanectomy (OR 17.1 [95% CI 5.40-54.16]). The odds of a patent posterior tibial artery were 3.3 times higher for patients that underwent vertical contour calcanectomy (OR 3.3 [95% 1.09-10.09]). The secondary aim of the study was to evaluate preoperative factors and postoperative outcomes in patients with failed vertical contour calcanectomy, defined as needing a below knee amputation. The odds of vertical contour calcanectomy failure was 13.7 times higher in male patients (OR 13.7 [95% CI 1.80-107.60]). Vertical contour calcanectomy failure was 5.7 times higher in patients with renal disease (OR 5.7 [95% CI 1.10-30.30]), and vertical contour calcanectomy failure was 16.1 times higher for patients who needed additional surgery post closure (OR 16.1 [95% CI 1.40-183.20]).</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535821","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

Utilizing the Frailty Index to Predict Long-term Mortality in Patients Undergoing Major Lower Extremity Amputation 利用虚弱指数预测下肢大截肢患者的长期死亡率。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-07-02 DOI: 10.1053/j.jfas.2024.06.012

{"title":"Utilizing the Frailty Index to Predict Long-term Mortality in Patients Undergoing Major Lower Extremity Amputation","authors":"","doi":"10.1053/j.jfas.2024.06.012","DOIUrl":"10.1053/j.jfas.2024.06.012","url":null,"abstract":"<div><p><span>The 5-factor modified Frailty<span> Index (mFI-5) is a risk-stratification tool utilized to predict complications and mortality following major lower extremity (LE) amputation. However, its prognostic value for long-term mortality is unknown. The study aim was to assess whether a high mFI-5 score relates to long-term mortality following major LE amputation for chronic wounds. Patients ≥60 years who underwent major LE amputation from 2017 to 2021 were retrospectively reviewed. Data regarding demographics, comorbidities, perioperative factors, amputation type, and postoperative complications was collected and mFI-5 was calculated. Survival analysis was performed with Kaplan-Meier curves and differences were assessed with Log-Rank test. A total of 172 patients were identified. Mean age was 70.7 ± 8.0 years. Median time to ambulation was 3.7 months (IQR 4.0). By final follow-up of 17.5 ± 15.9 months, ambulatory rate was 51.7% (n = 89), overall mortality 36.0% (n = 62), 1-year mortality 14.0% (n = 24), and 3-year mortality 27.9% (n = 48). Patients with an mFI-5 of ≥4 (26.7%, n = 46) compared with patients with mFI-5 <4 (73.3%, n = 126) had a higher rate of prolonged postoperative LOS (34.8% vs 19.8%, </span></span><em>p</em> = .042), overall mortality (52.2% vs 30.2%, <em>p</em> = .008), 1-year mortality (23.9% vs 10.3%, <em>p</em> = .023), and 3-year mortality (45.7% vs 21.4%, <em>p</em><span> = .002). Multivariate analysis demonstrated mFI-5 was an independent predictor of 3-year mortality (OR 2.35, </span><em>p</em> = .043). At a threshold ≥4, the mFI-5 demonstrated utility in predicting long-term mortality. The value of this prognostic indicator is in its preoperative application of assessing risk of mortality, which should be utilized in conjunction with other measures.</p></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499500","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

Immediate Weightbearing after Modified Lapidus Arthrodesis Using a Medial Plate: A Retrospective Descriptive Cohort Study 使用内侧钢板进行改良 Lapidus 关节置换术后立即负重：回顾性描述性队列研究

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-06-28 DOI: 10.1053/j.jfas.2024.06.004

{"title":"Immediate Weightbearing after Modified Lapidus Arthrodesis Using a Medial Plate: A Retrospective Descriptive Cohort Study","authors":"","doi":"10.1053/j.jfas.2024.06.004","DOIUrl":"10.1053/j.jfas.2024.06.004","url":null,"abstract":"<div><div>The modified Lapidus procedure has emerged as a versatile solution for various pedal pathologies, particularly hallux abducto valgus. There have been numerous modifications over time regarding fixation techniques, joint preparation methods, graft utilization, and weightbearing protocols. However, concerns persist regarding prolonged nonweightbearing postoperatively, prompting the need for alternative approaches. This retrospective descriptive cohort analysis assessed the outcomes of 40 feet from 34 patients who underwent the modified Lapidus procedure with a medial plating system, aimed to evaluate immediate weightbearing outcomes on union rate, fixation-related complications, and functional outcomes. Among the 40 feet, findings showed a 95% (38/40) union rate within 6 months, with 2.5% (1/40) experiencing delayed union and 2.5% (1/40) facing fixation-related complications. There is a single case of malunion in the cohort. Additionally, statistically significant improvements were observed across all domains of the Manchester-Oxford Foot Questionnaire at <em>p</em> < .001. These findings suggest immediate weightbearing as a potential alternative to traditional nonweightbearing protocols. However, the study's retrospective nature and lack of a comparative group warrant cautious interpretation. Further research is essential to validate these findings and refine postoperative care protocols. By challenging conventional practices, this study underscores the complexity of optimizing patient outcomes in modified Lapidus procedure management. Tailored approaches and prospective investigations are imperative for establishing definitive guidelines and enhancing surgical techniques in this domain.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472160","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

External Versus Internal Fixation Techniques for Ankle Arthrodesis: A Systematic Review and Meta-analysis 踝关节固定术的外固定与内固定技术：系统回顾与荟萃分析。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2024-06-27 DOI: 10.1053/j.jfas.2024.05.010

{"title":"External Versus Internal Fixation Techniques for Ankle Arthrodesis: A Systematic Review and Meta-analysis","authors":"","doi":"10.1053/j.jfas.2024.05.010","DOIUrl":"10.1053/j.jfas.2024.05.010","url":null,"abstract":"<div><div>Ankle arthrodesis is an effective surgical intervention for end-stage arthritis or severe ankle joint deformity. Both internal (IF) and external fixation (EF) techniques are valid options, but there is controversy regarding the most effective technique. This study compares the safety and efficacy of EF and IF fixation techniques for ankle arthrodesis. A systematic review and meta-analysis was conducted according to the Preferred reporting items for systematic reviews and meta-analyses (PRISMA) Guidelines. A literature search of electronic databases, including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL), was performed to identify all studies directly comparing the two techniques. Both fixed and random effects models of analysis were used depending on heterogeneity. Odds of union in the EF and IF groups were comparable (OR = 0.60, CI 0.36-1.02, <em>p</em> = .06) however, EF was associated with greater odds of deep hardware infections (OR = 3.67, 1.97-6.83, <em>p</em> < .05) and amputations (OR = 3.17, CI 1.06-9.54, <em>p</em> = .04). Odds of revision surgery and superficial wound complications were similar between groups. EF techniques had significantly longer operation times (MD = 31.23, CI-25.11-37.34, <em>p</em> < .05) and intraoperative blood loss (MD = 44.1, CI 28.77-59.43, <em>p</em> < .05<strong>)</strong>. No significant difference was noted in pain and functionality scores. IF and EF techniques have reasonable union rates with similar postoperative outcomes.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472159","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