Foot & ankle specialist最新文献

{"title":"Non-emergent Conditions of the Ankle, Hindfoot, and Midfoot in Elderly Patients Are as Mobility Limiting as Congestive Heart Failure.","authors":"Wesley J Manz, Amalie E Nash, Jack Novak, Juliet Fink, Rishin Kadakia, Michelle M Coleman, Jason T Bariteau","doi":"10.1177/19386400221127836","DOIUrl":"10.1177/19386400221127836","url":null,"abstract":"<p><strong>Background: </strong>Mobility limitations are well linked to increased morbidity and mortality. Older patients with chronic pathologies of the foot and ankle can suffer from significant mobility limitations; however, the magnitude of limitation experienced by this cohort is not well characterized. Conversely, the effects of congestive heart failure (CHF) on patient mobility are routinely assessed via the New York Heart Association (NYHA) classification. New York Heart Association classification is determined by a patient's physical activity limitation and is strongly correlated to functional status. We hypothesized that non-emergent conditions of the foot and ankle would be as mobility limiting as CHF.</p><p><strong>Methods: </strong>Life-Space Mobility Assessments (LSAs) were prospectively collected from orthopaedic patients at their preoperative visits and from CHF patients at a cardiology clinic. Patients over the age of 50 years were included in this study. Congestive heart failure patients NYHA class II or greater were included. The non-emergent foot and ankle cohort included Achilles tendonitis, ankle joint cartilage defects, ankle arthritis, subtalar arthritis, and midfoot arthritis. Patient demographics and LSA scores were analyzed using Mann-Whitney U and chi-squared tests.</p><p><strong>Results: </strong>A total of 96 elderly, non-emergent foot and ankle operative patients and 45 CHF patients met inclusion criteria. All medical comorbidities, except smoking status, were significantly more prevalent in the CHF cohort. No statistical difference was observed between CHF and preoperative foot and ankle LSA scores (56.1 vs 62.4, P = .320). Life-Space Mobility Assessment scores in the foot and ankle cohort were significantly improved relative to CHF patients, at 6-month and 1-year postoperative visits (P = .028, P < .0001, respectively).</p><p><strong>Conclusion: </strong>Non-emergent ankle, hindfoot, and midfoot pathology is associated with similar mobility limitation to that of NYHA class II and III CHF. Older patients undergoing elective foot and ankle procedures exceeded the mobility of CHF patients at 6 months post-operation, and the mobility gains persisted at 1-year post-operation.</p><p><strong>Levels of evidence: </strong>Level II: Prospective cohort study.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"88-96"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33495754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readability of Online Foot and Ankle Surgery Patient Education Materials.","authors":"Davis A Hartnett, Alexander P Philips, Alan H Daniels, Brad D Blankenhorn","doi":"10.1177/19386400221116463","DOIUrl":"10.1177/19386400221116463","url":null,"abstract":"<p><p><i>Background</i>. Online health education resources are frequently accessed by patients seeking information on orthopaedic conditions and procedures. The objectives of this study were to assess the readability of information provided by the American Orthopaedic Foot and Ankle Society (AOFAS) and compare current levels of readability with previous online material. <i>Methods</i>. This study examined 115 articles classified as \"Conditions\" or \"Treatments\" on FootCareMD.org. Readability was assessed using the 6 readability assessment tools: Flesch Reading Ease, Flesch-Kincaid Grade Level (FKGL), Gunning Fog Score, Simple Measure of Gobbledygook (SMOG) Index, Coleman-Liau Index, and the Automated Readability Index. <i>Results</i>. The mean readability score across all metrics ranged from 9.1 to 12.1, corresponding to a 9th- to 12th-grade reading level, with a mean FKGL of 9.2 ± SD 1.1 (range: 6.3-15.0). No articles were written below the recommended US sixth-grade reading level, with only 3 articles at or below an eighth-grade level. Treatment articles had higher mean readability grade levels than condition articles (P = .03). <i>Conclusion</i>. Although the volume and quality of the AOFAS resource Web site has increased, readability of information has worsened since 2008 and remains higher than the recommended reading level for optimal comprehension by the general population.<b>Levels of Evidence:</b> Level IV:Retrospective quantitative analysis.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"9-18"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40591054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity in Medical School, Orthopaedic Surgery Residency, and ACGME-Accredited Foot and Ankle Orthopaedic Surgery Fellowship Training by Gender, Race, and Ethnicity.","authors":"Jason Silvestre, Kola George, Elizabeth K Nadeau, Daniel J Scott, Christopher E Gross","doi":"10.1177/19386400241312945","DOIUrl":"https://doi.org/10.1177/19386400241312945","url":null,"abstract":"<p><strong>Introduction: </strong>Increasing diversity in the US health care workforce is a topic of increasing scrutiny and interest. This study analyzes the pipeline of demographic diversity for Accreditation Council for Graduate Medical Education (ACGME)-accredited foot and ankle orthopaedic surgery fellowship training.</p><p><strong>Methods: </strong>This was a cross-sectional study of medical students, orthopaedic surgery residents, and orthopaedic foot and ankle fellows at US-accredited training programs from 2013 to 2022. Self-reported demographic data were available for trainees and compared with the 2020 US Census according to federal guidelines. Participation-to-prevalence ratios (PPRs) were calculated and analyzed to classify representation of demographic groups in orthopaedic foot and ankle surgery training as overrepresented (PPR > 1.2), equivalent (PPR = 0.8-1.2), and underrepresented (PPR < 0.8).</p><p><strong>Results: </strong>Disparities existed in demographic representation among medical students, orthopaedic surgery residents, and ACGME-accredited orthopaedic foot and ankle fellows among women (48.4% vs 16.1% vs 20.1, P < .001), black (6.9% vs 4.6% vs 4.5%, P < .001), Asian (23.9% vs 14.1% vs 23.9%, P < .001), and Hispanic (6.1% vs 4.6% vs 3.0%, P < .001) trainees. There were no self-reported American Indian/Alaska Native and Native Hawaiian/Pacific Islander trainees in orthopaedic foot and ankle fellowship training (PPR = 0). Women (PPR = 0.40), black (PPR = 0.36), and Hispanic (PPR = 0.16) trainees were underrepresented in orthopaedic foot and ankle training relative to the US population. In contrast, Asian (PPR = 3.45), men (PPR = 1.61), and white (PPR = 1.21) trainees were overrepresented in orthopaedic foot and ankle relative to the US population.</p><p><strong>Discussion: </strong>There is a lack of gender, racial, and ethnic diversity in orthopaedic foot and ankle training relative to the US patient population and earlier stages of medical training. Increased efforts to recruit underrepresented groups may promote diversity and inclusion in the emerging orthopaedic foot and ankle surgery workforce.</p><p><strong>Levels of evidence: </strong>III.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400241312945"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computerized Tomography for Diagnosing Traumatic Arthrotomies of the Ankle.","authors":"Elizabeth Cho, Ryan LeDuc, Hector Castillo, Michael S Pinzur, Kamran S Hamid, Adam P Schiff","doi":"10.1177/19386400251314167","DOIUrl":"https://doi.org/10.1177/19386400251314167","url":null,"abstract":"<p><strong>Background: </strong>Owing to the risk for septic arthritis, traumatic arthrotomies are an urgent surgical problem for the treating orthopaedic surgeon. Traditionally, diagnosis is with the saline load test (SLT), although in the awake patient is an invasive and potentially painful procedure. While computerized tomography (CT) has been shown to be a reliable diagnostic tool for traumatic arthrotomies of other joints, its role has only recently been investigated in the setting of ankle arthrotomy.</p><p><strong>Methods: </strong>Eight fresh-frozen mid-tibia ankle cadaveric specimens were included for study. Baseline CT scans were performed to confirm intact ankle joint capsules with absence of intra-articular air. Ankle arthrotomies were performed under fluoroscopic guidance with vertical 1 cm incisions made at the anteromedial or anterolateral portals. After arthrotomy, all ankles underwent a second CT scan, and images were evaluated for the presence of intra-articular air. Finally, SLT was performed and the volume of saline required for extravasation was recorded.</p><p><strong>Results: </strong>Of 8 ankles, 100% (n = 8) demonstrated intra-articular air on CT scan following arthrotomy. Computerized tomography scan and SLT both demonstrated 100% sensitivity and specificity for diagnosing ankle arthrotomies. Average saline volume necessary for extravasation (and positive SLT) was 4 mL (range: 2-7 mL) and did not differ by foot position.</p><p><strong>Conclusion: </strong>In this small cadaveric study, CT scan and SLT were both able to detect 100% (n = 8) of traumatic ankle arthrotomies with 100% sensitivity and specificity. Further comparative study of CT scan and SLT for detection of traumatic ankle arthrotomy in a clinical setting is warranted.</p><p><strong>Levels of evidence: </strong><i>Level IV</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400251314167"},"PeriodicalIF":0.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of Pathogens in Surgical Site Infections in Ankle Fractures and Implications for Empirical Antibiotic Treatment.","authors":"Hannah Plasmeijer, Jasper Tausendfreund, Martine Hoogewerf, Diederick Penning, Pieter Joosse, Tim Schepers, Erik Tanis","doi":"10.1177/19386400241313418","DOIUrl":"https://doi.org/10.1177/19386400241313418","url":null,"abstract":"<p><p>Surgical site infections (SSIs) are the most common complication after surgery for ankle fractures. This retrospective study aimed to determine the pathogens cultured in SSI and their antimicrobial susceptibility patterns to provide a recommendation for empirical therapy. Patients who underwent surgical treatment for an ankle fracture were included. Cases were screened for the occurrence of SSI and divided into superficial (short course [total of <2 weeks] of oral antibiotics) and deep SSI (surgical debridement and long course [total of >2 weeks] antibiotics). Culture results, antimicrobial susceptibility patterns, empirical antibiotic regimen, type and timing of culture collection, and treatment strategies were collected from electronic health records. In total, 81 (9%) out of 931 patients developed an SSI (39 (48%) superficial SSI and 42 (52%) deep SSI). The most common pathogens in 16 superficial SSI and 37 deep SSI with positive cultures were <i>Staphylococcus aureus</i>, cultured in 11 (69%) superficial SSI and 23 (62%) deep SSI, and <i>Enterobacter cloacae</i> species, cultured in 5 (31%) superficial SSI and 12 (32%) deep SSI. Higher frequencies of gram-negative bacteria and polymicrobial infections were found in deep SSI. It is recommended to aim for empirical treatment at gram-positive and gram-negative microorganisms in the case of both superficial and deep SSI.<b>Level of Evidence:</b> Prognostic, Level 2: Retrospective.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400241313418"},"PeriodicalIF":0.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Experience With the Quantum Total Ankle Prosthesis.","authors":"Lauren M Christie, Terrence M Philbin","doi":"10.1177/19386400241310695","DOIUrl":"https://doi.org/10.1177/19386400241310695","url":null,"abstract":"<p><p>The Quantum total ankle prosthesis is a newer Food and Drug Administration (FDA)-approved fourth-generation 2-component, fixed-bearing implant in its first-generation design. The purpose of this study was to evaluate early outcome data and present our initial experience with the Quantum implant with a minimum of a 1-year follow-up. A retrospective, single-centered chart and radiographic review was performed on all patients who underwent total ankle arthroplasty with the Quantum implant from December 2021 to August 2023. Implant survivorship, radiographic outcomes, clinical outcomes, and complications were evaluated. The survivorship for the implant was 100% for the tibial component and 91.67% for the talar component, respectively. Pre-operatively, there were 3 ankles with a coronal deformity greater than 10 degrees. Post-operatively, coronal plane deformity was 100% corrected into neutral alignment. This study is the first to report on short-term outcomes for the Quantum total ankle prosthesis. Our findings showed promising results of short-term implant survivorship with good clinical and radiographic outcomes.<b>Level of Evidence:</b> IV.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400241310695"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repairing the Deltoid Ligament in Ankle Fractures Is it time for a Paradigm Shift?","authors":"Joy Van den Berg, Diederick Penning, Sebastian Baumbach, Tim Schepers","doi":"10.1177/19386400241307817","DOIUrl":"https://doi.org/10.1177/19386400241307817","url":null,"abstract":"<p><strong>Background: </strong>It remains unclear whether repairing the deltoid ligament (DL) is beneficial in acute ankle fractures. The aim of this review is to critically review the developments in deltoid ligament repair (DLR) in ankle fractures over the course of 44 years.</p><p><strong>Method: </strong>An electronic search was conducted on the PubMed and Embase database including comparative studies evaluating the effect of performing DLR in adults suffering from a closed acute ankle fracture with suspected rupture of the DL.</p><p><strong>Results: </strong>A total of 27 studies were retrieved, of which only one was a randomized study. A total of 1327 patients were reviewed (663 undergoing DLR and 664 receiving non-DLR treatment for an acute ankle fracture). Although earlier studies concluded that DLR holds little necessity in ankle fracture treatment if the anatomy of the ankle is restored, more recent studies support DLR due to more favorable clinical and radiographic outcomes.</p><p><strong>Discussion: </strong>All studies agree that restoration of the ankle anatomy to its pre-fracture state is necessary to achieve the best clinical outcome. However, there is still controversy in whether to standardize DLR in ankle fracture treatment. The literature shows a clear shift toward more frequent restoration of the DL, and in light of improved surgical techniques and implants, there is a need for more rigorous studies to provide a clear indication for DLR in acute ankle fracture treatment.</p><p><strong>Level of evidence: </strong><i>III</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400241307817"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic and Patient-Reported Outcomes for First Tarsometatarsal Arthrodesis Using an Intramedullary Nail for Hallux Valgus Deformity A Consecutive Case Series.","authors":"Connor C Ott, Ayush D Shah, Kayla J Seiffert, Rebecca Stone McGaver, Paul M Cammack, Scott M Holthusen, Jeffrey D Seybold, John C Tanner, William M Engasser","doi":"10.1177/19386400241301822","DOIUrl":"https://doi.org/10.1177/19386400241301822","url":null,"abstract":"<p><strong>Background: </strong>First tarsometatarsal (TMT) arthrodesis is one of the most common procedures performed each year for the correction of hallux valgus deformity, and nonunion rates for first TMT arthrodesis are commonly reported to be between 4% and 15%. The purpose of this study was to evaluate the effectiveness of an intramedullary nail system in patients requiring first TMT arthrodesis.</p><p><strong>Methods: </strong>An ambispective, multisurgeon, consecutive case series was conducted, in which retrospective and prospective collection of patient-reported outcome measure (PROM) and radiologic data were conducted. Patients who underwent first TMT arthrodesis from July 2019 to July 2022 for hallux valgus deformity with an intramedullary nail system and had adequate records for a minimum of 3 months postoperation (±4 weeks) were included.</p><p><strong>Results: </strong>Seventy patients were included in the final analysis, with a median prospective PROM follow-up of 1.6 years. There was an overall union rate of 91.4% (64/70 patients). Nine patients required secondary procedures: 4 hardware removals and 5 nonunion revisions. Collected PROMs and radiologic data showed significant improved from preoperative to prospective follow-up (P < .01).</p><p><strong>Conclusion: </strong>First TMT arthrodesis using an intramedullary nail system result in nonunion rates and PROMs comparable to other techniques currently being used.</p><p><strong>Levels of evidence: </strong><i>Level IV: Retrospective Case Series</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400241301822"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of Utilization of Weightbearing Computed Tomography Within AOFAS Membership.","authors":"Sudheer C Reddy, Cesar de Cesar Netto","doi":"10.1177/19386400241297605","DOIUrl":"https://doi.org/10.1177/19386400241297605","url":null,"abstract":"<p><strong>Background: </strong>Weightbearing computed tomography (WBCT) has been increasingly employed to evaluate and treat patients with varied pathologies such as progressive collapsing foot deformity (PCFD), posttraumatic deformity, hallux valgus, ankle arthritis, Charcot arthropathy, lisfranc, and syndesmosis injuries. However, little is known regarding its overall availability to foot and ankle providers and how it is being used in clinical practice. The goal of this study is to assess the utilization of WBCT among AOFAS members, identify the indications for use in clinical practice and potential barriers for implementation.</p><p><strong>Methods: </strong>A survey was emailed to AOFAS members inquiring about the use WBCT in clinical practice. Practice and demographic information were also collected. A total of 220 responses were collected over a 2-month period. Respondents were queried with respect to the availability of WBCT in practice, indications for use, frequency of use, ownership of the scanner, and barriers to implementation.</p><p><strong>Results: </strong>58% of respondents did not have access to WBCT. Most respondents were in practice 10 years or more (69%). Single-specialty private practice was the most common practice type (39%). Of those with access to WBCT, 5 or fewer scans were ordered per week (57% of respondents). Evaluation of hindfoot/ankle deformity was the most common indication (69% of respondents) with it being used as a preoperative evaluation tool approximately 25% of the time (57% of respondents). Radiology department owned WBCT in most institutions (34%). 75% of respondents with WBCT use it postoperatively less than 25% of the time. Of those without WBCT, 94% stated they would like to have it with cost being the most significant barrier to implementation.</p><p><strong>Conclusion: </strong>Most respondents surveyed did not have access to WBCT, with cost being the greatest barrier. However, 94% of those without it would like to have access to it. For those with access, it is used 5 or fewer times per week with evaluation of hindfoot/ankle deformity being the most common indication.</p><p><strong>Level of evidence: </strong>Level IV (Observational Study).</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400241297605"},"PeriodicalIF":0.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal Fibula Fractures-Intramedullary Fixation Versus Plating: A Systematic Review and Meta-analysis of Randomized Control Trials.","authors":"Vikash Raj, Sitanshu Barik, Richa","doi":"10.1177/19386400221118470","DOIUrl":"10.1177/19386400221118470","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the present study is to compare the functional scores and complications of intramedullary fixation versus plate osteosynthesis of distal fibular fractures in adults.</p><p><strong>Methods: </strong>Study was performed in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses format from MEDLINE, Embase, Ovid, and Cochrane databases. The included articles were assessed according to the risk of bias assessment tool by Cochrane collaboration.</p><p><strong>Results: </strong>A total of 5 randomized control trials were included for quantitative review. Random sequence generation and allocation concealment of the study subjects were the strengths of all the included studies. There was high heterogeneity among the included studies (I² > 75%). There was no significant difference between the Olerud-Molander scores in both the groups but the trend favored the intramedullary nailing of distal fibula (mean difference of 3.42, 95% confidence interval [CI] of 8.90). Complications were significantly lesser in the intramedullary group across the studies (odds ratio 0.26, 95% CI of 0.81).</p><p><strong>Conclusion: </strong>Intramedullary nailing of fibula with the use of modern locking fibular nails is an alternative to fibular plating for unstable distal fibular fractures in properly selected cases. There remains the need for standardizing the method of operative treatment of distal fibular fractures which can be done by a well-planned large-scale prospective study design.</p><p><strong>Level of evidence: </strong>Level 1.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"621-631"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40417957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}