Michael S Pinzur, Adam P Schiff, Kamran Hamid, Ryan LeDuc
Critical sized bone defects in the ankle are becoming increasingly more common in patients undergoing limb reconstruction with tibiotalocalcaneal arthrodesis. Bulk allografts have not fared well over time. There have been scattered preliminary reports using custom spinal cages or 3D-printed Titanium Implants to address the critical bony defect; however, the cost of these devices is prohibitive in many clinical practice settings. The purpose of this investigation is to report the preliminary experience using a commercially available Trabecular Metal (Zimmer-Biomet) tibial metaphyseal cone combined with a retrograde locked intramedullary nail to address this challenging problem...
March 19, 2024: Foot & Ankle Specialist
Zachary Hill, Ryan Stone, Timothy Holmes
Tibialis anterior tendon (TAT) ruptures are rare, equating to less than 1% of all musculotendinous injuries. These injuries can be acute or atraumatic, with the latter often associated with chronic degenerative tendinopathy. Surgical repair is indicated when conservative measures fail in meeting functional demands. Direct end-to-end repair is the preferred method for TAT ruptures but may not be feasible with a large tendon defect. Various surgical techniques have been described to address this pathology, including allograft tendon interposition or extensor hallucis longus (EHL) transfer...
March 18, 2024: Foot & Ankle Specialist
Maximilian Waehner, Kajetan Klos, Hans Polzer, Robbie Ray, Thomas Lorchan Lewis, Hazibullah Waizy
BACKGROUND: The aim of this study was to evaluate and compare different fixation methods to achieve Tarsometatarsal joint I (TMT-1) arthrodesis in patients with hallux valgus regarding radiographic correction, complication profile, and clinical outcomes. METHODS: A systematic review and meta-analysis included primary literature results of evidence level 1 to 3 studies in German and English. Inclusion and exclusion criteria were established and applied, along with parameters suitable for comparison of data...
March 14, 2024: Foot & Ankle Specialist
Lee M Hlad, Jacob N Rizkalla, Eric So, John E Herzenberg
Pin tract infections are virtually universal complications with the use of external fixation. While most are superficial and respond to oral antibiotics and local care, septic loosening may occur at the bone-pin interface, which may lead to instability of the fixator, catastrophic failure, fracture, and long-term osteomyelitis. Classification systems and prevention protocols have been developed to address this ubiquitous complication. Treatment of severe pin tract infections often requires debridement, parenteral antibiotics, and removal of the offending pin or the entire external fixator...
March 7, 2024: Foot & Ankle Specialist
Isabel Shaffrey, Emily Teehan, Kristin Caolo, Scott Ellis, Jonathan Deland, Jensen Henry, Constantine Demetracopoulos
Owing to the last decade's increase in the number of total ankle arthroplasty (TAA) procedures performed annually, there is a concern that the disproportionate distribution of orthopaedic surgeons who regularly perform TAA may impact complications and/or patient satisfaction. This study examines patient-reported outcomes and complications in TAA patients who had to travel for surgery compared to those treated locally. This is a single-center retrospective review of 160 patients undergoing primary TAA between January 2016 and December 2018, with mean age 65 (range: 59-71) years, mean body mass index (BMI) 28...
March 7, 2024: Foot & Ankle Specialist
Annemarie Galasso, Alexander M Caughman, Adam Griffith, Caroline Hoch, James Rex, Daniel J Scott, Christopher E Gross
INTRODUCTION: This study analyzes the incidence rate and median workdays missed due to foot and ankle injuries across age groups, sexes, and industries. METHODS: Workplace injury data from 2003 to 2019 were obtained using the Nonfatal Cases Involving Day Away from Work: Selected Characteristics database provided by the Bureau of Labor Statistics (BLS). The data were grouped by injury location (ie, foot, ankle), injury type (ie, fracture, sprain), and industry, and reported with injury incidence rates and median workdays missed...
February 29, 2024: Foot & Ankle Specialist
Hannah H Nam, Brandon J Martinazzi, F Jeffrey Lorenz, Gregory J Kirchner, Vincenzo Bonaddio, Adeshina Adeyemo, Kempland C Walley, Michael C Aynardi
BACKGROUND: The incidence of phantom limb pain in patients with Charcot neuroarthropathy who undergo major amputation is not well described. The purpose of this study was to determine whether patients with Charcot neuroarthropathy and diabetes who underwent either a below-knee amputation (BKA) or above-knee amputation (AKA) had an increased rate of phantom limb pain compared with those with a diagnosis of diabetes alone. METHODS: Using international classification of disease (ICD) and common procedural terminology (CPT) codes, the TriNetX research database identified 10 239 patients who underwent BKA and 6122 who underwent AKA between 2012 and 2022...
February 12, 2024: Foot & Ankle Specialist
Kaissar Yammine
INTRODUCTION: Diabetic foot ulcers (DFUs) reflect a pivotal event that could lead to serious complications such as amputation and death. Although conservative surgery was reported to have better outcomes when compared to nonsurgical standard of care of forefoot wounds, the surgical management of diabetic toe ulcers (DTUs) is hardly researched. METHODS: The aim of this study is to describe the types and techniques of surgical procedures that could be needed when managing DTU...
February 2024: Foot & Ankle Specialist
Adam Astrada, Rian Adi Pamungkas, Khoirul Rista Abidin
Despite numerous available agents claiming anti-biofilm properties on wounds, the substantiating evidence remains inconclusive. This study aimed to assess the immediate impact of topical wound treatments on wound biofilm and healing outcomes in acute and chronic ulcers. We comprehensively searched PubMed,, and Google Scholar. In addition, eligible gray literature was incorporated. English-language randomized controlled trials (RCTs), observational, cohort, and case-control studies targeting biofilm prevention, inhibition, or elimination across diverse wound types were included...
January 28, 2024: Foot & Ankle Specialist
Joseph R Brown, Zachary P Hill, Ross Groeschl, Robert W Mendicino, Brian Steginsky, Joshua Houser
BACKGROUND: Parallax is an imaging phenomenon where an object appears to be at different positions when viewed from different angles. Distortion can occur secondary to internal fluoroscopic, or external environmental, factors. Fluoroscopy is a vital tool to assist surgeons intraoperatively. However, parallax and distortion can lead to inaccuracy, potentially leading to incorrect surgical decisions. The purpose of this study was to investigate the prevalence of parallax/distortion in large fluoroscopy units at a level-1 trauma center...
January 28, 2024: Foot & Ankle Specialist
Yianni Bakaes, Tyler Gonzalez, James W Hardin, J Benjamin Jackson
BACKGROUND: Both isolated talonavicular arthrodesis and talonavicular and subtalar (such as double) arthrodesis can be effective treatments for adult-acquired flatfoot deformity (AAFD) with good success rates, but double arthrodesis has become more commonly performed in recent years. The purpose of this study is to evaluate whether isolated talonavicular versus talonavicular and subtalar arthrodesis led to significantly different 30-day postoperative complication rates in patients with AAFD...
January 7, 2024: Foot & Ankle Specialist
David M Noble, Anna Sumpter, Benjamin Small, Jeffrey R Ruland, M Truitt Cooper, Joseph S Park, Venkat Perumal
BACKGROUND: First metatarsophalangeal (MTP) arthrodesis is a common surgical procedure for addressing hallux MTP pathology. In the setting of revision procedures with significant bone loss, porous titanium wedges may provide an alternative to structural bone autograft or allograft. OBJECTIVE: The purpose of this study is to report the clinical and radiographic outcomes achieved in first MTP interposition arthrodesis using porous titanium wedges. METHODS: A retrospective analysis of 9 patients with a mean age 65...
December 21, 2023: Foot & Ankle Specialist
Henrique Mansur, Phelipe Pinheiro Alves Lucas, Daniel Augusto Maranho
The claw toe deformity is characterized by the flexion of interphalangeal joints (IPJs) with hyperextension of the metatarsophalangeal (MTP) joint. It can be flexible and reducible or rigid and irreducible, or dynamic. The most common cause of dynamic claw toes is a neurological disorder, like sequelae of an ischemic contracture of the muscle belly after a compartment syndrome. Most of the surgical techniques require multiple procedures and may be associated with complications such as toe stiffness, persisting metatarsalgia, and toe malalignment...
December 20, 2023: Foot & Ankle Specialist
Justin C Haghverdian, Andrew R Hsu
One of the most discussed but misunderstood topics in foot and ankle is shoe wear choices and the purported benefits of each type of shoe versus their actual scientific advantages. All foot and ankle care providers should be familiar with the various shoe wear types available to patients to improve their overall foot health. Recently, mainstream popularity and media coverage of maximalist shoes has created increased interest in the science and potential clinical benefits of maximalist shoes. The purpose of this review is to present the current biomechanical evidence of maximalist shoes and to help inform the foot and ankle community of their potential therapeutic applications...
December 20, 2023: Foot & Ankle Specialist
Daniel T DeGenova, Klay B Miller, Alex S Paulini, Anthony J Melaragno, Trent Davis, Brett Hoffman, Benjamin C Taylor
BACKGROUND: Talus fractures are often result of high energy mechanisms and can lead to devastating complications. Treatment is often operative; however, the appropriate timing of this has been debated. The purpose of this study is to determine the efficacy and safety of the early treatment of talus fractures. METHODS: Patients aged 18 years or older who underwent definitive operative stabilization of their talus fracture at a single urban level 1 trauma center were retrospectively reviewed...
December 14, 2023: Foot & Ankle Specialist
Daniel Baumfeld, Matheus Silva, Ana Paula Simões, Tiago Baumfeld
Chronic exertional compartment syndrome (CECS) is a challenging pathology that causes pain and physical limitations. Fasciotomy is the gold standard and different techniques have been described. Techniques that allow a fast return to sports and low recurrence rates are of great interest for the athletic population. This is a prospective case series presenting a mini open surgical technique and its results regarding the level of return to sports and quality of life in 13 patients. A specific CECS questionnaire was applied and analyzed concerning the distance patients were able to run before and after treatment, Tegner score, Medical Outcomes Short-Form Health Survey (SF-36), and epidemiological measures...
December 12, 2023: Foot & Ankle Specialist
Albert T Anastasio, Kempland C Walley, Billy I Kim, Mikhail A Bethell, Samuel B Adams
BACKGROUND: As new literature emerges and practice patterns fluctuate, there is a significant potential for variation with regard to adjunctive procedures performed with primary total ankle arthroplasty (pTAA) and revision total ankle arthroplasty (rTAA). Our study aims to evaluate yearly trends in the incidence of concomitant procedures and compare the incidence of adjunctive procedures between pTAA and rTAA. METHODS: The 2012-2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for all pTAA and rTAA...
December 11, 2023: Foot & Ankle Specialist
Nicholas J Jackson, Koen Flores, Andrew Blake, Joel B Harley, Christopher W Reb, Jennifer A Nichols
BACKGROUND: The optimal placement for a syndesmosis reduction clamp remains an open question. This study compared the center-center axis, which localizes clamp placement using only an internally rotated lateral ankle X-ray, with other common approaches, whose accuracy can only be confirmed using computed tomography (CT). METHODS: Bone models of anatomically aligned (n = 6) and malreduced (n = 48) limbs were generated from CT scans of cadaveric specimens. Four axes for guiding clamp placement (center-center, centroid, B2, and trans-syndesmotic) were then analyzed, using digitally reconstructed radiographs derived from the bone models...
December 6, 2023: Foot & Ankle Specialist
Margaret E Giro, Nawreen Quazi, Michael Elder Waters, Wonyong Lee
Mallet hallux injuries are relatively rare, and management can range from conservative treatment to surgical fixation. Only a few cases of surgically treated are reported, and there is no consensus on the superiority of one technique to others in surgical treatment. We reviewed various options for surgical fixation of Mallet hallux injury and presented a case of mallet hallux injury treated with Kirschner wires with an extension blocking technique.Level of Evidence: V .
December 1, 2023: Foot & Ankle Specialist
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December 2023: Foot & Ankle Specialist
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