Ankle

CASE: A 23-year-old woman sustained a skin defect in the anterior ankle involving the extensor retinaculum (ER) and 10 cm of extensor tendons (ETs) after a wide resection of clear cell sarcoma. The skin defect was reconstructed with free latissimus dorsi flap, ER with tensor fascia lata, and ETs with 2-staged tendon reconstruction using silicone rod interposition, followed by semitendinosus and gracilis tendon grafts. Four years postoperatively, she achieved 92% of ankle and 70% of great toe motion of the contralateral side...

The pedestrian is one of the most vulnerable road users and has experienced increased numbers of injuries and deaths caused by car-to-pedestrian collisions over the last decade. To curb this trend, finite element models of pedestrians have been developed to investigate pedestrian protection in vehicle impact simulations. While useful, modeling practices vary across research groups, especially when applying knee/ankle ligament and bone failure. To help better standardize modeling practices this study explored the effect of knee ligament and bone element elimination on pedestrian impact outcomes...

This study aims to determine the validity of the lower extremity joint kinematics measured by inertial measurement units (IMUs) in non-rearfoot strike pattern (NRFS) runners across different speeds. Fifteen NRFS runners completed three 2-min running tests on a treadmill in random order at 8, 10 and 12 km/h, whilst data were synchronously collected using the IMU system and an optical motion capture system. Before the offset was corrected, the validity of the knee angle waveform was higher than that of the hip and ankle; after the offset was corrected, the validity increased in all three joints...

IMPORTANCE: Few people with lower extremity peripheral artery disease (PAD) participate in supervised treadmill exercise covered by the Center for Medicare and Medicaid Services. In people with PAD, the benefits of home-based walking exercise, relative to supervised exercise, remain unclear. OBJECTIVE: To study whether home-based walking exercise improves 6-minute walk (6MW) more than supervised treadmill exercise in people with PAD (defined as Ankle Brachial Index ≤0...

BACKGROUND: The misuse and abuse of opioid pain medications have become a public health crisis. Because orthopedic surgeons are the third highest prescribers of opioids, understanding their postoperative pain medication prescribing practices is key to solving the opioid crisis. To this end, we conducted a study of the variability in orthopedic foot and ankle surgery postoperative opioid prescribing practice patterns. METHODS: Three hundred fifty orthopedic foot and ankle surgeons were contacted; respondents completed a survey with 4 common patient scenarios and surgical procedures followed by questions regarding typical postoperative pain medication prescriptions...

INTRODUCTION: Many orthopedic providers currently treat chronic spondylolysis as self-limited fractures. While the condition has previously been associated with back pain in pediatrics, there has been little attention on the risk of neurologic harm. Electromyography (EMG) is a common study used to evaluate nerve injury, but it has not been previously reported for testing pediatric patients with stress fractures. In this study, pediatric patients with chronic pars fractures and muscle extremity weakness who underwent EMG testing were reviewed to analyze their risk of chronic nerve injury...

BACKGROUND: The Patient-Reported Outcomes Measurement Information System® (PROMIS®) may be used to assess an individual patient's perspective of their physical, mental, and social health through either standard or computer adaptive testing (CAT) patient questionnaires. These questionnaires are used across disciplines; however, they have seen considerable application in orthopaedic surgery. Patient characteristics associated with PROMIS CAT completion have not been examined within the context of social determinants of health, such as social deprivation or health literacy, nor has patient understanding of the content of PROMIS CAT been assessed...

The purpose of this study was to determine the differences in muscle synergy between skilled and unskilled participants using various loading conditions for power clean. Nineteen participants (ten skilled and nine unskilled) performed power clean at 60-90% one repetition maximum (1RM), while measured 12 muscles across the entire body. The vertical impulse was calculated for the unweighting associated with the double-knee bend (DKB) manoeuvre in power clean. Muscle synergies were extracted using non-negative matrix factorization...

We applied the recently introduced concept of intra-muscle synergies in spaces of motor units (MUs) to quantify indices of such synergies in the tibialis anterior during ankle dorsiflexion force production tasks and their changes with fatigue. We hypothesized that MUs would be organized into robust groups (MU-modes), which would co-vary across trials to stabilize force magnitude, and the indices of such synergies would drop under fatigue. Healthy, young subjects (n = 14; 7 females) produced cyclical, isometric dorsiflexion forces while surface electromyography was used to identify action potentials of individual MUs...

Floating Knee is a rare injury caused by high velocity, and has rarely been described in children. The purpose of this report is to present a case of a six-year-old female after a fall down three and a half flights of stairs, suffering from this rare injury and a rare complication, and her rehabilitation. She suffered fractures of the femur and tibia (Floating Knee type), and was operated on the day of the injury with closed reduction and internal fixation (CRIF). Following the operation, painful drop-foot was evident, related to the fractured bone pressure on the sciatic nerve and a very high level of anxiety...

This cross-sectional study assessed the risk factors for infection in 150 diabetic foot patients admitted to the Xiamen University Hospital between October 2020 and October 2022. Patients were categorised as infected (n = 80) or uninfected (n = 70) cohorts. The diabetic foot was evaluated using the American Diabetic Foot Grading system, whereas ulcers were categorised using Wagner's method. Analysed were patient-specific information, clinical data and risk factors including neuropathy, arterial disease and foot deformities...

The aim of this study was to elucidate the effects of eccentric contraction (ECC) on force enhancement in rat fast-twitch skeletal muscle. Gastrocnemius (GAS) muscles were subjected to 200 ECCs in situ by electrical stimulation. Immediately before and after the stimulation, isometric torque produced by ankle flexion was measured at an ankle angle of 90°. After the second torque measurement, the superficial regions of the muscles were dissected and subjected to biochemical and skinned fiber analysis. ECC did not induce changes in the amount of degraded titin...

BACKGROUND: To systematically evaluate the efficacy of arthroscopic microfracture surgery combined with platelet-rich plasma (PRP) injection in treating osteochondral lesions of talus (OLT). METHOD: A computer-based search of the PubMed, EMbase, Cochrane Library was developed. The search time was dated in December 2022. Randomized controlled trials and prospective case control studies comparing the treatment of OLT with microfracture surgery combined with PRP injection and microfracture surgery alone were included...

UNLABELLED: Ankle fracture is the third most prevalent fracture in older adults. Wound dehiscence is the most frequent complication. Our objective is to determine the operative wound complication rate in patients with unstable ankle fracture in whom a prophylactic simple fasciocutaneous advancement was used. METHODS: Prospective registry of patients with unstable ankle fracture, in whom a prophylactic fasciocutaneous advancement was performed between August 2020 and July 2021...

INTRODUCTION: Plantar fasciitis is the main cause of heel pain in middle-aged patients. In chronic cases, limited ankle dorsiflexión caused by isolated gastrocnemius contracture is considered the main risk factor for suffering it. Therefore, in recent years the number of patients operated on by proximal fasciotomy of the medial gastrocnemius (FPGM) has increased to treat chronic plantar fasciitis. MATERIAL AND METHODS: Systematic review following the PRISMA guidelines...

PURPOSE OF REVIEW: The purpose of the current review is to analyze the current literature regarding the tools available to evaluate patient expectations and satisfaction. There have been an increasing number of tools that have been developed and validated for various orthopedic procedures. Despite the growing number of tools, there are a limited number of tools available for pediatric patients. RECENT FINDINGS: Several tools have been developed in orthopedics to evaluate patient expectations...

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We evaluated the use of autologus bone marrow stem cells transplantation in patients with critical limb ischaemia (CLI) not eligible for revascularization. Eighty consecutive patients candidate to amputation were enrolled in a single-centre retrospective study. The primary endpoint was defined as the amputation-free rate from stem cells transplantation. Secondary endpoints were the evaluation of transcutaneous oximetry and its predictive potential for probability of amputation and the evaluation of rest pain...

Whether the lateral ankle ligaments contribute to syndesmotic stability is still controversial and has been the subject of frequent research recently. In our study, we tried to elucidate this situation using the finite element analysis method. Intact model and thirteen different injury models were created to simulate injuries of the lateral ankle ligaments (ATFL, CFL, PTFL), injuries of the syndesmotic ligaments (AITFL, IOL, PITFL) and their combined injuries. The models were compared in terms of LFT, PFT and EFR...

PURPOSE: This study examines the use and impact of directional atherectomy with antirestenotic therapy (DAART) versus angioplasty plus Supera stent implantation on the outcomes during endovascular treatment of popliteal lesions in clinical practice. METHODS: Overall 143 consecutive patients (mean age 75.0±12.2 years, 72% male), with isolated atherosclerotic disease of the popliteal artery who underwent endovascular treatment using DAART therapy or percutaneous transluminal angioplasty (PTA)/Supera stenting of the popliteal artery between January 2016 and December 2021 were identified from a retrospectively database...