Pub Date : 2023-12-11DOI: 10.1097/btf.0000000000000406
Julian B. F. Zimmermann, A. Leucht, Christoph Meier
Closed reduction combined with temporary ankle-spanning external fixation is the gold standard if immediate open reduction and internal fixation is not feasible or closed reduction may not be maintained in highly unstable fracture-dislocations of the ankle. Although external fixation is a quick and technically simple procedure, considerable operation-related complications have been reported in the literature. As an alternative, primary reduction and screw fixation of the medial malleolus may provide sufficient stability to maintain adequate reduction of the ankle joint. With this approach, potential problems of external fixation may be avoided, and the operating time of definitive open reduction and internal fixation is shortened. Level of Evidence: Level V.
{"title":"Primary Screw Fixation of the Medial Malleolus in Highly Unstable Ankle Fracture-dislocations as an Alternative to Temporary Ankle-spanning External Fixation","authors":"Julian B. F. Zimmermann, A. Leucht, Christoph Meier","doi":"10.1097/btf.0000000000000406","DOIUrl":"https://doi.org/10.1097/btf.0000000000000406","url":null,"abstract":"Closed reduction combined with temporary ankle-spanning external fixation is the gold standard if immediate open reduction and internal fixation is not feasible or closed reduction may not be maintained in highly unstable fracture-dislocations of the ankle. Although external fixation is a quick and technically simple procedure, considerable operation-related complications have been reported in the literature. As an alternative, primary reduction and screw fixation of the medial malleolus may provide sufficient stability to maintain adequate reduction of the ankle joint. With this approach, potential problems of external fixation may be avoided, and the operating time of definitive open reduction and internal fixation is shortened. Level of Evidence: Level V.","PeriodicalId":507475,"journal":{"name":"Techniques in Foot & Ankle Surgery","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139184260","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}
Pub Date : 2023-11-21DOI: 10.1097/btf.0000000000000399
Jacek Mazek, Maciej Gnatowski, Antonio Porthos Salas, Marcin Domżalski, Mateusz Mazek
There is no consensus as to the standard treatment of ruptured Achilles tendon. In this paper, we present an innovative method of treating Achilles tendon rupture. Ultrasound-guided percutaneous Achilles tendon repair is a minimally invasive method in the treatment of Achilles tendon rupture. This study aims to assess the feasibility and effectiveness of the procedure in treating ruptured Achilles tendons and in minimizing the complications of surgical percutaneous suturing. Thirty-four patients were treated for Achilles tendon rupture using a percutaneous suturing method under the control of ultrasound. The average follow-up was ~22 months with good and excellent results. As the sural nerve can be easily displayed by high-frequency real-time ultrasonography, the percutaneous repair of the Achilles tendon rupture can be aided by intraoperative ultrasound. The presented method is a quick and efficient surgery, which allows the treatment of torn Achilles tendons in a low-invasive way. The outcomes of this method are promising and enable the reduction of complications of the classic suturing methods. Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence.
{"title":"Ultrasound-guided Percutaneous Achilles Tendon Repair","authors":"Jacek Mazek, Maciej Gnatowski, Antonio Porthos Salas, Marcin Domżalski, Mateusz Mazek","doi":"10.1097/btf.0000000000000399","DOIUrl":"https://doi.org/10.1097/btf.0000000000000399","url":null,"abstract":"There is no consensus as to the standard treatment of ruptured Achilles tendon. In this paper, we present an innovative method of treating Achilles tendon rupture. Ultrasound-guided percutaneous Achilles tendon repair is a minimally invasive method in the treatment of Achilles tendon rupture. This study aims to assess the feasibility and effectiveness of the procedure in treating ruptured Achilles tendons and in minimizing the complications of surgical percutaneous suturing. Thirty-four patients were treated for Achilles tendon rupture using a percutaneous suturing method under the control of ultrasound. The average follow-up was ~22 months with good and excellent results. As the sural nerve can be easily displayed by high-frequency real-time ultrasonography, the percutaneous repair of the Achilles tendon rupture can be aided by intraoperative ultrasound. The presented method is a quick and efficient surgery, which allows the treatment of torn Achilles tendons in a low-invasive way. The outcomes of this method are promising and enable the reduction of complications of the classic suturing methods. Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":507475,"journal":{"name":"Techniques in Foot & Ankle Surgery","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139252098","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}
Pub Date : 2023-11-20DOI: 10.1097/btf.0000000000000400
Wei Shao Tung, Mani Eftekhari, Christopher P. Miller
Metatarsus adductus is a common congenital foot deformity with an inward deviation of the forefoot occurring in the transverse plane of the foot. This article describes a minimally invasive approach using proximal metatarsal metaphyseal osteotomies to address the adduction of metatarsals at the tarsometatarsal joint complex. This approach offers possible advantages of minimally invasive surgery over open procedures in terms of outcomes, including lowered incidences of sagittal malunion, nonunion of the arthrodesis or metatarsal osteotomy, wound healing complications, and joint stiffness. Further research is warranted for the long-term outcomes of the procedure and how much of the deformity can be corrected. Level IV.
{"title":"Treatment of Hallux Valgus with Metatarsus Adductus","authors":"Wei Shao Tung, Mani Eftekhari, Christopher P. Miller","doi":"10.1097/btf.0000000000000400","DOIUrl":"https://doi.org/10.1097/btf.0000000000000400","url":null,"abstract":"Metatarsus adductus is a common congenital foot deformity with an inward deviation of the forefoot occurring in the transverse plane of the foot. This article describes a minimally invasive approach using proximal metatarsal metaphyseal osteotomies to address the adduction of metatarsals at the tarsometatarsal joint complex. This approach offers possible advantages of minimally invasive surgery over open procedures in terms of outcomes, including lowered incidences of sagittal malunion, nonunion of the arthrodesis or metatarsal osteotomy, wound healing complications, and joint stiffness. Further research is warranted for the long-term outcomes of the procedure and how much of the deformity can be corrected. Level IV.","PeriodicalId":507475,"journal":{"name":"Techniques in Foot & Ankle Surgery","volume":"147 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139255327","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}
Pub Date : 2023-11-20DOI: 10.1097/btf.0000000000000398
A. Zayda, I. Badr
Nonunion of the periarticular distal tibial fractures is a challenging issue with limited options for treatment. The study aims to evaluate the outcomes of treatment of non-united periarticular distal tibial fractures using Ilizarov external fixation. A retrospective study included 16 patients with distal tibial fracture nonunion treated with Ilizarov fixator from 2014 to 2019 with a minimum 1-year follow-up after frame removal. Fibular plating was done in 8 cases and supplementary interfragmentary screws at the nonunion site in 5 cases. Primary or delayed bone graft was used in 11 patients. The ASAMI protocol was used to assess the bone and functional results. The American Orthopaedic Foot and Ankle Society (AOFAS) scale was used to assess the functional outcomes. Study included 9 males and 7 females, mean age of 47.4±14.1 years. 15 cases had previous surgeries for nonunion. 7 had active infection. duration of nonunion was 24.1±13.2 months. Mean duration of fixation was 5.7±1.0 months. Mean follow-up was 21.8±8.5 months. Mean AOFAS score improved from 52.4±3.7 preoperatively to 85.4±9.8 at the latest follow-up (P<0.001). Finally, the infection was resolved, and union was achieved in all patients. Bone results were excellent in 3 cases and good in 13, whereas functional results were excellent in 6 cases, good in 8, fair in 1, and poor in 1. Ilizarov fixator is a reliable option for treating nonunion in the periarticular distal tibial fractures. It provides secure fixation for short distal fragments, especially with history of infection, those with bad skin conditions, previous failed internal fixation, and osteopenic bone. Level IV.
{"title":"Management of Nonunion of Distal Tibial Periarticular Fractures Using Ilizarov External Fixator","authors":"A. Zayda, I. Badr","doi":"10.1097/btf.0000000000000398","DOIUrl":"https://doi.org/10.1097/btf.0000000000000398","url":null,"abstract":"Nonunion of the periarticular distal tibial fractures is a challenging issue with limited options for treatment. The study aims to evaluate the outcomes of treatment of non-united periarticular distal tibial fractures using Ilizarov external fixation. A retrospective study included 16 patients with distal tibial fracture nonunion treated with Ilizarov fixator from 2014 to 2019 with a minimum 1-year follow-up after frame removal. Fibular plating was done in 8 cases and supplementary interfragmentary screws at the nonunion site in 5 cases. Primary or delayed bone graft was used in 11 patients. The ASAMI protocol was used to assess the bone and functional results. The American Orthopaedic Foot and Ankle Society (AOFAS) scale was used to assess the functional outcomes. Study included 9 males and 7 females, mean age of 47.4±14.1 years. 15 cases had previous surgeries for nonunion. 7 had active infection. duration of nonunion was 24.1±13.2 months. Mean duration of fixation was 5.7±1.0 months. Mean follow-up was 21.8±8.5 months. Mean AOFAS score improved from 52.4±3.7 preoperatively to 85.4±9.8 at the latest follow-up (P<0.001). Finally, the infection was resolved, and union was achieved in all patients. Bone results were excellent in 3 cases and good in 13, whereas functional results were excellent in 6 cases, good in 8, fair in 1, and poor in 1. Ilizarov fixator is a reliable option for treating nonunion in the periarticular distal tibial fractures. It provides secure fixation for short distal fragments, especially with history of infection, those with bad skin conditions, previous failed internal fixation, and osteopenic bone. Level IV.","PeriodicalId":507475,"journal":{"name":"Techniques in Foot & Ankle Surgery","volume":"244 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139258237","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}
Pub Date : 2023-11-20DOI: 10.1097/btf.0000000000000397
Jorge I. Acevedo, Alexander R. Garcia, Joseph D. Queen, J. Mcwilliam
The surgical method described in this paper has shown numerous benefits when compared with traditional minimally invasive surgery (MIS) techniques for the correction of hallux valgus. Although modern, third-generation MIS techniques have been widely adopted for this purpose due to perceived improvements in patient outcomes, those can be largely attributed to the incorporation of a novel system of rigid internal fixation allowing for a reduced risk of surgical complications. By incorporating the second-generation MIS technique of transverse osteotomy with third-generation fixation techniques, the authors have been able to devise a hybrid, fourth-generation MIS technique that shows improvements both in terms of patient recovery and ease of surgical operation. The mechanism-based reasoning used in this study classifies it as diagnostic level V in accordance with the OCEBM 2011 Levels of Evidence. For a complete description of levels of evidence, see Instructions for Authors.
与传统的微创手术（MIS）技术相比，本文介绍的手术方法在矫正拇指外翻方面具有诸多优势。尽管现代第三代 MIS 技术因其对患者疗效的明显改善而被广泛采用，但这在很大程度上要归功于采用了新型的刚性内固定系统，从而降低了手术并发症的风险。通过将第二代横向截骨 MIS 技术与第三代固定技术相结合，作者设计出了一种混合型第四代 MIS 技术，该技术在患者康复和手术操作简便性方面均有改善。 根据 OCEBM 2011 年证据等级标准，本研究采用的基于机制的推理将其归类为诊断等级 V。有关证据等级的完整描述，请参阅 "作者须知"。
{"title":"Fourth Generation Hallux Valgus Correction","authors":"Jorge I. Acevedo, Alexander R. Garcia, Joseph D. Queen, J. Mcwilliam","doi":"10.1097/btf.0000000000000397","DOIUrl":"https://doi.org/10.1097/btf.0000000000000397","url":null,"abstract":"The surgical method described in this paper has shown numerous benefits when compared with traditional minimally invasive surgery (MIS) techniques for the correction of hallux valgus. Although modern, third-generation MIS techniques have been widely adopted for this purpose due to perceived improvements in patient outcomes, those can be largely attributed to the incorporation of a novel system of rigid internal fixation allowing for a reduced risk of surgical complications. By incorporating the second-generation MIS technique of transverse osteotomy with third-generation fixation techniques, the authors have been able to devise a hybrid, fourth-generation MIS technique that shows improvements both in terms of patient recovery and ease of surgical operation. The mechanism-based reasoning used in this study classifies it as diagnostic level V in accordance with the OCEBM 2011 Levels of Evidence. For a complete description of levels of evidence, see Instructions for Authors.","PeriodicalId":507475,"journal":{"name":"Techniques in Foot & Ankle Surgery","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139256535","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}
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