The Foot
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There are no studies looking at the success rate of low-intensity pulsed ultrasound (LIPUS) in fifth metatarsal fracture delayed unions to our knowledge. The aim of this study is to investigate the use of LIPUS treatment for delayed union of fifth metatarsal fractures. ⋯ Level 4.
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Sustentaculum tali fractures are rare foot fractures accounting for 1% of all calcaneal fractures, which accounts for about 1-2% of all bone fractures. Since the importance of sustentaculum tali in maintaining the medial foot arch, its fractures should be dealt with anatomical fixation to avoid post-traumatic arthrosis. ⋯ Fractures of the sustentaculum tali are rare injuries associated with high energy mechanisms. These fractures have a high incidence of misdiagnosis. A high index of suspicion is, therefore, required when there is pain and hematoma directly over the sustentaculum tali. Open reduction and internal fixation of these fractures is reliable and possible through a medial approach.
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Ankle fractures are common injuries presenting to trauma departments and ankle open reduction and internal fixation (ORIF2) is one of the first procedures targeted in early orthopaedic training. Failure to address the fracture pattern with the appropriate surgical technique and hardware may lead to early failure, resulting in revision procedures or premature degenerative change. Patients undergoing revision ORIF are known to be at much greater risk of complications and many of these secondary procedures may be preventable. ⋯ Errors are being made at all levels of training in applying basic principles such as restoring fibula length and screening the syndesmosis intra-operatively. Appropriate placement and selection of hardware is not always being deployed in osteopenic bone resulting in premature failure of fixation and fracture patterns are not being fully appreciated. Patients are undergoing preventable secondary procedures in the operative treatment of ankle fractures.
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Chronic osteomyelitis necessities appropriate infected bone and soft tissue excision. The authors describe the Silo surgical technique for the treatment of calcaneal osteomyelitis using a new antibiotic-loaded absorbable calcium sulphate/hydroxyapatite biocomposite. ⋯ Level IV- case series.
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The ideal treatment of osteochondral lesions of the talus (OLT) is debatable. The TruFit plug has been investigated as a potential treatment method for osteochondral defects. This is a biphasic scaffold designed to stimulate cartilage and subchondral bone formation. The purpose of this retrospective study was to investigate the long-term functional and MRI outcomes of the TruFit Plug for the treatment of OLT. ⋯ Retrospective case series, Level IV.