Foot & ankle international
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Randomized Controlled Trial
Ankle tourniquet pain control in forefoot surgery: a randomized study.
Forefoot surgery is often performed under regional anesthesia in awake patients, using tourniquet or Esmarch bandage to obtain a bloodless field. The purpose of this study was to examine the value and need for local tourniquet pain control using local subcutaneous analgesic mixture in patients undergoing forefoot surgery under ankle block anesthesia. ⋯ An ankle tourniquet was well-tolerated by patients without need for local anesthetic beneath the cuff.
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Controversy exists regarding the surgical treatment of unstable ankle fractures in the very elderly age group of over 80 years. However, the literature regarding the prognosis of surgery in this elderly group is limited. The purpose of our study was to evaluate the results of patients above 80 years old who underwent operative fixation for unstable ankle fractures. ⋯ The results of operative fixation of unstable ankle fractures were encouraging with good functional recovery and return to pre injury mobility status in most cases.
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The purpose of this study was to compare the axial and torsional stiffness between anterolateral and medial distal tibial locking plates in a pilon fracture model. ⋯ We believe this study indicates the primary concern when treating a pilon fracture may be soft-tissue considerations. Further clinical studies are required before definitive changes can be recommended regarding pilon fracture fixation.
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Nonunion following a proximal fifth metatarsal metaphyseal-diaphyseal or Jones fracture can cause considerable pain with high morbidity and loss of work. Treatment should aim for early union, thus allowing early return to activity. The present study evaluated the outcomes and the time required for union following closed intramedullary screw fixation for this condition. ⋯ Closed intramedullary screw fixation achieved an excellent union rate when used in the treatment of nonunion of a Jones fractures.
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When treating ankle fractures with associated syndesmosis injury, failure to anatomically reduce the syndesmosis may lead to poor outcome. While shortening and posterior subluxation of the distal fibula are readily detected by intraoperative fluoroscopy, it is unclear how well malrotation can be assessed. The ability of fluoroscopy to detect rotational malreduction of the fibula was the subject of this study. ⋯ In the setting of ankle fractures with syndesmosis disruption, fixing the fibula in as much as 30 degrees of external rotation may go undetected using intraoperative fluoroscopy alone.