Foot & ankle international
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Comparative Study
Minimally invasive technique versus an extensile lateral approach for intra-articular calcaneal fractures.
The optimal method for treating intra-articular fractures of the calcaneus remains controversial. Extensile approaches allow excellent fracture exposure, but high rates of wound complications are seen. Newer minimally invasive techniques for calcaneus fracture fixation offer a potentially lower wound complication rate, but long-term clinical results are not available. The aim of this study was to compare the outcomes of intra-articular calcaneus fractures treated with open reduction and internal fixation via an extensile approach versus those with a minimally invasive sinus tarsi approach. ⋯ Level III, retrospective comparative case series.
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The goal of this study was to discuss the outcomes of treating calcaneal fracture malunion by restoring the subtalar joint with a reconstructive osteotomy. ⋯ Level IV, retrospective case series.
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There remains no consensus regarding the role of computed tomography (CT) scans in preoperative planning for malleolar ankle fractures. The aim of this study was to determine the role of preoperative CT scans on operative planning in these fractures. ⋯ Level III, retrospective comparative study.
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Grade 3 syndesmosis (high ankle) sprains of the ankle are frequently treated using screws that fix the distal fibula to the tibia. We hypothesized that forces acting on the distal fibula and displacements of the distal fibula relative to the tibia recorded during simulated ankle loading tests would be significantly affected by syndesmosis screw size and the number of engaged tibial cortices. ⋯ In terms of mechanical stability, surgeons may have considerable flexibility with regard to screw fixation of high ankle sprains.
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Comparative Study
Comparison of supination external rotation type IV ankle fractures in geriatric versus nongeriatric populations.
Geriatric patients' (defined as those older than 65 years old) inherent comorbidities, functional limitations, and bone quality present obstacles to successful clinical outcomes for operatively treated supination external rotation (SER) ankle fractures. We retrospectively reviewed a prospectively collected series of SER injuries between 2004 and 2010. This is a comparison of the radiographic and clinical outcomes of our geriatric (27 patients) and nongeriatric (81 patients) populations. We hypothesized that geriatric patients would have worse outcomes when compared to nongeriatric patients. ⋯ Geriatric patients exhibited equivalent complication rates, radiographic outcomes, and functional outcomes compared to nongeriatric patients in this series. Anatomic fixation and soft tissue management counter the inherent risks of operative intervention in geriatric populations that report higher rates of comorbidities. This study supports aggressive fracture- and ligament-specific operative intervention in geriatric patients presenting with unstable SER injuries.