Foot & ankle international
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Failure to anatomically reduce and stabilize the fractured distal fibula can result in malunion of the fibula and malreduction of the ankle mortise. Fibular malunion results in altered ankle joint biomechanics which often leads to the development of pain, stiffness, and premature joint degeneration. ⋯ In this review, the oblique fibular osteotomy is described for the reconstruction of SER-type fibular fractures. For more proximal fibular malunion, the transverse osteotomy technique with lengthening and structural bone graft is reviewed.
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In an effort to minimize narcotic analgesia and its potential side effects, anti-inflammatory agents offer great potential provided they do not interfere with bone healing. The safety of ketorolac administration after foot and ankle surgery has not been well defined in the current literature. The purpose of this study was to report clinical healing and radiographic outcomes for patients treated with a perioperative ketorolac regimen after open reduction and internal fixation (ORIF) of ankle fractures. ⋯ Level IV, case series.
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Comparative Study
Reoperation Rate Differences Between Open Reduction Internal Fixation and Primary Arthrodesis of Lisfranc Injuries.
Controversy persists as to whether Lisfranc injuries are best treated with open reduction internal fixation (ORIF) versus primary arthrodesis (PA). Reoperation rates certainly influence this debate, but prior studies are often confounded by inclusion of hardware removal as a complication rather than as a planned, staged procedure inherent to ORIF. The primary aim of this study was to evaluate whether reoperation rates, excluding planned hardware removal, differ between ORIF and PA. A secondary aim was to evaluate patient risk factors associated with reoperation after operative treatment of Lisfranc injuries. ⋯ Level III, retrospective comparative study.
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Randomized Controlled Trial
Prospective Randomized Trial of Electrolysis for Chronic Plantar Heel Pain.
Chronic plantar heel pain (CPHP) is a common condition with high prevalence rates and a projected cost of treatment of US$192 to US$376 million. There are several therapeutic approaches and there is increased interest in treatments aimed at the regeneration of tissues with poor healing potential. Our purpose was to investigate the effectiveness of ultrasound-guided percutaneous needle electrolysis in chronic plantar heel pain. ⋯ Level I, randomized controlled trial.
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Subtalar arthrodesis is a common salvage operation for posttraumatic subtalar arthritis. This study aimed to identify factors associated with functional outcomes and quality of life after subtalar fusion for posttraumatic subtalar arthritis after calcaneal fracture. ⋯ Prognostic level III, comparative series.