Foot & ankle international
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Reports of nonunion of proximal fifth metatarsal fractures treated by internal fixation indicate that current fixation methods do not always adequately address the stresses to which the bone is subjected during ambulation. In particular, the insertion sites of the peroneus brevis and peroneus tertius tendons on the fifth metatarsal suggest that their actions can impose torsional stresses on the areas of the bone in which Jones fractures and stress fractures occur. Intramedullary screw fixation, however, offers little resistance to rotation of the proximal and distal fragments relative to one another. ⋯ This finding has implications for the treatment of both Jones fractures and stress fractures of the proximal fifth metatarsal. An internal fixation device that has the capability to resist torsion as well as tension and bending would appear optimal to treat these fractures.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Personal gait satisfaction after displaced intraarticular calcaneal fractures: a 2-8 year followup.
Patients' satisfaction with gait after calcaneal fracture has rarely been studied. The objective of this paper was to determine how patient demographics, fracture type and treatment affected gait satisfaction after displaced intraarticular calcaneal fractures. The design of the study is a prospective randomized trial performed in four Level I trauma centers. ⋯ Subcategories determined that younger patients who were self-employed and treated operatively had improved gait scores. Treatment (operative or nonoperative) of calcaneal fractures did not affect gait satisfaction according to patient outcome scores.
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We assessed acute phase multidetector computed tomography (MDCT) findings of Lisfranc fracture-dislocations in patients with multiple trauma referred to a Level I trauma center over a 29-month period. ⋯ Standard radiography remains a primary diagnostic modality in acute foot and ankle trauma. Multidetector CT with high-quality multiplanar reconstruction (MPR) is recommended as a complementary examination in high-energy injury in patients with multiple trauma or in patients in whom radiographic images are equivocal. This may reveal Lisfranc fracture-dislocations, show the extent of the fracture-dislocation, and reveal occult fractures in other parts of the foot and ankle.
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Meta Analysis
A meta-analysis of outcome rating scales in foot and ankle surgery: is there a valid, reliable, and responsive system?
Rating scales that are valid, reliable, and responsive communicate the severity of a functional problem, facilitate the accurate study of treatment modalities, and provide a common language for those involved in research. The purpose of this study was to determine which outcome rating scales are currently used in the foot and ankle literature and to identify rating scales with proven reliability, validity, and responsiveness. ⋯ The development of a reliable, valid, and responsive rating scale would have value not only in assessing patient outcomes but also in reporting the results of clinical studies in foot and ankle surgery.