Search Our Scientific Publications & Authors

Foot Ankle Clin 2021 Jun 18;26(2):361-371. Epub 2021 Apr 18.

Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands. Electronic address:

The most common injury mechanism for ankle fractures with concomitant deltoid ligament injury is a supination external rotation type 4 trauma. In the acute setting, malalignment, ecchymosis, and profound edema of the affected ankle can be found. Clinical examination is a poor indicator for deltoid ligament injury. Read More

Foot Ankle Clin 2021 Jun;26(2):315-327

Foot and Ankle Surgery Department, J Slullitel Institute of Orthopaedics, San Luis 2534, Rosario, Santa Fe 2000, Argentina. Electronic address: https://twitter.com/pieijs.

Although far less common than lateral ankle injuries, medial ankle sprains have been reported to result in significantly greater time lost and long-term disability when not diagnosed and treated accurately. Adequate diagnosis is paramount and the most important aspect is to determine whether the lesion is stable or unstable. Evidence confronting surgical versus conservative treatment in acute deltoid ligament lesions is largely anchored in the setting of ankle fractures. Read More

J Mech Behav Biomed Mater 2021 May 11;120:104568. Epub 2021 May 11.

INCUAPA-CONICET-UNICEN. Facultad de Ciencias Sociales, Universidad Nacional del Centro de la Provincia de Buenos Aires, Avda. del Valle 5737, Olavarría, 7400, Buenos Aires, Argentina. Electronic address:

Calcaneus fractures are scarcely reported in archaeological assemblages worldwide. The main goal of this paper is to present a study case related to a calcaneus fracture and a set of bone lesions recorded in an adult individual dated in the Middle Holocene (ca. 6000-3000 years BP). Read More

Microsurgery 2021 May 14. Epub 2021 May 14.

Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, Hunan Province, China.

Background: Management of large wounds of the lower extremities remains a challenge for plastic and reconstructive surgeons. Herein, a surgical technique and clinical algorithm using the combined transfer of a latissimus dorsi (LD) musculocutaneous flap and flow-through anterolateral thigh (ALT) perforator flap for the treatment of extensive soft-tissue defects is described.

Methods: From January 2012 to September 2018, 12 patients (six men and six women) aged 6-37 years, sustained injuries in road traffic accidents with large soft-tissue defects in the lower extremities. Read More

Ann Transl Med 2021 Apr;9(8):695

Department of Hand and Foot Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China.

Background: This study sought to assess and compare the clinical efficacy and complications of a modified sinus tarsi approach (MSTA) and the extensile lateral approach (ELA) in the treatment of displaced intra-articular calcaneal fractures.

Methods: This retrospective study enrolled 108 patients (117 feet) with Sanders II-IV calcaneal fractures, including 52 patients (56 feet) in the MSTA group and 56 patients (61 feet) in the ELA group. The functional and radiological results of the affected feet were analysed retrospectively. Read More

J Clin Orthop Trauma 2021 Jul 19;18:20-24. Epub 2021 Apr 19.

Department of Orthopaedic Surgery, J. N. Medical College, Faculty of Medicine, AMU, Aligarh, UP, India.

Back Ground: Complex gap nonunion of tibia following open fractures and osteomyelitis with pathological fractures in children is a treatment challenge with unpredictable outcome. Treatment options available are bone transport bone grafting, induced membrane technique, allograft reconstruction and Huntington procedure (ipsilateral transposition of vascularized fibula). There is no consensus in the literature about which technique is optimal in the given situation. Read More

J Foot Ankle Surg 2021 Apr 9. Epub 2021 Apr 9.

Department of Orthopaedic Surgery, the 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, P. R. China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, P. R. China; Orthopaedic Institution of Hebei Province, Shijiazhuang, Hebei, P. R. China. Electronic address:

There are no studies on epidemiologic characteristics of deep vein thrombosis (DVT), when specified at in patients with bilateral calcaneal fractures. This study aimed to address the preoperative DVT in bilateral calcaneal fractures. Between October 2014 and December 2018, adult patients presenting with bilateral calcaneal fractures and having preoperative Duplex ultrasound (DUS) of bilateral lower extremities for detection of DVT were included. Read More

J Bone Joint Surg Am 2021 May;103(10):869-878

VA Puget Sound Health Care System, Seattle, Washington.

Background: The rate of total ankle arthroplasty (TAA) is increasing relative to ankle arthrodesis (AA) for patients seeking surgical treatment for end-stage ankle arthritis. Patients and providers would benefit from a more complete understanding of the rate of improvement, the average length of time to achieve maximal function and minimal pain, and whether there is a greater decline in function or an increase in pain over time following TAA compared with AA. The objectives of this study were to compare treatment changes in overall physical and mental function and ankle-specific function, as well as pain intensity at 48 months after TAA or AA in order to determine if the improvements are sustained. Read More

J Bone Joint Surg Am 2021 May 12. Epub 2021 May 12.

Background: Selecting the best treatment for patients with severe terminal lower-limb injury remains a challenge. For some injuries, amputation may result in better outcomes than limb salvage. This study compared the outcomes of patients who underwent limb salvage with those that would have been achieved had they undergone amputation. Read More

Arch Orthop Trauma Surg 2021 May 11. Epub 2021 May 11.

Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, UK.

Introduction: Intramedullary locking devices (ILDs) have recently been advocated as a minimally invasive approach to manage displaced intraarticular calcaneal fractures (DIACFs), to minimise complications and improve outcomes. We reviewed clinical and biomechanical studies dealing with commercially available devices to identify their characteristics, efficacy and safety.

Methods: Following a PRISMA checklist, Medline, Scopus and EMBASE databases were searched to identify studies reporting the use of ILDs for treating DIACFs. Read More

JBMR Plus 2021 May 19;5(5):e10484. Epub 2021 Mar 19.

Department of Electrical and Computer Engineering, College of Engineering University of Iowa Iowa City IA USA.

Osteoporosis causes fragile bone, and bone microstructural quality is a critical determinant of bone strength and fracture risk. This study pursues technical validation of novel CT-based methods for assessment of peripheral bone microstructure together with a human pilot study examining relationships between bone microstructure and vertebral fractures in smokers. To examine the accuracy and reproducibility of the methods, repeat ultra-high-resolution (UHR) CT and micro-CT scans of cadaveric ankle specimens were acquired. Read More

J Am Acad Orthop Surg Glob Res Rev 2021 05 11;5(5). Epub 2021 May 11.

From the Geisinger Medical Center, Department of Orthopaedics, MSK Institute, Danville, PA (Dr. Friedman and Dr. Horwitz); the Universidad del Rosario, School of Medicine and Health Sciences, Bogota, Colombia (Dr. Sanchez); the Department of Orthopaedic Surgery, University of California Davis Health System, Sacramento, CA (Dr. Zachos); Department of Orthopedic Surgery, Lahey Hospital and Medical Center, Burlington, MA (Dr. Marcantonio); Department of Orthopaedic Surgery, Beaumont Health, Royal Oak, MI (Dr. Audet); Department of Orthopaedic Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH (Dr. Vallier); Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN (Dr. Mullis); University of Miami, Department of Anesthesiology, Jackson Memorial Hospital, Miami, FL (Dr. Myers-White); Department of Orthopaedic Surgery, Carolinas Medical Center, Atrium Health Musculoskeletal Institute, Charlotte, NC (Dr. Kempton); and Department of Orthopedic Surgery, Cleveland Clinic Akron General Hospital, Akron, OH (Dr. Watts).

Introduction: Ankle fractures are one of the most prevalent musculoskeletal injuries, with a significant number requiring surgical treatment. Postoperative complications requiring additional interventions frequently occur during the early postoperative period. We hypothesize that there is a limited need for routine clinical and radiographic follow-up once the fracture is deemed healed. Read More

J Orthop Trauma 2021 Mar 16. Epub 2021 Mar 16.

Department of Orthopaedic Surgery, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106.

Objective: Analyze the correlation between surgical timing and outcomes for calcaneus fractures treated using a sinus tarsi approach (STA).

Setting: Single level 1 Trauma Center.

Design: Retrospective. Read More

Foot Ankle Surg 2021 May 1. Epub 2021 May 1.

Department of Orthopedics and Traumatology, Ambroise-Paré Hospital, AP-HP, Île-de-France Ouest University, 9 Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France; Department of Orthopedic Surgery, Clinique du Sport, 36 Boulevard Saint-Marcel, 75005 Paris, France.

Background: Ankle trauma in children and adolescents is the most common orthopedic injury encountered in pediatric trauma. It has long been recognized that a lateral ankle injury in this population is often a Salter and Harris type I fracture of the distal fibula (SH1). The purpose of this study is to confirm the existence of a lateral ankle sprain and to report the incidence of each pathology of the lateral ankle compartment: SH1 fracture, ATFL injury, and osteochondral avulsions. Read More

Foot (Edinb) 2021 Apr 8;47:101797. Epub 2021 Apr 8.

Northwestern Memorial Hospital, Chicago, IL, USA.

Displaced isolated fractures of sustentaculum tali are rare. Inadequate treatment of these injuries can rarely lead to non-union or mal-union and in most cases are treated non-surgically. We report a unique case of undiagnosed mal-union of sustentaculum tali in the setting of underlying tarsal coalition that resulted in symptoms of tarsal tunnel. Read More

Acta Anaesthesiol Scand 2021 May 8. Epub 2021 May 8.

Research Group of Surgery, Anaesthesiology and Intensive Care Medicine, Medical Research Center, Oulu University, Oulu University Hospital, Oulu, Finland.

Background: Surgical treatment of ankle fracture is associated with significant pain and high postoperative opioid consumption. The anaesthesia method may affect early postoperative pain. The main objective of the study was to compare postoperative opioid consumption after ankle-fracture surgery between patients treated with spinal anaesthesia and general anaesthesia. Read More

Disabil Rehabil 2021 May 7:1-7. Epub 2021 May 7.

Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.

Purpose: To evaluate clinically relevant fracture characteristics by age, sex, and ambulatory status among individuals with cerebral palsy.

Methods: Fracture location, energy of fracture, and activities that lead to a fracture were assessed among a clinic-based sample of children (0-17 years;  = 57) and adults (18-70 years;  = 58) with cerebral palsy that sustained a fracture by sex and gross motor function classification system (GMFCS) I-III vs. IV/V. Read More

Foot (Edinb) 2021 Jan 21;47:101780. Epub 2021 Jan 21.

Division of foot, ankle and limb reconstruction surgery, Department of Trauma and Orthopaedics, The Queen Elizabeth University Hospital, Glasgow, United Kingdom.

Background: Pilon fractures are severe, intra-articular and comminuted fractures to the distal tibia. They are uncommon injuries and are often associated with fibular fractures. The optimal management of these fractures is widely debated. Read More

World J Orthop 2021 Apr 18;12(4):207-213. Epub 2021 Apr 18.

Department of Orthopedic Surgery, University of Tokyo, Tokyo 113-8655, Bunkyo-ku, Japan.

Fracture of an ossification of the Achilles tendon (OAT) is a rare entity, and its etiology, pathology, and treatment remain unclear. We reviewed and scrutinized 18 cases (16 articles) of the fracture of an OAT. The most common etiologies of the ossifications include previous surgery and trauma. Read More

Ortop Traumatol Rehabil 2021 Apr;23(2):121-127

University Hospitals Derby and Burton , Orthopaedic Department, UK.

Background: Different methods have been adopted to treat delayed union and non-union of fractures of the base of the fifth metatarsal using screws, plates and tension band wires. There has been increasing use of intramedullary screw fixation to treat these fractures with variable rates of success. The optimum screw diameter and properties have been a subject of debate. Read More

Orthop Rev (Pavia) 2021 Mar 31;13(1):9108. Epub 2021 Mar 31.

Department of Orthopedic Surgery, Mayo Clinic, Phoenix, AZ, USA.

Basketball is a popular internationally played sport. With the physical requirements the game has on athletes, players are at risk of injury. Ankle injuries are the most common injury type suffered by basketball players. Read More

J Foot Ankle Surg 2021 Mar 20. Epub 2021 Mar 20.

Associate Professor, Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address:

Patients with diabetes mellitus that undergo ankle fracture surgery have higher rates of postoperative complications compared to patients without diabetes mellitus. We evaluated the rate of complications in insulin-dependent diabetes mellitus patients, non-insulin-dependent diabetes mellitus patients, and patients without diabetes in the 30-day postoperative period following ankle fracture surgery. We also analyzed hospital length of stay, unplanned readmission, unplanned reoperation, and death. Read More

Arthroscopy 2021 Apr 30. Epub 2021 Apr 30.

Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Purpose: To verify whether lateral hinge fracture (LHF) affects correction accuracy in open wedge high tibial osteotomy (OWHTO), and to identify the fracture characteristics responsible for inaccurate correction, including LHF type and hinge location.

Methods: Patients undergoing OWHTO with locking plate fixationbetween 2010 and 2016 were retrospectively reviewed. Patients who did not have a minimum 2-year of follow-up or postoperative long-standing hip-to-ankle radiographs were excluded. Read More

Mil Med 2021 May 3. Epub 2021 May 3.

Medical Modeling and Simulation, Naval Health Research Center, San Diego, CA 92106-3521, USA.

Introduction: Extremity injuries have comprised the majority of battlefield injuries in modern U.S. conflicts since World War II. Read More

OTA Int 2021 Mar 18;4(1):e097. Epub 2021 Feb 18.

Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD.

Objectives: To compare peri-incisional perfusion, perfusion impairment and wound closure time between the conventional interrupted Allgöwer-Donati (IAD) technique and a modified running Allgöwer-Donati (RAD) technique in ankle fracture surgery.

Design: Prospective, randomized controlled clinical trial.

Setting: Level I and II trauma centers. Read More

OTA Int 2020 Sep 27;3(3):e080. Epub 2020 Jul 27.

MetroHealth Medical Center, affiliated with Case Western Reserve University, Cleveland, Ohio.

Objectives: To identify predictors of functional outcomes following treatment of ankle fracture in patients 55 years or older.

Setting: Level 1 Trauma Center.

Patients/participants: Four hundred twenty-nine patients with torsional ankle fractures (44A-C): 233 patients (54%) were ages 55 to 64, 25% were between the ages 65 and 74; 21% were 75 years or older. Read More

OTA Int 2020 Jun 6;3(2):e077. Epub 2020 May 6.

MetroHealth Medical Center, Cleveland, Ohio, affiliated with Case Western Reserve University.

Objectives: To identify comorbidities and injury characteristics associated with surgical site infection (SSI) following internal fixation of malleolar fractures in an urban level 1 trauma setting.

Design: Retrospective.

Setting: Level 1 trauma center. Read More

OTA Int 2020 Jun 21;3(2):e076. Epub 2020 May 21.

London Health Sciences Center, London, ON, Canada.

Objectives: To determine whether patients with AO/OTA 43-B anterior impaction tibial plafond fractures have worse clinical outcomes, and an increased risk of progression to ankle arthrodesis.

Design: Retrospective cohort study.

Setting: Level 1 academic trauma center. Read More

OTA Int 2020 Jun 23;3(2):e060. Epub 2020 Apr 23.

Applied Physics Laboratory, The Johns Hopkins University, Laurel, MD.

Objectives: Ankle fracture treatment involves reduction of the bone fragments and stabilization of the joint by reversing the mechanics of injury. For posterior malleolar fracture however, the true mechanism is not understood, leading to a lack of consistent guidance on how to best treat this injury.

Methods: Fifteen cadaver ankles were subjected to fracture loading that replicated the Lauge-Hansen pronation-external rotation mechanism. Read More