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Clin Podiatr Med Surg 2019 Apr 12;36(2):323-337. Epub 2018 Dec 12.

Plastic Reconstructive and Orthopaedic Surgery, University of Pennsylvania Health System, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, South Pavilion, 1st Floor, Philadelphia, PA 19104, USA.

Soft tissue defects and wound healing complications related to calcaneus fractures may result in significant morbidity. The management of these soft tissue complications requires following reconstructive principles that provide the requisites for preservation of the injured limb and the maximization of function. Soft tissue complications are addressed with methods that commensurate with the degree of injury, ranging from local wound care to free flap reconstruction. Read More

Clin Podiatr Med Surg 2019 Apr 24;36(2):279-293. Epub 2019 Jan 24.

Guangdong Provincial Engineering Research Center of Wound Repair and Regenerative Medicine, Affiliated Baoan Hospital of Shenzhen, Southern Medical University, The 8th People's Hospital of Shenzhen, Shenzhen, Guangdong 518101, China; Guangdong Provincial Academician Workstation of Wound Repair and Regenerative Medicine, Affiliated Baoan Hospital of Shenzhen, Southern Medical University, The 8th People's Hospital of Shenzhen, Shenzhen, Guangdong 518101, China; Department of Trauma and Orthopedics, Affiliated Baoan Hospital of Shenzhen, Southern Medical University, The 8th People's Hospital of Shenzhen, Shenzhen, Guangdong 518101, China.

The list of late complications after calcaneal fracture that can be treated through arthroscopic and/or endoscopic approach continues to expand. The late complications of calcaneal fractures can be classified into 3 groups: (1) those causing focal hindfoot or ankle pain, (2) those causing functional deficit, and (3) those present with diffuse and poorly localized pain. Many group 1 and some group 2 complications can be managed arthroscopically and/or endoscopically. Read More

Clin Podiatr Med Surg 2019 Apr 24;36(2):269-277. Epub 2019 Jan 24.

Coastline Foot and Ankle Center, 800 Liberty Street Southeast, Salem, OR 97302, USA.

Fractures of the calcaneus are detrimental injuries, often caused by high-energy trauma. To best restore the functionality of a limb and allow normal ambulation, it is recommended to repair displaced intra-articular calcaneus fractures surgically. This article presents several methods of reduction and repair of the calcaneus. Read More

Clin Podiatr Med Surg 2019 Apr 24;36(2):225-231. Epub 2019 Jan 24.

Kaiser Permanente Santa Clara and GSAA, 710 Lawrence Expressway, Department 140, Santa Clara, CA 95051, USA.

Displaced intra-articular calcaneal fractures can be treated with open reduction and internal fixation through various methods, including the extensile lateral approach, sinus tarsi approach, percutaneous reduction and fixation, external fixation, and calcaneoplasty. Although the gold standard is the extensile lateral approach, this method has significant wound-healing complications associated with it. Literature shows that the reduction achieved through minimally invasive techniques is equal to that achieved with the extensile lateral approach, while reducing the amount of postoperative complications. Read More

BMJ 2019 Feb 19;364:l457. Epub 2019 Feb 19.

J Orthop Trauma 2019 Mar;33(3):e93-e99

Vanderbilt Medical Center, Nashville, TN.

Objective: This retrospective study aimed at identifying opiate prescribing practices, the number of morphine milligram equivalents (MMEs) prescribed by orthopaedic and nonorthopaedic providers in patients with operatively treated isolated lower extremity fractures, and provide opiate prescribing recommendations.

Methods: Patients older than 18 years with isolated lower extremity (unicondylar, bicondylar, tibial shaft, pilon, and ankle) fractures between 2005 and 2016 were identified. Prescribing information was obtained from the State Controlled Substance Monitoring Database. Read More

J Orthop Surg (Hong Kong) 2019 Jan-Apr;27(1):2309499019828500

The Department of Orthopaedics and Traumatology, Duchess of Kent Children's Hospital, Hong Kong, China.

Background:: Atypical triplane fractures are defined as triplane fractures that are intra-articular but affect the non-weight-bearing area of the tibia plafond or extra-articular triplane fractures where the epiphyseal fracture line exits outside the articulating cortex of the medial malleolus. These fractures are scarcely reported in the literature. Here, we study the fracture pattern, mechanisms, and recommendations for management. Read More

Osteoporos Sarcopenia 2017 Dec 7;3(4):192-194. Epub 2017 Dec 7.

Department of Orthopedic Surgery, Myongji Hospital, Goyang, Korea.

Objectives: There remains controversy over osteoporotic feature of the ankle. Therefore, we investigated the possibility of the existence of a relationship between axial bone mineral density (BMD) in patients with ankle fracture group with that of the normal population in Korea under control of other confounding factors such as body mass index (BMI).

Methods: This study retrospectively reviewed medical records of patients who were treated in our institution from 2005 to 2015. Read More

Orthop Res Rev 2017 29;9:45-50. Epub 2017 May 29.

Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA,

Ankle fractures are the third most common osseous injury in the elderly, behind hip and distal radius fractures. While there is a rich history of clinical advancement in the timing, technique, perioperative management, and associated risks of hip fractures, similar evaluations are only more recently being undertaken for ankle fractures. Traditionally, elderly patients were treated more conservatively; however, nonoperative management has been found to be associated with increased mortality. Read More

Injury 2019 Feb 8. Epub 2019 Feb 8.

Department for Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria.

Introduction: "Blobbing" is a modern outdoor activity where a participant sits on the end of a partially inflated air bag ("blobber") and is launched into the water when another participant jumps onto the air bag from a platform on the opposite side ("jumper"). This is the first study to evaluate the injury patterns associated with blobbing.

Patients And Methods: A retrospective data analysis was conducted based on 86 patients who sustained blobbing injuries between January 2011 and December 2016. Read More

Foot Ankle Int 2019 Feb 17:1071100719830999. Epub 2019 Feb 17.

2 Aintree University Hospital, Lower Lane, Liverpool, United Kingdom.

Background:: To date, there have been no studies describing the characteristics of posteromedial fragment in the posterior malleolus fracture. The aim was to investigate the variability of posteromedial fracture fragments to enable better surgical planning.

Methods:: All Mason and Molloy type 2B fractures, defined as fracture of both the posterolateral and the posteromedial fragments of the posterior malleolus, from our database were identified to analyze the preoperative computed tomography scan. Read More

Foot Ankle Surg 2019 Feb 5. Epub 2019 Feb 5.

The Department of Orthopaedic Surgery and Rehabilitation, Loyola University Health System, 2160 South First Avenue, Maywood, IL 60153, United States. Electronic address:

Background: Unstable ankle fractures in diabetics with peripheral neuropathy have an increased risk of postoperative complications, often leading to amputation. Primary ankle arthrodesis has been suggested as an alternative when acceptable reduction and mechanical stabilization cannot be obtained.

Methods: Over a fourteen year period, thirteen diabetic patients with peripheral neuropathy underwent an attempt at primary ankle arthrodesis following the early post-fracture development of acute neuropathic (Charcot) deformity of the ankle after sustaining a low energy unstable ankle fracture. Read More

Arch Orthop Trauma Surg 2019 Feb 15. Epub 2019 Feb 15.

Trauma unit, Amsterdam UMC, Location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.

Background: There is no consensus about the optimal treatment of anterior inferior ligament avulsion fractures of the ankle. The aim of this study is to provide insights regarding the incidence of anterior inferior ligament avulsion fractures, the association with fracture type, and correlation with treatment.

Methods: This study is a retrospective analysis in a level-1 trauma center of adult patients with an ankle fracture operated between the dates 01-01-2009 and 01-09-2017 who had a pre- and postoperative CT-scan. Read More

J Foot Ankle Surg 2019 Feb 13. Epub 2019 Feb 13.

Professor, Department of Orthopaedics and Traumatology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.

Distal tibia and fibula fractures are challenging injuries to treat as evidenced by the high rates of wound complications because of vulnerable soft tissue coverage. The aim of this study was to examine the effect on soft tissue complications of the pie-crusting technique when applied between 2 incisions in distal tibia and fibula fractures treated with open reduction and internal fixation. We reviewed 34 patients with distal tibia and fibula fractures treated between September 2014 and March 2017. Read More

J Foot Ankle Surg 2019 Feb 11. Epub 2019 Feb 11.

Department of Orthopaedic Surgery and Rheumatology, Kyoto Shimogamo Hospital, Kyoto, Japan.

Despite a high incidence of proximal diaphyseal stress fractures of the fifth metatarsal (zone 3) in soccer (football) players, studies that examine risk factors of the fractures in professional soccer players are scarce; in particular, ankle structures have not yet been investigated. This study was designed to investigate ankle structures of professional soccer players with proximal diaphyseal stress fractures of the fifth metatarsal. We reviewed the ankle radiographs of 100 professional soccer players (stress fractures n = 15; controls n = 85) and measured the medial malleolar slip angle (MMSA), the ratio of the medial malleolar length to the width of the talar dome (MML:TD ratio), the ratio of the lateral malleolar length to the width of the TD (LML:TD ratio), and the ratio of the MML to the LML (MML:LML ratio). Read More

J Foot Ankle Surg 2019 Feb 11. Epub 2019 Feb 11.

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

The purpose of this study was to compare the rates of readmission, reoperation, and mortality in patients with and without diabetes mellitus during the 30-day postoperative period after ankle fracture surgery. Patients who underwent operative management for ankle fractures between 2006 and 2015 were identified in the American College of Surgeons National Surgical Quality Improvement Program database by using Current Procedural Terminology codes for ankle fracture surgery. A total of 17,464 patients undergoing ankle fracture surgery were identified. Read More

J Orthop Sports Phys Ther 2019 Feb 13:1-32. Epub 2019 Feb 13.

University of Utah, Salt Lake City, UT.

Study Design: Multi-site double blind randomized clinical trial.

Background: Patients with surgical fixation of ankle and/or hindfoot fractures often experience decreased range of motion and loss of function following surgery and post-surgical immobilization, yet there is minimal evidence to guide care for these patients.

Objectives: To assess if manual therapy produces short-term improvements in range of motion, muscle stiffness, gait, and balance for patients undergoing operative fixation of an ankle and/or hindfoot fracture. Read More

J Orthop Sports Phys Ther 2019 Feb 13:1-26. Epub 2019 Feb 13.

Naval Medical Center San Diego, San Diego, CA.

Background: Severe ankle and foot injuries in the U.S. military can result in high-level functional limitation, lost duty days and medical discharge. Read More

Arch Osteoporos 2019 Feb 12;14(1):19. Epub 2019 Feb 12.

CIUSSS Nord de l'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 bl. Gouin ouest, Montreal, QC, H4J 1C5, Canada.

The study design of a multidisciplinary Fracture Liaison Service (2-year follow-up) aiming to optimize fragility fracture management in an outpatient setting is presented. Patient characteristics, investigation, and treatment initiation data at baseline were recorded. Results corroborate the care gap in osteoporosis management, reinforcing the need for secondary fracture prevention programs. Read More

Sports Med 2019 Feb 11. Epub 2019 Feb 11.

Faculty of Physical Education and Physiotherapy, Human Physiology Research Group, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.

Objective: The aim of this systematic review was to identify prospective studies that used a criteria-based return to sport (RTS) decision-making process for patients with lateral ankle sprain (LAS) injury.

Design: Systematic review and narrative synthesis.

Data Sources: The PubMed (MEDLINE), Web of Science, PEDro, Cochrane Library, SPORTDiscus (EBSCO), ScienceDirect, and Scopus databases were searched to 23 November 2018. Read More

J Foot Ankle Surg 2019 Feb 8. Epub 2019 Feb 8.

Surgeon, Department of Traumatology and Orthopedic Surgery, Hospital Regional Universitario de Málaga, Málaga, Spain.

Avulsion fractures of the posterior calcaneal tuberosity are rare injuries, and little is known about the underlying factors, outcomes, and prognosis. Furthermore, classifications described previously focus on fracture morphology, with uncertain clinical utility. We present the results of a retrospective study of 21 patients treated for this pathology from January 2002 to December 2015. Read More

Chin J Traumatol 2019 Jan 9. Epub 2019 Jan 9.

Department of Orthopedic Surgery, United Family Hospital, Beijing 100015, China. Electronic address:

Bosworth ankle fracture-dislocation is rare, known to be an irreducible type of ankle injury, with a high incidence of complication. We present two cases of even rarer variants of Bosworth ankle fracture-dislocation. The first case is a type of supination external rotation adduction, and the second case is a type of supination external rotation adduction. Read More

J Foot Ankle Surg 2019 Feb 8. Epub 2019 Feb 8.

Professor, Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan.

Bony mallet injury of the hallux is uncommon. In the few reports of this injury, authors have described surgical treatments such as closed reduction with percutaneous pinning and open surgical fixation with Kirschner wires or a suture anchor. However, the appropriate surgical management for this injury remains controversial. Read More

J Am Podiatr Med Assoc 2018 Nov;108(6):503-507

Background:: The scope of podiatric practice has changed significantly in the past couple of decades. Despite the increased quality of training, many people outside of podiatry may not realize what our scope of practice entails.

Methods:: We conducted a survey consisting of 10 items and asked internal medicine residents at Rush University Medical Center and patients whether they would feel comfortable consulting podiatrists, or being treated for each issue. Read More

Ulus Travma Acil Cerrahi Derg 2019 Jan;25(1):75-79

Department of Orthopaedics and Traumatology, İstanbul Bilim University Şişli Florence Nightingale Hospital, İstanbul-Turkey.

Background: Lateral malleolar fractures associated with syndesmotic injuries are common. Various surgical implants may be used for the management of syndesmosis injury. One of these is ANK nail. Read More

NASN Sch Nurse 2019 Feb 9:1942602X18819223. Epub 2019 Feb 9.

Professor, Departments of Emergency Medicine and Pediatrics, Penn State College of Medicine.

Illness and injury associated with sport and physical activities may occur in the school setting. Although most sport-related illness and injury in students are considered minor emergencies, life- and limb-threatening illnesses or injuries may occur, such as sudden cardiac arrest, heat stroke, status asthmaticus, catastrophic brain or cervical spine injuries, hypoglycemia, blunt chest/abdominal injuries, or extremity fractures requiring surgery. It is important for the school nurse to recognize potential life- and limb-threatening emergencies associated with sport and physical activity, to initiate stabilization of the student with life- and limb-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow up at their primary healthcare provider's office, or directly to the closest emergency department via emergency medical services). Read More

J Orthop Case Rep 2018 Sep-Oct;8(5):7-10

Department of Orthopedics, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.

Introduction: The Tillaux fracture is a rare subtype of tibial physeal fracture that usually occurs in adolescents. There are only a few case series or reports published in the literature and, to our knowledge, this is the first time, a painful nonunion is reported after this type of fracture.

Case Report: A 13-year-old athlete presented to our orthopedic department because of persistent pain after an acute ankle injury 2months before. Read More

Injury 2019 Feb 2. Epub 2019 Feb 2.

Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy.

Calcaneus is the most common site of hindfoot fracture, frequently caused by fall from height or high energy trauma. The therapeutic strategy ranged from non-operative to ORIF (Open Reduction Internal Fixation). Indications for percutaneous fixation include soft tissue damage or relative contraindications to open surgery. Read More

J Clin Hypertens (Greenwich) 2019 Feb 7. Epub 2019 Feb 7.

Department of Geriatric Medicine, Shanghai Jiatong School of Medicine, Ruijin Hospital North, Shanghai, China.

Although the association of arterial stiffness and osteoporosis has been reported, the relation of arterial stiffness with risk of osteoporosis and bone fracture is not established. The authors investigated the correlation between arterial stiffness (brachial-ankle pulse wave velocity [baPWV]), including a cutoff value, and risk of osteoporosis as assessed by the Osteoporosis Self-assessment Tool for Asia (OSTA) index in 129 elderly Chinese community-dwelling individuals (age 83.2 ± 12. Read More

J Arthroplasty 2019 Jan 17. Epub 2019 Jan 17.

Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, South Korea.

Background: This study compared the rates of plain radiographs and computed tomography (CT) for detecting lateral hinge fractures and to evaluate factors affecting lateral hinge fractures in patients following medial opening-wedge high tibial osteotomy (MOWHTO).

Methods: This prospective study included 59 patients (65 knees) undergoing MOWHTO for primary medial compartment osteoarthritis with a 2-year follow-up between 2013 and 2016. Clinical and radiographic evaluations were performed using Knee Society Score and Western Ontario and McMaster Universities Arthritis Index, and we calculated the hip-knee-ankle angle, weight-bearing line ratio, lateral distal femoral angle, medial proximal tibial angle, posterior tibial slope, osteotomy gap height, and osteotomy gap filling rate. Read More

Case Rep Hematol 2019 8;2019:1585014. Epub 2019 Jan 8.

Department of Neurointensive Care, Cerebrovascular Center, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.

Objective: To report a case of false-negative serological tests in the diagnosis of heparin-induced thrombocytopenia (HIT) followed by a brief review of the literature on this topic.

Case Presentation: A 75-year-old Caucasian female patient was admitted with a traumatic right ankle fracture that required open reduction and internal fixation. Despite postoperative subcutaneous heparin chemoprophylaxis, she developed deep vein thrombosis (DVT) and pulmonary embolism (PE) on day 4 and subsequently started on continuous heparin infusion. Read More

Nutr Health 2019 Feb 6:260106019826422. Epub 2019 Feb 6.

1 Department of Oncology and Metabolism, University of Sheffield, Medical School, UK.

Background:: Several studies have revealed a substantial increase in the incidence of fractures in children in the past few decades.

Aim:: To assess the strength of the association between suggested risk factors and fracture prevalence in children.

Method:: A cross sectional observational study. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Feb 5. Epub 2019 Feb 5.

Orthopaedic Department, Centro Hospitalar Póvoa de Varzim, Vila do Conde, Portugal.

Purpose: The purpose of this review is to systematically analyse current literature on the use of allografts in the surgical treatment of foot and ankle disorders in adult patients. Based on this study, we propose evidence-based recommendations.

Methods: The database for PubMed was searched for all published articles. Read More

Bull Emerg Trauma 2019 Jan;7(1):80-83

Medical University of Graz, Department of Orthopaedics and Trauma, Graz, Austria.

Tarsal coalition is an often unrecognised cause of foot and ankle pain and represents a congenital osseous, cartilaginous or fibrous connection between two or more tarsal bones. Fractures in combination with tarsal coalitions are rarely described in the literature. We report the case of a 43-year-old male patient with a talocalcaneal coalition who sustained an open comminuted calcaneal fracture and a closed transverse cuboid fracture. Read More

Geriatr Orthop Surg Rehabil 2019 24;10:2151459318821461. Epub 2019 Jan 24.

Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY, USA.

Introduction: Posterior tibialis tendon insufficiency is the most common cause of adult acquired flatfoot deformity in elderly patients. We performed a literature search of primary and secondary journal articles pertaining to posterior tibialis tendon insufficiency in the geriatric population. We examined relevant data from these articles regarding current evaluation in addition to both conservative and advanced treatment approaches that correspond to disease severity. Read More

Acta Biomed 2018 Dec 20;90(1-S):146-149. Epub 2018 Dec 20.

PARMA UNIVERSITY DEPARTMENT OF SURGICAL SCIENCES ORTHOPAEDIC AND TRAUMATOLOGY SECTION.

Background And Aim: There is a wide debate about the number, diameter and length of the syndesmotic screw and necessity and timing for its removal. The aim of this study is to determine whether functional and radiological outcomes differ in patients operated for Weber type B and C ankle fractures who had syndesmotic screws removed (group 1) compared to those who did not (group 2). Furthermore, authors want to define if it is really necessary to remove this device and its correct timing. Read More

Foot Ankle Spec 2019 Feb 2:1938640019826692. Epub 2019 Feb 2.

Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Introduction: Metabolic syndrome (MetS) is associated with significant postoperative morbidity. Despite an increasing prevalence of MetS in the US population, its impact on postoperative outcomes following ankle fractures remains limited.

Materials And Methods: The 2012-2016 American College of Surgeons-National Surgical Quality Improvement Program database was queried for patients undergoing open reduction with internal fixation (ORIF) for ankle fractures using Current Procedural Terminology codes: 27766, 27769, 27792, 27814, 27822, and 27823. Read More

Foot Ankle Spec 2019 Feb 2:1938640019826701. Epub 2019 Feb 2.

Department of Orthopaedic Surgery, Columbia University Medical Center, New York (DT, GH, JK, HCB, BA, CF, JKG, JTV).

Background: Fracture dislocation of the ankle represents a substantial injury to the bony and soft tissue structures of the ankle. There has been only limited reporting of functional outcome of ankle fracture-dislocations. This study aimed to compare functional outcome after open reduction internal fixation in ankle fractures with and without dislocation. Read More

J R Army Med Corps 2019 Jan 31. Epub 2019 Jan 31.

Joint Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Introduction: Parametric survival models are used to develop injury risk curves (IRCs) from impact tests using postmortem human surrogates (PMHS). Through the consideration of different output variables, input parameters and censoring, different IRCs could be created. The purpose of this study was to demonstrate the feasibility of the Brier Score Metric (BSM) to determine the optimal IRCs and derive them from lower leg impact tests. Read More

Foot Ankle Surg 2019 Jan 18. Epub 2019 Jan 18.

Department of Trauma and Orthopaedics, Torbay and South Devon NHS Foundation Trust, Torbay Hospital, Torquay, TQ2 7AA, UK.

Background: Direct fixation of the posterior malleolus through a posterolateral approach is increasing in popularity. However, data is limited, and no studies have stratified results by posterior malleolus size.

Methods: A retrospective cohort study of patients with posterior malleolus (PM) fractures undergoing internal fixation over an 18-month period was conducted. Read More

Skeletal Radiol 2019 Jan 31. Epub 2019 Jan 31.

Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK.

Subchondral insufficiency fracture (SIF) is a non-traumatic condition that has historically been associated with elderly, osteoporotic women and patients with systemic conditions. There has been much work done to determine the pathogenesis of SIF, which has previously been regarded as idiopathic, rapid-progressive osteoarthritis or osteonecrosis of the hip, spontaneous osteonecrosis of the knee (SONK), osteochondral defect (OCD) of the talus and adult-onset Freiberg infraction of the metatarsal head. Early diagnosis and management are crucial to prevent subchondral collapse, secondary osteonecrosis and early-onset osteoarthritis. Read More

J Clin Orthop Trauma 2019 Jan-Feb;10(1):173-177. Epub 2017 Aug 24.

University of Maryland, Department of Orthopaedics, University of Maryland Medical System, 22 S. Greene St, Baltimore, MD, 21201 United States.

Background: Unstable ankle syndesmosis injuries are common, and the optimal surgical fixation is controversial. The two main options for stabilization of syndesmotic injuries are suture button fixation and screw fixation. Suture button fixation has a higher initial cost, but may have a lower hardware removal rate. Read More

Medicine (Baltimore) 2019 Feb;98(5):e14311

Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan, Korea.

Rationale: Stress fractures are most commonly sustained in the lower extremities owing to the repetitive weight-bearing forces. They are overuse injuries that are seen often in athletes, but rare in the general population, so early diagnosis and proper treatment are important to enable athletes to return to activity. This is a rare example of successful treatment of a medial malleolar stress fracture with lateral ankle instability. Read More

Bone Joint J 2019 Feb;101-B(2):178-188

Center for Ilizarov Techniques, Akola, India.

Aims: Double-level lengthening, bone transport, and bifocal compression-distraction are commonly undertaken using Ilizarov or other fixators. We performed double-level fixator-assisted nailing, mainly for the correction of deformity and lengthening in the same segment, using a straight intramedullary nail to reduce the time in a fixator.

Patients And Methods: A total of 23 patients underwent this surgery, involving 27 segments (23 femora and four tibiae), over a period of ten years. Read More

Ann R Coll Surg Engl 2019 Jan 30:1-7. Epub 2019 Jan 30.

University Hospitals Plymouth NHS Trust , UK.

Introduction: Fractures are a common reason for admission to hospital around the world. Varying incidences have been reported but these are mainly based on small studies from individual centres. The aim of our study was to analyse fracture admissions in England over a ten-year period. Read More

BMC Musculoskelet Disord 2019 Jan 29;20(1):43. Epub 2019 Jan 29.

Department of Orthopedic Surgery, College of Medicine, Soonchunhyang University Bucheon Hospital, 1174 Jung-1-dong, Wonmi-gu, Bucheon-si, Gyunggi-do, 420-767, Republic of Korea.

Background: We hypothesized that calcaneal reconstruction can relieve chronic pain due to calcaneal malunion. We report the mid-term follow-up results of calcaneal reconstruction for calcaneal malunion.

Methods: We reviewed the records of 10 male patients (10 ft) who underwent calcaneal reconstruction for calcaneal malunion between January 2009 and July 2014 at the mid-term follow-up. Read More

BMC Emerg Med 2019 Jan 28;19(1):17. Epub 2019 Jan 28.

Centre for Rural Health, University of Aberdeen, Inverness, Scotland, UK.

Background: The aim of the present review is to assess the effectiveness of ultrasound (US) in the detection of upper and lower limb bone fractures in adults compared to a diagnostic gold standard available in secondary and tertiary care centres (e.g. radiography, CT scan or MRI). Read More

J Bone Miner Res 2019 Jan 28. Epub 2019 Jan 28.

Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.

Mineral and bone disorders including osteoporosis are common in dialysis patients and contribute to increased morbimortality. However, whether denosumab and alendronate are effective and safe treatments in hemodialysis patients is not known. Thus, we conducted a prospective, three-center study of 48 hemodialysis patients who were diagnosed as having osteoporosis and had not received anti-osteoporotic agents previously. Read More

Foot Ankle Int 2019 Jan 28:1071100718820352. Epub 2019 Jan 28.

2 Department of Orthopaedic Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Background:: Considerable debate exists regarding how soft-tissue edema should influence timing of surgery for ankle and other lower extremity fractures. Assessment of swelling is subjective, and timing varies among surgeons. However, timing of surgery is one of the few modifiable factors in fracture care. Read More