Search Our Scientific Publications & Authors

Skeletal Radiol 2020 Jul 6. Epub 2020 Jul 6.

Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126, Wenzhou Road, Gongshu District, Hangzhou, 310000, Zhejiang, China.

Objective: To analyze the MRI manifestations of and factors related to ankle injuries in asymptomatic amateur marathon runners.

Materials And Methods: A total of 113 amateur marathon runners without any ankle joint symptoms were recruited. Each participant was asked to complete a questionnaire at the beginning of the study and underwent MRI of the ankle. Read More

Injury 2020 Jun 29. Epub 2020 Jun 29.

Department of Plastic & Reconstructive Surgery, Sheri Kashmir Institute of Medical Sciences, Srinagar, J&K, India.

Background: Open traumatic tendoachilles injuries due to toilet seats are least reported. The exact mechanism of such injuries is debatable. None of the studies have reported associated neurovascular injuries and the need for microvascular tissue transfer. Read More

Foot Ankle Surg 2020 Jun 15. Epub 2020 Jun 15.

Department of Orthopedics, Clinica Del Remei, Barcelona, Spain; Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Barcelona, Spain.

Background: Ankle injuries are one of the most common musculoskeletal disorder. The purpose of this study was to analyze and describe the detailed anatomical arrangement and relationship of posterior ligaments of the ankle, especially de posteroinferior tibiofibular ligament (PITFL) and intermalleolar ligament (IML). Controversy exists in the previous literature regarding their morphology and denomination, as well as the relation with ankle injuries including posterior soft tissue impingement syndrome. Read More

J Orthop Case Rep 2020 ;9(6):58-61

Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.

Introduction: It remains controversial whether amputation or limb salvage is the best approach for mangled foot cases because there are no clear criteria for treatment. We report a case of successful limb salvage for a mangled foot, with good outcomes.

Case Report: The patient was a 30-year-old man who sustained a crush injury to his left foot and ankle and lower legs in a car crash; he had severe open left foot and ankle fracture and bilateral open tibial shaft fractures. Read More

Foot Ankle Int 2020 Jun 17:1071100720929007. Epub 2020 Jun 17.

Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.

Background: The current operative standard of treatment for bimalleolar equivalent ankle fracture is open reduction and internal fixation (ORIF) of the lateral malleolus followed by syndesmotic stabilization if indicated. There is controversy surrounding the indication and need for deltoid ligament repair in this setting. The purpose of this study was to quantify the biomechanical effect of deltoid ligament repair in an ankle fracture soft tissue injury model. Read More

Ann Plast Surg 2020 Jun 11. Epub 2020 Jun 11.

From the Division of Plastic Surgery, Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston; and Memorial Hermann Hospital-Texas Medical Center, Houston, TX.

Background: The gracilis muscle free flap has proven to be a dependable tool for the reconstructive microsurgeon for coverage of small- to medium-sized lower-extremity soft tissue defects because of its reliable anatomy, ease of elevation, and minimal donor site morbidity. We describe our experience with the adductor magnus muscle free flap which we have utilized in cases when confronted with the rare situation in which the dominant vascular pedicle to the gracilis muscle is insufficient or absent.

Methods: We conducted a retrospective chart review of a single surgeon's experience (EG Melissinos) over an 18-year period of all patients that underwent adductor magnus muscle free flap coverage for lower-extremity soft tissue injuries. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Jun;34(6):756-760

Department of Orthopedics, the Second Affiliated Hospital of Anhui Medical University, Hefei Anhui, 230000, P.R.China.

Objective: To investigate the effectiveness of Masquelet technique combined with flap transplantation in treatment of infectious bone and soft tissue defects of the lower leg.

Methods: Between January 2013 and January 2017, 35 cases of infectious bone and soft tissue defects of lower leg were treated with Masquelet technique combined with flap transplantation. There were 21 males and 14 females, with an average of 31. Read More

Knee Surg Sports Traumatol Arthrosc 2020 Jun 9. Epub 2020 Jun 9.

Laboratory of Arthroscopic and Surgical Anatomy. Department of Pathology and Experimental Therapeutics (Human Anatomy Unit), University of Barcelona, Via Augusta, 281, 08023, Barcelona, Spain.

Purpose: ATFL's superior fascicle injury has been considered to be the underlying cause in cases of ankle microinstability. As its clinical diagnosis can be difficult, arthroscopic examination may be the only objective diagnostic tool. The purpose of this study was to determine what types of injuries to the ATFL's superior fascicle are associated with ankle microinstability, and to provide the reader with an arthroscopic classification of the types of microinstability affecting the ankle. Read More

Sci Rep 2020 Jun 9;10(1):9303. Epub 2020 Jun 9.

Alfaisal University, College of Medicine, Department of Physiological Sciences, Riyadh, 11533, Kingdom of Saudi Arabia.

Soft tissue injury screening faces two main diagnostic challenges. One is the perceptual bias of the athlete in terms of referred pain and second injury assessment tools are not only in need of highly specialized personal but they are also financially demanding. Since ankle sprains is one of the leading soft tissue injuries, the current study was set to examine the suitability of functional infrared thermal imaging (fITI) in evaluating physiological alteration on the ankle as a result of exercise or injury. Read More

Injury 2020 May 23. Epub 2020 May 23.

Department of Orthopaedics, Kaohsiung Veterans General Hospital, 386, Da-Chung 1st Road, Kaohsiung City, 813, Taiwan, ROC; Department of Orthopaedics, National Defense Medical Center, 161, Section 6, Minquan E Rd, Neihu District, Taipei City, Taiwan 114 Taipei city, Taiwan Republic of China. Electronic address:

Introduction: Soft tissue swelling after acute fracture surgery is a challenge which may increase wound dehiscence, delay early range of motion, and increase infection rate postoperatively. This study investigates closed incision negative pressure therapy (ciNPT) using wide-range cover over the incision site and the peripheral swelling trauma zone to promote early active motion and to mitigate joint stiffness, bulla formation, and tendon adhesion.

Methods: Twenty-nine patients were enrolled between January 2018 and December 2018. Read More

J Foot Ankle Surg 2020 May 29. Epub 2020 May 29.

Associate Registrar, Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China. Electronic address:

The management of pilon fractures remains challenging owing to the high-energy axial loading mechanism that produces comminution of the articular surface, displacement of tibia metaphysis, and severe soft tissue injury. How to preserve the vitality of soft tissue and achieve anatomic reduction has become a timely issue. We report and evaluate the effect of a modified staging treatment for AO Foundation/Orthopaedic Trauma Association (AO/OTA) 43C1 pilon fracture accompanied by distal fibular and posterior lip of the distal tibia fracture. Read More

Clin Podiatr Med Surg 2020 Jul 12;37(3):553-568. Epub 2020 May 12.

Department of Podiatric Surgery, Advent Health East Orlando Podiatric Surgery Residency, 250 North Alafaya Trail Suite 1115, Orlando, FL 32828, USA.

Treatment of Achilles tendon ruptures may be surgical or nonsurgical depending on health, history, age, acuity, and severity of the injury. With chronic or revisional injuries, the best method often requires an open repair with reconstructive soft tissue procedures. Revision surgery can be challenging because of the complexity involving tendinous deficits with nonviable and friable tissue. Read More

Injury 2020 Jul 7;51(7):1576-1583. Epub 2020 May 7.

Limb Reconstruction Unit, Leeds General Infirmary, Leeds, UK.

Aim: We examined the management and outcome of patients suffering complex paediatric lower limb injuries with bone and soft tissue loss.

Method: Patients were identified from our prospective trauma database (2013-2018). Inclusion criteria were age (<18 years) and open lower-limb trauma. Read More

J Clin Orthop Trauma 2020 May-Jun;11(3):432-437. Epub 2019 Sep 5.

Christian Medical College, Vellore, India.

Introduction: Complex posttraumatic foot deformity results in painful foot, altered gait and affects cosmesis. We did a retrospective study on 16 patients to analyse the etiology, types of foot deformity and their outcomes after corrective surgery.

Methods: This retrospective study was done on a consecutive series of patients who underwent corrective surgery for complex post-traumatic foot and ankle deformities. Read More

J Clin Orthop Trauma 2020 May-Jun;11(3):380-387. Epub 2019 Nov 4.

Department of Orthopaedics, AIIMS, New Delhi, India.

The management of Osteoporotic ankle fractures is still considered to be a challenge by many surgeons. One of the issues seems to be a lack of data focused on this special subgroup, with very little evidence of good quality. We did a narrative review of the literature in an attempt to identify the magnitude of the problem and to evaluate the evidence in support of management options. Read More

J Clin Orthop Trauma 2020 May-Jun;11(3):348-356. Epub 2020 Apr 21.

Indian Spinal Injuries Centre, New Delhi, India.

Background: Numerous publications of the late 20th century have presented the radiological outcome of open technique for distal metatarsal osteotomy for mild to moderate hallux valgus and the clinical outcomes by means of well-established scoring systems which have been published and make these open techniques today's benchmark and gold standard. Minimally invasive procedures reduce surgical trauma because they are performed without large incisions, and injury to the soft tissues is limited. This has the theoretical advantages of improved recovery and decreased rehabilitation times. Read More

J Foot Ankle Surg 2020 May 8. Epub 2020 May 8.

Orthopedic Surgeon, Orthopaedic and Traumatology Department, University Hospital of Martinica, Martinique, France.

Total or complete dislocation of the talus is a triple dislocation of the tibiotalar, talocalcaneal, and talonavicular joints. It is a rare injury and is considered to be 1 of the most disabling ankle injuries. In light of the literature, there is a lack of consensus on their surgical treatment. Read More

F1000Res 2020 8;9:245. Epub 2020 Apr 8.

FSPE Applied Bioenergetics Lab, University of Novi Sad, Novi Sad, 21000, Serbia.

The traditional treatment of soft tissue injuries consists of the RICE protocol - rest, ice, compression, and elevation, followed for up to 72 hours after a trauma. Although designed as an immediate therapy to reduce inflammation that occurs after an acute injury, the RICE protcol might not be the best way to promote healing due to limiting blood flow. Molecular hydrogen (H ) has recently been put forward as a possible adjuvant treatment in musculoskeletal medicine, yet limited data are available concerning its effectiveness as a first-aid intervention. Read More

J Orthop Trauma 2020 Apr 27. Epub 2020 Apr 27.

Medical Director of Orthopedic Trauma, Westchester Medical Center, 100 Woods Rd, Valhalla, NY 10595, United States.

Open ankle and pilon fractures in patients with poor soft tissue quality represent a challenge for the treating Orthopedic Surgeon. Occasionally, the typical transverse medial wound is very cephalad and does not allow proper visualization of the fracture. It is difficult to decide how to extend these open wounds to get access to the fracture while minimizing disruption of the blood supply to the skin. Read More

J Foot Ankle Surg 2020 Jul - Aug;59(4):795-800. Epub 2020 Apr 25.

Assistant Professor, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA. Electronic address:

Running is one of the most popular sports worldwide, with many health benefits. Injuries are also common, with running-related injuries reported in up to 79% of runners annually. Extracorporeal shockwave treatment can be used to treat soft tissue conditions, with the strongest level of evidence for management of plantar fasciitis. Read More

J Emerg Nurs 2020 Apr 24. Epub 2020 Apr 24.

Introduction: This study aimed to determine the effect of cold application time on symptoms, edema, and patient satisfaction in soft tissue injuries.

Methods: A randomized controlled trial was conducted with 105 patients who were treated with cold applications of different durations (10, 20, and 30 minutes). Interview-assisted data were collected on symptoms and patient satisfaction. Read More

Injury 2020 Mar 9. Epub 2020 Mar 9.

Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Department of Plastic Reconstructive Surgery and Burns, Grigore Alexandrescu Clinical Emergency Hospital for Children, Bucharest Romania.

Introduction: Extensive lower limb traumatic injuries are particularly challenging when they associate skin and soft tissue defects, moreover when the patient is a child. In view of more frequent recommendations and reports of negative pressure wound therapy (NPWT) use for severe trauma and extensive soft tissue defects of the lower extremity, we aimed at reviewing the indications and outcomes of this technique in our pediatric plastic surgery department.

Method: We performed a retrospective study for the period 2016-2019, in order to identify patients having suffered injuries of the ankle and foot, for who NPWT was used in the therapeutic protocol. Read More

Injury 2020 Mar 25. Epub 2020 Mar 25.

Department for Plastic, Reconstructive and Hand Surgery, Evangelisches Hospital, Oldenburg, Germany.

Background: The lateral circumflex femoral artery one of the most favoured donor-site for a wide array of free flaps including either cutaneous, fascial and muscle components or a combination thereof. Here, we provide evidence on the safe use of the free vastus lateralis muscle flap and its feasibility for optimal soft tissue coverage of the weight-bearing foot.

Methods: Eighteen consecutive patients with soft tissue defects of the heel (n = 3, 16. Read More

Zhongguo Gu Shang 2020 Mar;33(3):203-8

Department of Orthopaedics, People's Hospital of Deyang City, Deyang 618000, Sichuan, China.

Objective: To compare clinical effects of calcaneal traction and external fixator fixation of fractional delayed surgery in treating type C Pilon fractures.

Methods: From January 2012 to December 2017, clinical data of 45 patients with tibial Pilon fractures were respectively analyzed. There were 24 patients in traction group, including 16 males and 8 females, aged from 21 to 57 years old with an average age of (38. Read More

Injury 2020 Apr 12;51(4):1077-1085. Epub 2020 Feb 12.

Southmead Hospital, North Bristol NHS Trust Westbury-on-Trym, Bristol, BS10 5NB, United Kingdom. Electronic address:

Background: The medial sural artery perforator (MSAP) flap provides a thin, pliable and durable soft tissue reconstruction with adequate pedicle length and low donor morbidity. It is an ideal choice for small-to-moderate defects of the lower extremity, although it does have limitations. We report our experience of the flap in a three-pronged anatomical, clinical and patient reported outcome-based study. Read More

BMC Musculoskelet Disord 2020 Mar 18;21(1):176. Epub 2020 Mar 18.

Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, China.

Backgrounds: Poor prognosis was reported for complex Pilon fractures involving severe soft tissue damage. It is therefore useful to explore the evolution of different treatment strategies in an effort to reconstruct the axial alignment and articular surface, while minimizing additional damage to the surrounding soft tissues.

Methods: Seventeen patients with Pilon fractures were enrolled in this retrospective study from December 2009 to October 2014. Read More

Int Orthop 2020 May 17;44(5):973-977. Epub 2020 Mar 17.

Orthopedic Surgery Dept, Hamad General Hospital, P.O. Box 3050, Doha, Qatar.

Introduction: Talus fractures are not uncommon and one of the serious fractures in the foot and ankle. Peroneal tendon dislocation is one of the commonly missed soft tissue injuries which may have significant impact on the outcomes including persistent pain and swelling. They have been reported to be associated with calcaneum as well as talus fractures. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Mar;34(3):367-372

Department of Orthopedics, the 920th Hospital of Joint Logistic Support Force of Chinese PLA, Kunming Yunnan, 650032, P.R.China.

Objective: To study the effectiveness of digital technique in repairing of heel wound with peroneal artery perforator propeller flap.

Methods: Between March 2016 and March 2019, the heel wounds of 31 patients were repaired with the peroneal artery perforator propeller flaps. There were 21 males and 10 females, with an average age of 36 years (range, 12-53 years). Read More

Injury 2020 Feb 21. Epub 2020 Feb 21.

"Bagdasar-Arseni" Emergency Hospital, Plastic and Reconstructive Department, University of Medicine and Pharmacy "Carol Davila", 10-12 Berceni Road, District 4, 41914 Bucharest, Romania.

Defects of the lower limb are generally difficult to correct, especially in patients with associated pathologies, and they represent a challenge for the reconstructive surgeon. The sural flap provides considerable versatility for lower limb reconstructions, successfully covering defects located between the knee and the ankle or the heel. Most frequently, this flap is used for defects located in the middle to distal third of the lower limb. Read More

J Foot Ankle Surg 2020 Jul - Aug;59(4):841-848. Epub 2020 Mar 5.

Student, University of California, San Diego, La Jolla, CA.

The surgical treatment of Charcot foot is a widely debated topic, with issues ranging from when to operate to how to properly correct a deformity. Historically, correction of a severe deformity was attempted in 1 acute surgical procedure that frequently required open reduction and internal fixation through large incisions. This 1-time procedure would often result in complications including under- or overcorrection of the deformity, neurovascular injury, or incision dehiscence leading to possible soft-tissue infection or osteomyelitis. Read More

Plast Reconstr Surg 2020 03;145(3):813-822

Philadelphia, Pa. From the Division of Plastic Surgery, Department of Surgery, and the Department of Orthopedic Surgery, University of Pennsylvania.

Background: Little is known about the efficacy of newer skin substitute scaffolds to reconstruct complex lower extremity wounds. The investigators present a multihospital experience of reconstructive surgeons utilizing collagen-GAG bilayer wound matrix in lower extremity soft-tissue reconstruction with the goals to (1) characterize a suitable patient population, (2) categorize failures to optimize patient selection, and (3) determine wound factors affecting success.

Methods: Subjects underwent collagen-GAG-based lower extremity wound reconstruction from May of 2010 to June of 2017. Read More

Injury 2020 Feb 11. Epub 2020 Feb 11.

Department of Traumatology, University of Szeged, Hungary.

Diabetes is a common disease that potentially interferes with healing processes after lower limb trauma. In our presented case a trimalleolar ankle fracture with undiscovered serious soft-tissue injuries resulted in chronic soft-tissue complications in a diabetic patient, requiring three and a half months of hospitalization in a higher level center and the application of state-of-the-art wound treatment, including vacuum-assisted closure therapy, Integra bioengineered skin substitute, split-thickness skin-grafting, and methods enhancing wound healing, such as polarized light therapy and transdermal CO delivery. The presented case emphasizes the importance of soft-tissue care and multidisciplinary approach in diabetic trauma patients with poor compliance. Read More

Unfallchirurg 2020 Apr;123(4):330-338

Leiter der Sektion Fuß- und Sprunggelenkchirurgie Campus Großhadern & Innenstadt, Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität, LMU München, Nussbaumstr. 20, 80336, München, Deutschland.

Objective: Identification and treatment of intra-articular injuries, stabilization of the syndesmotic complex by open reduction and internal fixation (ORIF) of the posterior malleolus (PM).

Indications: Bimalleolar and trimalleolar fractures, patients with functional demands.

Contraindications: Soft tissue injuries/infections in the area of the surgical approach, higher grade circulatory disorders, diabetes mellitus. Read More

AJR Am J Roentgenol 2020 04 11;214(4):871. Epub 2020 Feb 11.

Department of Radiology, Centre Hospitalier de l'Université de Montréal, 1000 rue Saint-Denis, Montreal, QC H2X 0C1, Canada.

The purpose of this article is to show the sonographic anatomy of the extremities relevant to various ligamentous, tendinous, and articular injuries occurring in the hand, wrist, and ankle. A brief discussion and depiction of the specific elements relevant to the pathophysiologic mechanism of these entities is followed by demonstrations of the dynamic ultrasound techniques that can be used to diagnose these injuries. The schematics and video clips illustrate the normal and pathologic features of these injuries. Read More

Instr Course Lect 2020 ;69:477-488

Ankle fractures are among the most common fractures encountered by orthopaedic surgeons and, in the setting of tibiotalar instability, are usually treated surgically. Although orthopaedic surgeons from diverse educational backgrounds often feel comfortable treating such fractures, many controversies and clinical challenges remain. A detailed understanding of the unique issues presented by each patient as well as the best available treatments are required to optimize outcome. Read More

J Orthop Trauma 2020 Feb;34 Suppl 1:S14-S20

Department of Orthopaedics and Sports Medicine, Harborview Medical Center, University of Washington, Seattle, WA.

The treatment of tibial pilon fractures has evolved substantially over the past decades due to ever-increasing high-energy injuries. Open reduction and internal fixation of these intra-articular fractures requires an appreciation for a number of basic principles: respect the soft tissues, understand the fracture pattern, use safe surgical approaches, and provide stability that allows for early motion of the ankle. Surgical strategy should be customized based on the fracture pattern, access needed for fracture visualization and reduction, and status of the soft tissues. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Jan;34(1):87-91

Depantment of Microsurgical and Reconstruction, the First Affiliated Hospital of Xinjiang Medical University, Urumchi Xinjiang, 830054,

Objective: To investigate the clinical application of the anterior tibial artery perforator propeller flap relay peroneal artery terminal perforator propeller flap in repair of foot and ankle defects.

Methods: Between October 2014 and October 2018, 18 cases with foot and ankle defects were treated. There were 12 males and 6 females with an average age of 32. Read More

J Foot Ankle Surg 2020 Jan - Feb;59(1):128-130

Surgeon, Department of Plastic and Reconstructive Surgery, Azienda Ospedaliera Universitaria "Ospedali-Riuniti" Trieste, Italy.

Damage to the weightbearing surface of the foot is a challenge for the reconstructive surgeon. The aim is to reconstruct the skeletal tripod and soft tissue, allowing the patient to walk normally. We report the case of a patient admitted with an acute right foot open fracture of the second, third, fourth, and fifth metatarsal bones. Read More

Wounds 2019 Dec;31(12):E77-E81

Hahnemann University Hospital/DUCOM, Philadelphia, PA.

Introduction: Degloving injuries of the foot involve the management of extensive soft tissue and osseous damage secondary to significant forced avulsion of soft tissue, which can present a major challenge for the surgeon. Surgical procedures on pediatric foot degloving involving split-thickness and/or full-thickness skin grafts and rotational flaps can result in negative consequences, such as donor site comorbidities and psychosocial implications when the pediatric patient returns to daily life.

Case Report: The authors report the case of a 16-year-old girl with no past medical history who sustained an extensive degloving injury to her right foot involving severe subcutaneous and muscular soft tissue disruption and contamination. Read More

Zhongguo Gu Shang 2019 Nov;32(11):1014-1020

Department of Orthopaedics, the Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu, China;

Objective: To compare clinical effect of modified anterolateral approach combined with modified posteromedial approach and conventional posterolateral approach combined with medial-aided in treating trimalleolar fractures.

Methods: From January 2015 to August 2017, 108 patients with trimalleolar fractures were enrolled and randomly divided into modified approaches (experimental group) and conventional approaches(control group). There were 53 patients in experimental group including 31 males and 22 females aged from 18 to 67 years old with an average of(40. Read More

Microsurgery 2020 Mar 9;40(3):395-398. Epub 2019 Dec 9.

Department of Oral and Maxillofacial Surgery and Centre for Reconstructive Surgery, University Hospital of the Private Medical University Paracelsus, Salzburg, Austria.

In cases of large defects of the limbs, post-traumatic deformity and disability can have devastating effects on patients' quality of life. The purpose of this report is to describe the technique for raising a fasciocutaneous iliotibial perforator flap and present its application in the reconstruction of a complex soft tissue defect of the foot. The patient was a 13-year-old male who had suffered a crush injury to the foot in a motor vehicle accident 5 years earlier. Read More

Injury 2019 Dec 23;50 Suppl 5:S17-S20. Epub 2019 Oct 23.

Orthopedics and Traumatology, Hand and Microsurgery Unit, Sohag University, Sohag, Egypt. Electronic address:

Objective: Management of complex foot injuries including skin, tendons, vessels, bone, with soft tissue defects is considered as an orthopedic challenge. Microsurgical free muscle flaps provide the best solution in such cases.

Patients And Methods: Thirty two consecutive cases of complex ankle and foot injuries were treated by skin grafted muscle free flap in one stage procedure after radical debridement. Read More

Biomed Res Int 2019 7;2019:1491796. Epub 2019 Nov 7.

Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China.

Background: Both percutaneous Achilles tendon lengthening by triple hemisection and the traditional open Z-lengthening are effective methods for Achilles tendon contracture. This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon, as compared with the traditional open Z-lengthening.

Methods: Retrospective analysis of the Achilles tendon contracture cases in our hospital between January 2010 and September 2016 was conducted. Read More

J Orthop Surg Res 2019 Nov 20;14(1):374. Epub 2019 Nov 20.

Department of foot and hand trauma surgery, Qingdao Central Hospital, Qingdao, City, 266071, People's Republic of China.

Objectives: By observing the infection and soft tissue defect on the wound surface of the foot and ankle, this paper attempts to explore the effect of preoperative irrigation and vacuum sealing drainage with antibiotic-containing drainage fluid (abPI-VSD) on the bacterial quantity and the local inflammatory response at the flap, and further to provide a basis for applying this technique before a reconstructive skin flap surgery of foot and ankle wounds.

Methods: Seventy-five patients were randomly divided into two groups, and all surgeries were done by one physician. The flap reconstructions were done to 31 cases with the abPI-VSD being used (group A); the flap reconstructions were done to the rest 44 cases after wound cleaning using antibiotic irrigation solution without the use of the abPI-VSD (group B). Read More

Br J Radiol 2020 Jan 4;93(1105):20180989. Epub 2019 Dec 4.

St Luke's Radiology Oxford Ltd, Oxford, UK.

Objective: To assess the rates of fractures and ligament injuries in patients with an acute ankle injury and a normal radiographic examination, and to consider the most appropriate examination protocol.

Methods: Patients with an acute ankle injury who presented to the John Radcliffe Hospital Emergency Department with a normal radiographic examination were eligible for the study. They were invited to receive a cone beam CT and ultrasound examination at a local radiology department within 5 days of their ankle injury. Read More

Clin Podiatr Med Surg 2020 Jan 22;37(1):23-37. Epub 2019 Oct 22.

PMSR/RRA Podiatric Residency, Western University College of Podiatric Medicine, Chino Valley Medical Center, 309 East Second Street, Pomona, CA 91766, USA.

Imaging with biomechanical analysis augments the clinical examination and improves outcomes by correlating imaging findings with the examination. Plain film radiographs are the gold standard to assess osseous alignment. The biomechanical examination provides information to formulate an accurate assessment. Read More

Foot Ankle Surg 2019 Oct 25. Epub 2019 Oct 25.

Oulu University Hospital, Department of Surgery, Division of Orthopedic and Trauma Surgery, Oulu, Finland.

Background: Postoperative infection is a severe complication after operative treatment of ankle fractures, associated with age, comorbidities, and severe soft tissue injuries. We assessed the efficacy of intramedullary fibular nailing for treating ankle fractures in patients at high risk of wound complications.

Methods: 41 high-risk patients were included in the study. Read More

Injury 2019 Dec 21;50 Suppl 5:S32-S39. Epub 2019 Oct 21.

Department of Plastic Surgery, University of Tennessee Health Science Center Memphis, TN, 38163, USA. Electronic address:

Background: Goals of lower extremity microvascular reconstruction (LEMR) include the restoration of function, prevention of infection, and optimal cosmesis. Indications for LEMR include large defects that are not amenable to pedicled options, a large zone of injury, and large complex defects. The novice microsurgeon should first master a handful of free flaps to develop an armamentarium of options for addressing such defects. Read More