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Foot (Edinb) 2021 Jan 29;47:101785. Epub 2021 Jan 29.

Consultant Orthopaedic Surgeon, Sportsmed Mumbai, India. Electronic address:

Dislocations of the first metatarsophalangealjoint are rare, and recurrent dislocations unique. A national-level Kabaddi player dislocated his right first metatarsophalangeal joint while playing a game bear footed. After self-manipulative reduction, the patient had multiple dislocations. Read More

Foot (Edinb) 2021 May 3;47:101777. Epub 2021 May 3.

Mallinckrodt Institute of Radiology, Musculoskeletal Section, Washington University School of Medicine, Campus Box 8131, St. Louis, MO 63110, United States. Electronic address:

Background: Diabetes mellitus (DM) with peripheral neuropathy (PN) results in foot deformity increasing ulceration, joint dislocation, and amputation risk. This study describes the frequency and severity of foot and ankle musculoskeletal abnormalities and their relationship to radiographic alignment in people with DMPN with (DMPN + MCD) and without (DMPN - MCD) medial column deformity (MCD) compared to age- and body mass index-matched controls without DMPN or MDC.

Methods: DMPN + MCD (n = 11), DMPN - MCD (n = 12), and controls (n = 12) were studied. 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

Asian J Surg 2021 Apr 23. Epub 2021 Apr 23.

Department of Orthopaedic Surgery the Affiliated Hospital of Southwest Medical University Luzhou, China. Electronic address:

Recurrent patellar dislocation (RPD) is multifactorial disease, and excessive femoral internal torsion has been considered as an important risk factor for recurrence of patellar dislocation and graft failure after surgery 1 . Satisfactory clinical outcomes depend on correcting of the pathologic abnormalities around the patellofemoral joint and torsional deformity of the lower extremity. At present, conventional isolated medial patellofemoral ligament (MPFL) reconstruction without addressing excessive femoral internal torsion may lead to MPFL graft failure 2,3 , because increased femoral internal torsion can significantly increase a persistently lateralizing force on the patella 4 . Read More

Malays Orthop J 2021 Mar;15(1):85-92

Department of Orthopaedics, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India.

Introduction: Unstable ankle injuries require anatomical reduction and stabilisation for optimal outcome. In spite of adequate care, a few patients have poor outcome. In this study, we assessed the risk factors that predict the clinical outcomes in surgically treated unstable ankle fractures. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Apr;35(4):426-430

Department of Orthopedics, Tongji Hospital, Tongji University, Shanghai, 200065, P.R.China.

Objective: To evaluate the effectiveness of indirect fixation of the 3rd tarsometatarsal joint in the treatment of high-energy Lisfranc injury.

Methods: Between February 2015 and February 2019, 15 patients with high-energy Lisfranc injury were treated. There were 12 males and 3 females with an average age of 44. Read More

Biomedicine (Taipei) 2020 1;10(4):52-56. Epub 2020 Dec 1.

Department of Orthopaedic Surgery, Khoo Teck Puat Hospital, Singapore.

Nontuberculous mycobacteria (NTM) infections of the musculoskeletal system are commonly missed due to its rarity and the absence of systemic symptoms. A high clinical index of suspicion is required to recognize such infections as they may occur in immunocompetent hosts. We present two cases of foot and ankle NTM infections involving and in two such patients. Read More

Cureus 2021 Mar 10;13(3):e13801. Epub 2021 Mar 10.

Trauma and Orthopaedics, University Hospitals of Derby and Burton NHS Foundation Trust, Burton-on-Trent, GBR.

Skeletal trauma accounts for 10% to 15% of all childhood injuries, with approximately 15% to 30% of these representing physeal injuries. Talus fractures are rare injuries in children with an estimated prevalence of 0.008% of all childhood fractures. Read More

J Foot Ankle Surg 2021 Mar 18. Epub 2021 Mar 18.

Professor, Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

Hallux valgus deformity is one of the most common foot and ankle diseases, while brachymetatarsia is a rare foot anomaly with pathological shortening of a metatarsal bone. We present a case of hallux valgus deformity possibly due to second brachymetatarsia. As the hallux valgus was associated with dorsal dislocation of the second toe that made it difficult to evaluate the length of the second toe, the patient was unaware of the second metatarsal shortening until the lengths of the toes compared by manual reposition of the second MTP joint. Read More

J Foot Ankle Res 2021 Apr 7;14(1):26. Epub 2021 Apr 7.

Holsworth Research Initiative, La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo, Australia.

Background: Acute Charcot Neuroarthropathy (CN) is a destructive condition that is characterised by acute fractures, dislocations and joint destruction in the weight-bearing foot. The acute phase is often misdiagnosed and can rapidly lead to devastating health outcomes. Early diagnosis and management of CN is imperative to attenuate progression of this condition. Read More

J Int Med Res 2021 Apr;49(4):3000605211004697

Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Dongam-gu, Cheonan, Korea.

Midtarsal dislocations are relatively rare injuries secondary to high-energy trauma and are typically accompanied by disruption of ligamentous structures and fractures of the midfoot. We herein present a case of a pure isolated medial swivel dislocation of the talonavicular joint (TNJ) that was sustained following low-energy trauma without an associated fracture. A 78-year-old woman visited our emergency department with severe pain in the midfoot area of the right foot without neurovascular deficits. Read More

Foot Ankle Surg 2021 Mar 26. Epub 2021 Mar 26.

Department of Orthopaedics and Traumatology, Health Science University Gaziosmanpasa Training and Research Hospital, Istanbul, 34433, Turkey.

Background: To compare the efficacy, functional outcome, and complication frequency of splinting and external fixation in the initial treatment of ankle fracture-dislocations.

Method: Ankles with poor soft tissue conditions who underwent temporary stabilization due to using a splint or external fixator due to an ankle fracture-dislocation between 2012 and 2019 were retrospectively evaluated. Ankles were divided into two groups as the splint (n=69) and external fixator (n=48). Read More

Cureus 2021 Feb 23;13(2):e13519. Epub 2021 Feb 23.

Orthopedic Department, Thriasio General Hospital, Athens, GRC.

Although ankle fractures are very common cases for orthopedic surgeons with an easy diagnosis and very good outcomes either with conservative or with operative treatment, in diabetic patients, these fractures can be complex with difficult solutions. We report two cases with ankle fractures in diabetic patients from our department with demanding diagnostic or therapeutic approaches and poor outcomes. The first case, a 65-year-old man with undiagnosed diabetes mellitus and neglected ankle fracture dislocation because of diabetic neuropathy, underwent open reduction internal fixation with additional external fixation. Read More

Trauma Case Rep 2021 Apr 11;32:100453. Epub 2021 Mar 11.

Department of Orthopaedic Surgery, Dow University of Health Sciences, Ruth K M Pfau Civil Hospital Karachi, Pakistan.

Bilateral hip dislocation is a rare injury and asymmetrical hip dislocations are even very rare entities. We are reporting two cases of bilateral asymmetrical hip dislocations with associated acetabulum fractures. Mechanism of injury in first case was fall from height and in other case road traffic accident. Read More

J Foot Ankle Surg 2021 Mar 6. Epub 2021 Mar 6.

Foot and Ankle Surgeon, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

External fixation with a bilateral frame configuration (delta frame, DF) is a routine approach for treating ankle fractures and dislocations with severe soft tissue damage. The purpose of this study was to evaluate to what extent adding a first metatarsal fixation contributes to the stability of the fixation as evidenced by reduced frequency of early loss of reduction. A retrospective study was performed to compare the rate of early reduction loss in patients treated with a bilateral frame external fixation as part of a 2-stage treatment protocol for periarticular ankle fractures, in a level one trauma center between 2006 and 2016. Read More

J Orthop Trauma 2021 Mar 22. Epub 2021 Mar 22.

University of Texas Health San Antonio, Department of Orthopaedics University of Texas Health San Antonio, Long School of Medicine 3M Health Care, Medical Solutions Division, San Antonio, TX.

Objectives: To examine the incidence of surgical site complications associated with pronation-abduction ankle fracture-dislocations with an open medial tension wound.

Design: Retrospective case series.

Setting: Accredited level-1 trauma center. Read More

Medicine (Baltimore) 2021 Mar;100(12):e25202

Department of Orthopedics, The Second Affiliated Hospital of Bengbu Medical College, Bengbu.

Abstract: To introduce a novel technique of using individualized 3D printing occipitocervical fusion instrument (3D-OCF) for the treatment of upper cervical deformity with atlantoaxial joint dislocation.The surgery for deformity of the craniocervical junction area is a challenge in the field of spine. If the surgical deviation is too large to injure the spinal cord or vertebral artery, it will cause catastrophic damage to the patient. Read More

Diving Hyperb Med 2021 Mar;51(1):107-110

Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC; JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

A broad spectrum of conditions including neuropathic pain, complex regional pain syndrome (CRPS) and fibromyalgia, have been implicated as causes of chronic pain. There is a need for new and effective treatments that patients can tolerate without significant adverse effects. One potential intervention is hyperbaric oxygen treatment (HBOT). Read More

J Exp Orthop 2021 Mar 18;8(1):22. Epub 2021 Mar 18.

Department of Orthopaedic Surgery, Matsukura Hospital, Nara, Japan.

Purpose: To evaluate the usefulness of the false-pouch closure technique with an intact superior peroneal retinaculum (SPR).

Methods: From 2016 to 2020, 30 patients with recurrent dislocation of the peroneal tendon were treated with the current procedure. Clinical outcomes, including the time to resume running, the rate and time to return to sports, and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hind Foot score, were evaluated preoperatively and at the last follow-up. Read More

Oper Orthop Traumatol 2021 Apr 16;33(2):104-111. Epub 2021 Mar 16.

UniversitätsCentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Carl Gustav Carus, Fetscherstr. 74, 01307, Dresden, Deutschland.

Objective: Minimally invasive osteosynthesis of distal fibula fractures serves as a biomechanically stable and soft-tissue-friendly fixation method in the case of an unstable fracture, poor bone quality, and/or critical soft tissue conditions with restoration of the length, axis and rotation of the distal fibula as well as stabilization of the ankle mortise. The goal is to reduce and stabilize the distal fibular fracture in a quick and stable manner that protects the soft tissues in ankle fractures.

Indications: Unstable malleolar fractures and fracture dislocations; fibular fractures in combination with distal tibia fractures; critical soft tissue conditions around the ankle. Read More

Cureus 2021 Feb 8;13(2):e13224. Epub 2021 Feb 8.

Department of Orthopaedics, SRM Medical College Hospital and Research Centre, Chennai, IND.

Subtalar or peritalar dislocation is the loss of contact between the articular surface of the talus distally and the calcaneum and navicular. In this paper, a case of open medial type of subtalar dislocation associated with fractured posterior facet of the talus in a 27-year-old man with a history of road traffic accident was reported. Immediate wound irrigation and open reduction under general anesthesia at the emergency room operation theater was successful followed by cast immobilization. Read More

Int Orthop 2021 Mar 5. Epub 2021 Mar 5.

The First Affiliated Hospital of Military Medical University of the Army, Chongqing, China.

Background: Reconstructing bone structures and stabilizing adjacent joints are clinical challenges in treating talar necrosis and collapse (TNC). 3D printing technology has been demonstrated to improve the accuracy of talar replacement. This study aimed to evaluate anatomical talar replacement and the clinical results. Read More

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

Consultant, Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong SAR, China. Electronic address:

Chronic lateral ankle instability is a prevalent condition, and it is commonly associated with other foot and ankle injuries. Among the associated injuries, peroneal tendon pathologies and anterolateral ankle impingement are frequently encountered. In this report, a case of concomitant chronic lateral ankle instability and dislocation of the peroneal tendons is described. Read More

Foot Ankle Spec 2021 Feb 25:1938640021997285. Epub 2021 Feb 25.

UCHealth Steadman Hawkins Clinic, Denver, Colorado.

Fracture, Achilles tendon rupture, or traumatic dislocation of the peroneal tendons are often seen in isolation after a trauma or sports-related injury. However, in rare circumstances, a combination of these injuries can occur simultaneously. Multiple previous case reports describe a combination of 2 of these injuries. Read More

Foot Ankle Int 2021 Feb 25:1071100721995421. Epub 2021 Feb 25.

Department of Orthopaedic Surgery, Washington University, St Louis, MO, USA.

Dislocation of the native knee represents a challenging injury, further complicated by the high rate of concurrent injury to the common peroneal nerve (CPN). Initial management of this injury requires a thorough neurovascular examination, given the prevalence of popliteal artery injury and limb-threatening ischemia. Further management of a knee dislocation with associated CPN palsy requires coordinated care involving the sports surgeon for ligamentous knee reconstruction and the peripheral nerve surgeon for staged or concurrent peroneal nerve decompression and/or reconstruction. Read More

Emerg Radiol 2021 Feb 24. Epub 2021 Feb 24.

Trauma Imaging Research and Innovation Center, Brigham and Women's Hospital, Boston, MA, USA.

Purpose: To describe the pattern and distribution of lower extremity injuries in victims of intimate partner violence (IPV).

Materials And Methods: A retrospective radiological review of 688 patients reporting IPV to our institution's violence intervention and prevention program between January 2013 and June 2018 identified 88 patients with 154 lower extremity injuries. All lower extremity injuries visible on radiological studies were analyzed. Read More

Clin Cosmet Investig Dermatol 2021 12;14:153-161. Epub 2021 Feb 12.

Department of Hand Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, People's Republic of China.

Background/purpose: Anterolateral thigh perforator (ALTP) flap and deep inferior epigastric perforator (DIEP) flap have been advantageous over traditional myocutaneous flaps as they preserve the integrity of donor site muscles and minimize the damage and complication to donor site structures. Here, we reported the efficacy of free ALTP and DIEP in the repair of large skin area and soft tissue defects on both lower limbs after trauma.

Case Report: A 19-year-old female traffic accident victim presented with multiple open bilateral fractures to the lower extremities with joint dislocation, massive skin and soft tissue defects, and multiple soft tissue contusion. Read More

Arch Orthop Trauma Surg 2021 Feb 17. Epub 2021 Feb 17.

Department of Surgery of 1st Faculty of Medicine, Charles University and Thomayer Hospital, Videnska 800, Prague 4, 140 00, Czech Republic.

Introduction: Compartment syndrome (CS) is exceedingly rare in ankle fractures. However, the risk of CS development seems to be increased in the presence of a Bosworth fracture-dislocation (BF), a rare variant of locked dislocation of the fibula behind the tibia.

Materials And Methods: Here, we report the case of a 39-year old man with delayed diagnosis of CS after having sustained a BF and failed attempts on closed reduction. Read More

J Orthop Case Rep 2020 Oct;10(7):11-14

Department of Orthopaedics, All India Medical Sciences, Rishikesh, Uttarakhand, India.

Introduction: Combined talar body fracture with a medial malleolar fracture is rare in literature.

Case Presentation: A 30-year-old female presented to our hospital with complaints of pain and swelling over the right ankle joint with difficulty in bearing weight following a motor vehicle accident. Investigation showed talar body fracture of type 2 Sneppen (classification) with an ipsilateral medial malleolar fracture. Read More

Injury 2021 Feb 5. Epub 2021 Feb 5.

Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan.

Purpose: This study aimed to clarify the effectiveness of a novel technique utilizing the new unconstrained Ilizarov frame system by evaluating the clinical outcomes of equinus deformity correction.

Methods: From January 1998 to December 2012, a total of 9 consecutive patients (median age: 33 years) with equinus deformity were treated by using a simple, unconstrained, hinge-less Ilizarov frame, which was developed to correct talar subluxation using an unconstrained frame system. All patients had equinus deformity >30°, although preoperative radiographs showed a congruous ankle joint with no fixed bony deformity. Read More