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JBJS Case Connect 2020 Apr-Jun;10(2):e1900346

1Department of Orthopaedic Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan 2Plastic and Reconstructive Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan.

Case: A 70-year-old woman who sustained Gustilo type III open and comminuted tibial fractures presented with extensive soft-tissue defect. Definitive surgery was performed using a free latissimus dorsi muscle flap for the extensive soft-tissue defect and Ilizarov external fixation (IEF) to stabilize the fractures and arthrodese the ankle. Ankle arthrodesis was accomplished by the wires penetrating the implanted muscle flap. Read More

Foot Ankle Int 2020 Jul 10:1071100720933891. Epub 2020 Jul 10.

Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.

Background: Posttraumatic osteoarthritis (PTOA) of the subtalar joint is a serious, disabling, and frequent complication following intra-articular calcaneal fractures (IACFs). Using plain radiographs to assess the subtalar joint for PTOA is imprecise and insensitive, hindering progress toward improving treatment and assessing outcomes. This study explored how low-dose weightbearing computed tomography (WBCT) can be used to provide reliable, quantitative 3D measures of subtalar joint space width (JSW) following IACF and correlated the 3D JSW with clinical outcomes. Read More

Surgeon 2020 Jul 6. Epub 2020 Jul 6.

Department of Trauma and Orthopaedics, Raigmore Hospital, Old Perth Road, Inverness, IV2 3UJ, Scotland, UK.

Background: NHS Highland covers a wide geographical region encompassing the Isle of Skye, and Ben Nevis. Tourism is a significant contributor to the local economy and in 2017 the Highlands welcomed 534,000 visitors. Health services across the region treat tourists in addition to the local population. Read More

Int Orthop 2020 Jul 8. Epub 2020 Jul 8.

II Clinic of Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Purpose: An unsatisfactory reduction and internal fixation of an ankle fracture can result in an alteration of the anatomical axes and distribution of the load on the ankle, with consequent development of chronic pain and articular degeneration. The aim of this study is to evaluate the results of the articular re-balancing with realignment and lengthening of the fibula in case of malunited distal fibular fractures.

Methods: A review of prospectively collected data was performed for all patients with a diagnosis of malunion of the fibula and underwent ankle joint re-balancing with fibular lengthening. Read More

Foot Ankle Int 2020 Jul 8:1071100720935034. Epub 2020 Jul 8.

Hospital for Special Surgery, New York, NY, USA.

Background: Lesser toe metatarsophalangeal (MTP) joint pathology presents a challenge for surgical treatment. At our institution, arthroplasty using a polyvinyl alcohol (PVA) hydrogel implant has been utilized in the second and third MTP joints for advanced arthritis, failed management of Freiberg's infraction, and osteochondral defects. We present a case series describing the clinical outcomes of 13 patients following PVA implantation of the second or third MTP. Read More

Trauma Case Rep 2020 Aug 27;28:100322. Epub 2020 Jun 27.

Department of Orthopaedics Surgery and Traumatology, Complejo Hospitalario Universitario de Albacete, Spain.

An irreducible ankle-fracture dislocation in which the proximal fibular shaft fragment locks behind the posterior tibial tubercle is defined as "The Bosworth injury". Characteristically, this fracture is generally not reducible using closed methods. A high number of attempts can be counterproductive to get a good final functional result and it may also lead to the appearance of future complications. Read More

Foot Ankle Int 2020 Jul 7:1071100720924379. Epub 2020 Jul 7.

Department of Orthopaedic Surgery, University of South Carolina, Columbia, SC, USA.

Level V, expert opinion. Read More

BMC Musculoskelet Disord 2020 Jul 4;21(1):435. Epub 2020 Jul 4.

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Background: To aid design of exercise trials for people with pelvic and lower limb fragility fractures a systematic review was conducted to identify what types of exercise interventions and mobility outcomes have been assessed, investigate intervention reporting quality, and evaluate risk of bias in published trials.

Methods: Systematic searches of electronic databases (CENTRAL, MEDLINE, EMBASE, PEDro) 1996-2019 were conducted to identify randomised controlled trials of exercise for pelvic or lower limb fragility fractures. Two reviewers independently screened titles and abstracts. Read More

Foot Ankle Int 2020 Jul 2:1071100720937243. Epub 2020 Jul 2.

Midyat State Hospital, Mardin, Turkey.

Background: Osteochondral lesions of the talus (OCLTs) secondary to ankle fractures have previously been reported in the literature. However, no study has evaluated OCLTs using magnetic resonance imaging (MRI) following ankle fracture treatment. The purpose of our study was to investigate accompanying OCLTs in patients with an ankle fracture and evaluate its relationship with the clinical outcomes. Read More

Cancer Manag Res 2020 8;12:4299-4308. Epub 2020 Jun 8.

Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.

Aim: To evaluate the clinical effect of intercalary allograft transplantation and reconstruction in the treatment of diaphyseal defect after resection of lower extremity malignant bone tumor.

Methods: Clinical data of 17 patients diagnosed with malignant lower-limb bone tumors and having undergone segmental allograft reconstruction with a mean follow-up of 49.8 (26-78) months were included. Read More

J Orthop Sports Phys Ther 2020 Jul;50(7):410

A 20-year-old male military technician reported to a direct-access physical therapy clinic 1 week after falling off a skateboard. His primary complaint was left lateral ankle pain. Following examination, the physical therapist ordered ankle radiographs, which revealed a minimally displaced oblique trans-syndesmotic fibular fracture. Read More

J Bone Joint Surg Am 2020 Jun 25. Epub 2020 Jun 25.

Department of Trauma Surgery, Leiden University Medical Center, Leiden, the Netherlands.

Background: The clinical consequences of routine follow-up radiographs for patients with ankle fracture are unclear, and their usefulness is disputed. The purpose of the present study was to determine if routine radiographs made at weeks 6 and 12 can be omitted without compromising clinical outcomes.

Methods: This multicenter randomized controlled trial with a noninferiority design included 246 patients with an ankle fracture, 153 (62%) of whom received operative treatment. Read More

J Foot Ankle Surg 2020 Jun 26. Epub 2020 Jun 26.

Assistant Professor in Surgery, Department of Surgery, Harvard Medical School, Boston, MA; Chief, Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Cambridge, MA.

The gold standard for management of end-stage ankle arthritis was previously ankle arthrodesis; however, improvements in total ankle replacements are making this a more viable treatment option. The primary aim of this meta-analysis was to evaluate the survivorship of total ankle replacement implants currently in use. An extensive search strategy initially captured 20,842 citations that were evaluated for relevance. Read More

J Foot Ankle Surg 2020 Jul - Aug;59(4):664-672

Professor, Sports Innovation and Technology Centre (SITC), Institute of Human Centered Engineering (iHumEn), Universiti Teknologi Malaysia, Johor, Malaysia.

Osteoporosis and osteoarthritis are common pathological problems of the human bone tissue. There are some cases of pilon fractures associated with these 2 pathological conditions. In terms of treatment, for a normal and healthy bone with pilon fracture, the use of the Delta external fixator is a favorable option because it can allow early mobilization for patients and provide stability for the healing process. Read More

J Foot Ankle Surg 2020 Jul - Aug;59(4):653-656

Professor, Department of Orthopedic Surgery, The University of Texas Southwestern Medical Center, Dallas, TX.

The aim of this study was to evaluate the frequency of complications after an ankle fracture in patients with and without diabetes and to evaluate risk factors for nonunion. We conducted a retrospective study of 439 patients with ankle fractures (31.7% had diabetes) and followed them for 1 year or until the fracture healed. Read More

J Foot Ankle Surg 2020 Jul - Aug;59(4):648-652

Professor, Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing, China.

This study retrospectively evaluated patients with ankle fracture to compare the prognosis between patients who had primary repair of the superficial deltoid ligament and those who did not. A total of 71 patients with ankle fracture and fracture-dislocation combined with deltoid ligament injury were divided into 2 groups: repair of superficial layer group (33 cases) and nonrepair group (38 cases). For the repair group, patients first underwent open reduction and internal fixation of the lateral malleolus and received a stress test. Read More

Ter Arkh 2020 Jun 5;92(5):69-77. Epub 2020 Jun 5.

Nasonova Research Institute of Rheumatology.

Aim: Evaluate the frequency, nature and course of PTP, as well as the effectiveness and safety of NSAIDs in PTP in real clinical practice.

Materials And Methods: The assessment of the condition and need for NSAIDs (original meloxicam) in 1115 outpatient patients who suffered a fracture of the radius (32.2%), injury to the knee (35. Read More

Foot Ankle Surg 2020 Jun 18. Epub 2020 Jun 18.

Department of orthopaedic surgery, the 3rd Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, PR China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, Hebei, PR China; Orthopaedic Institution of Hebei Province, Shijiazhuang 050051, Hebei, PR China. Electronic address:

Backgrounds: Deep vein thrombosis (DVT) occurring during the preoperative waiting period may affect the prognosis of traumatic patients, but there still lack of relevant data. This study aimed to address the preoperative DVT in isolated calcaneal fractures.

Methods: Patients who presented with isolated calcaneal fracture and received preoperative Duplex ultrasound scanning of bilateral lower extremities for detection of DVT between October and December 2018 were eligible for inclusion. Read More

BMC Musculoskelet Disord 2020 Jun 27;21(1):407. Epub 2020 Jun 27.

Department of Orthopedics, Xiangya Hospital Central South University, No.87 Xiangya Road, Changsha, 410008, Hunan, China.

Background: Traditional methods for minimally invasive internal fixation (MIIF) of calcaneal fractures require extensive intraoperative fluoroscopy, and fracture recovery is usually not ideal. We developed a new surgical procedure using digital surgical simulation and constructed a patient-specific instrument (PSI) for calcaneal fracture that we used during the operation. This study investigated whether PSI-assisted MIIF of calcaneal fracture enables rapid and accurate execution of the preoperative plan. Read More

Aerosp Med Hum Perform 2020 Jul;91(7):597-603

A total ankle replacement in a jet pilot after an open, high-energy foot and ankle fracture and dislocation with talar extrusion in a plane crash was carefully evaluated before considering fitness to fly. A 33-yr-old male test pilot of the Italian Air Force was involved in a plane crash and reported an open high-energy fracture/dislocation of the right ankle, with the expulsion of the right talus due to the impact, and other fractures. A titanium replica was inserted inside the ankle. Read More

Medicine (Baltimore) 2020 Jun;99(26):e20862

Department of Orthopedic Surgery, China Medical University Hospital.

Rationale: Talar fracture accompanied with malleolar fracture is rare, and its management is complex. Ankle soft tissue is much thinner than other parts of the human body, and the shape of the ankle makes wounds difficult to close immediately after surgery, which may result in poor skin condition if the wound tension is too high. However, joint congruity and osteonecrosis are the main concerns of talar fracture. Read More

Orthopade 2020 Jun 25. Epub 2020 Jun 25.

Klinik für Allgemeine Orthopädie und Tumororthopädie, Universitätsklinikum Münster, Albert-Schweitzer Campus 1, 48149, Münster, Deutschland.

The tenosynovial giant cell tumor is a rare disease of the joint mucosa, tendon sheaths and bursa. We report on the rare constellation of an intraosseous manifestation of the proximal tibia of a lower leg stump after Burgess amputation as a result of a locally uncontrollable tenosynovial giant cell tumor of the upper ankle. The curettage of the local findings and operative stabilization through an intramedullary composite osteosynthesis led to an early rehabilitation of the exoprosthesis care with regaining patient autonomy. Read More

J Foot Ankle Surg 2020 Jun 22. Epub 2020 Jun 22.

Consultant, Hand and Reconstructive Microsurgery Unit, Careggi University Hospital, largo Palagi 2, Florence, Italy. Electronic address:

J Am Acad Orthop Surg 2020 Jun 15. Epub 2020 Jun 15.

From the Department of Orthopaedics and Physical Medicine, the Medical University of South Carolina, Charleston, SC (Dr. Traven, Dr. Brinton, Dr. Woolf, Dr. Leddy, Dr. Slone), and the Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA (Dr. Gottschalk).

Introduction: The purpose of this study was to evaluate nationwide trends and regional variability in opioid prescriptions after common orthopaedic procedures.

Methods: A retrospective analysis of privately insured subjects from the MarketScan database between 2015 and 2016 was conducted. Median oral morphine equivalents and interquartile ranges were analyzed by region for the initial post-op prescriptions and 90-day total prescriptions for opioid-naive patients undergoing the following: carpal tunnel release; anterior cruciate ligament reconstruction; arthroscopic meniscectomy; bimalleolar ankle fracture open reduction and internal fixation; distal radius fracture open reduction and internal fixation; arthroscopic rotator cuff repair; single-level anterior cervical discectomy and fusion; and total shoulder, hip, and knee arthroplasties. Read More

Int Orthop 2020 Jun 20. Epub 2020 Jun 20.

Joint Replacement Department, IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161, Milan, Italy.

Purpose: We asked whether the clinical and radiographic outcomes and survivorship after unicompartmental knee arthroplasty (UKA) for osteoarthritis (OA) consequent to lateral tibial plateau fracture were comparable with those obtained after lateral UKA for primary OA.

Methods: A total of 13 patients receiving lateral UKA for OA secondary to tibial plateau fracture (post-traumatic UKA, P-UKA) were compared with 13 patients who underwent lateral UKA for primary OA (OA-UKA). Patients were matched for age at surgery, gender, body mass index, and follow-up length. Read More

Eur J Trauma Emerg Surg 2020 Jun 19. Epub 2020 Jun 19.

Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Avulsion of the Lisfranc ligament, fleck sign, results in unstable Lisfranc injuries. This cross-sectional study was conducted to investigate the characteristics of Lisfranc injuries with fleck sign and the clinical and radiological outcomes following closed reduction and percutaneous screw fixation.

Methods: All consecutive operatively managed Lisfranc injuries with fleck sign were reviewed from 2016 to 2018. Read More

Skeletal Radiol 2020 Jun 18. Epub 2020 Jun 18.

Department of Radiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.

Objective: To compare fracture detection, image quality, and radiation dose in patients with distal extremity fractures using 3D tomography and computed tomography (CT).

Materials And Methods: IRB approval was obtained including informed consent for this prospective study from June to December 2016. Patients diagnosed with an acute fracture at CT were consecutively scanned on the same day using 3D tomography. Read More

J Clin Endocrinol Metab 2020 Jun 18. Epub 2020 Jun 18.

Robert and Arlene Kogod Center on Aging and Division of Endocrinology, Mayo Clinic College of Medicine, Rochester, MN, USA.

Context: Reduced bone material strength index (BMSi) and increased cortical porosity (CtPo) have emerged as potentially contributing to fracture risk in type 2 diabetes mellitus (T2DM) patients.

Objective: Determine whether BMSi or CtPo are related to other diabetic complications.

Design: Cross-sectional observational study. Read More

J Am Podiatr Med Assoc 2020 Mar;110(2)

St. Joseph Medical Center, Houston, TX.

Natural disasters, such as hurricanes and severe flooding, pose a threat of increased skin and soft-tissue infections, especially in the event of open fractures and wading through the waters. The purpose of this case study is to present a complex patient sustaining trauma resulting in an open bimalleolar fracture, multiple wounds, and exposure to a variety of water-borne pathogens during Hurricane Harvey in Houston, Texas, in 2017. He underwent multiple incision and drainage procedures, tissue cultures, and placement of antibiotic beads, with an application of external fixation to the left ankle. Read More

Rev Col Bras Cir 2020 15;47:e20202508. Epub 2020 Jun 15.

Universidade Federal do Rio de Janeiro (UFRJ), Departamento de Radiologia - Rio de Janeiro - RJ - Brasil.

Our objective is to describe the technique of intramedullary (IM) nailing of lateral malleolus in the surgical management of ankle fractures. Fracture reduction is performed either percutaneously with a small pointed reduction clamp in simple oblique fractures or using longitudinal traction and rotation for comminuted fractures, thus reducing complications related to open reduction and internal fixation with a plate. The technique has been shown to be simple and reproducible. Read More

Biomed Pharmacother 2020 Aug 15;128:110295. Epub 2020 Jun 15.

Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.

Background: The treatment of displaced calcaneal fractures is controversial.Open reduction and internal fixation are widely described as the gold standard in the literature,but these technique shave many complications,including skin necrosis,internal fixation leakage and deep infection and wound healing problems.Percutaneous reduction and unilateral external fixation have received increasing attention because they can provide a good, stable reduction and reduce the soft tissue complications caused by open surgery(such as deep infection and delayed wound healing). Read More

Foot Ankle Spec 2020 Jun 19:1938640020932049. Epub 2020 Jun 19.

Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, Boston, Massachusetts (IOI).

Background: The majority of retained syndesmotic screws will either loosen or break once the patient resumes weight-bearing. While evidence is limited, anecdotal experience suggests that intraosseous screw breakage may be problematic for some patients due to painful bony erosion. This study seeks to identify the incidence of intraosseous screw breakage, variables that may predict intraosseous screw breakage, and whether intraosseous screw breakage is associated with higher rates of implant removal secondary to pain. 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

J Orthop Case Rep 2020 ;9(6):19-22

Department of Orthopaedic Surgery, Sir J.J. Group of Hospitals and Grant Medical College, Mumbai, Maharashtra, India.

Introduction: Fibrous Dysplasia is a relatively rare Musculoskeletal disorders in which there is a defect in remodelling of immature bone to mature lamellar bone. Fibrous Dysplasia was first described by Von Recklinghausen in 1891, but it was Lichtenstein who labelled it polyostotic Fibrous Dysplasia in 1938. Union of Pathological Fractures in a bone affected by Fibrous Dysplasia poses a difficult set of Challenges for treating Physicians. 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

Acta Orthop Traumatol Turc 2020 May;54(3):262-268

Department of Orthopaedics and Traumatology, Ortopediatri Academy of Pediatric Otrhopaedics, İstanbul, Turkey.

Objective: The aim of this study was to analyze the results of the split anterior tibialis tendon transfer (SPLATT) to peroneus tertius (PT) for equinovarus foot deformity in children with cerebral palsy (CP).

Methods: The medical records of 25 ambulatory CP patients (mean age: 8.7±3. Read More

J Orthop Surg (Hong Kong) 2020 Jan-Apr;28(2):2309499020926282

Seoul Medical Center, Seoul, Republic of Korea.

Objective: Recurrent fifth metatarsal base stress fractures (MT5-BSF) in athletes present a challenging problem. The aim of this study was to evaluate the result of conservative treatment for the refracture of MT5-BSF after modified tension band wiring (MTBW).

Materials And Methods: The outcomes of 15 elite athletes undergoing conservative treatment for refracture of MT5-BSF after MTBW were retrospectively reviewed. Read More

Clin Hemorheol Microcirc 2020 Jun 8. Epub 2020 Jun 8.

Third Hospital of Hebei Medical University, Shijiazhaung, China.

Purpose: The purpose of this study was (1) to compare the effects of ankle pump exercise(APE) frequency on hemodynamics of the common femoral vein(CFV) and (2) to analyse the relationship between APE duration and lower limb fatigue.

Methods: Twenty-seven males and thirty-three females performed APE. Among them, there were thirty participants with non-lower limb fracture (N-LLF) and thirty participants with lower limb fracture (LLF). 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

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Jun;34(6):730-736

Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.

Objective: To investigate the safety, feasibility, and efficacy of full repair strategy under small incision in the treatment of closed Lauge-Hansen pronation-external rotation type Ⅳ ankle fracture.

Methods: The clinical data of 57 patients with closed Lauge-Hansen pronation-external rotation type Ⅳ ankle fracture treated by full repair strategy (fracture, ligament, and cartilage repair) under small incision between January 2012 and January 2017 were retrospectively analyzed. There were 31 males and 26 females, with an average age of 41. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Jun;34(6):696-701

Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Jiangsu, 221002, P.R.China.

Objective: To evaluate the effect of the surgeon's handedness on the distribution of prosthesis during primary total knee arthroplasty (TKA).

Methods: A retrospective analysis was performed on 86 patients (100 knees) with primary TKA completed by the same right-handed surgeon between December 2016 and December 2018, including 72 cases of single knee and 14 of bilateral knees. The patients were divided into dominant group (right side) and non-dominant group (left side) according to the operating position of the surgeon and each group had 50 knees. Read More

J Surg Educ 2020 Jun 11. Epub 2020 Jun 11.

Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York.

Background: Simulation-based education and objective evaluation of surgical skill have been incorporated into many surgical training programs. We describe the development and implementation of a timed, multitask, station-based Surgical Games to evaluate orthopedic resident surgical skills.

Methods: Participants in the study were postgraduate-year 2 to 5 orthopedic surgery residents from a single institution. Read More

J Orthop Surg (Hong Kong) 2020 Jan-Apr;28(2):2309499020930305

Department of Traumatic Orthopedics, Ningbo No. 6 Hospital, Ningbo, Zhejiang, People's Republic of China.

Purpose: The purpose of this study was to clinically compare the single-incision and dual-incision approaches for the treatment of distal tibial and fibular fractures.

Methods: In total, 93 patients were enrolled, and the mean follow-up was 15 months (range 12-19 months). The patients treated for open reduction and internal fixation were randomly classified into two groups based on the approach used: 45 patients were treated using the single-incision approach (group 1) and 48 patients were treated using the dual-incision approach (group 2). Read More

Injury 2020 Jun 2. Epub 2020 Jun 2.

Study performed at MetroHealth Medical Center, Cleveland, Ohio, affiliated with Case Western Reserve University. Electronic address:

Background: Obesity is a growing public health concern. While diabetes mellitus is associated with obesity and is a risk for infection and other complications, effects of obesity on outcomes remains less clear. The purpose was to determine effect of obesity on complications, secondary operations, and functional outcomes after surgical treatment of ankle fracture. Read More

J Shoulder Elbow Surg 2020 Jun 10. Epub 2020 Jun 10.

Shoulder and Elbow Unit, Traumatology and Orthopaedic Surgery Department, Universitat Autónoma de Barcelona, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain.

Background: The global spread of the 2019 novel coronavirus (COVID-19) has profoundly affected the way we conduct our healthcare practices. The goal of this paper is to report the outcomes of 11 patients who underwent humeral fracture surgery in the first few weeks of the COVID-19 outbreak in Spain.

Methods: This was a retrospective case series of 11 patients who underwent humeral fracture surgery during the first weeks of the COVID-19 outbreak in Spain, between 10 March and 25 April 2020. Read More

Rev Clin Esp 2020 Jun 9. Epub 2020 Jun 9.

Universidad Francisco de Vitoria, Departamento de Medicina Interna, Hospital Asepeyo Coslada, Madrid, España. Electronic address:

Thromboembolism prophylaxis is well-established in major orthopaedic surgery (hip and knee arthroplasty and hip fracture surgery), with low-molecular-weight heparins the most often chosen agent. In recent years, however, direct-acting anticoagulants have been gaining ground and can be used in this scenario (except for hip fracture surgery). In the US, even aspirin could be indicated for low-risk patients who undergo hip or knee arthroplasty. Read More

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

Director, Podiatric Foot and Ankle Residency, Beaumont Hospital Wayne, Wayne, MI.

Bone is a dynamic tissue constantly adapting to meet the demands of the body. There is extensive evidence of primary bone tumors causing remodeling but rarely does a soft-tissue tumor become encompassed in bone. This reaction is seen through a combination of increased stress and the increased activity of basic multicellular units. Read More

Clin Rehabil 2020 Jun 11:269215520929727. Epub 2020 Jun 11.

Department of Orthopaedic, Oslo University Hospital, Oslo, Norway.

Objective: To compare the functional outcomes and length of hospital stay for patients treated with conventional physiotherapy compared to a new ankle trainer device after Weber B ankle fractures.

Design: The patients were randomized, and then followed up at 3, 6, 12 and 52 weeks by a blinded physiotherapist.

Setting: This study was done at a level 1 trauma centre. Read More

Eur J Orthop Surg Traumatol 2020 Jun 9. Epub 2020 Jun 9.

Addenbrooke's Hospital, Hills Road, Cambridge, UK.

Aim: The aim of this study was to investigate the financial implications of the inpatient management of open lower limb fractures in adults over 65 years old. Further, the study compares the calculated cost to the income received by the hospital for these patients and to the existing body of literature.

Methods: This study employed direct inpatient costing analysis to estimate the cost of treating the open lower limb fractures incurred by 58 patients over the age of 65 years treated in our centre (Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust) between March 2014 and March 2019. Read More