Search Our Scientific Publications & Authors

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

Arch Orthop Trauma Surg 2021 Feb 16. Epub 2021 Feb 16.

Department of Orthopaedics, General Hospital of Central Theater Command (Wuhan General Hospital of Guangzhou Command, previously), Hubei, No. 627, Wuluo Road, Wuhan, 430030, People's Republic of China.

Introduction: Recently, endoscopically assisted Achilles tendon repair techniques have improved to overcome the surgical complications. However, the risk of sural nerve injury and the strength of repair are still the most concerning aspects.

Material And Methods: Twenty three patients with acute Achilles tendon rupture were reviewed in the present study. Read More

HSS J 2020 Dec 22;16(Suppl 2):238-244. Epub 2019 Jul 22.

Orthopaedic Trauma Service, Weill Cornell Medical College, 525 East 68th Street, New York, NY 10065 USA.

Background: The optimal method for the determination of ankle stability remains controversial in rotational ankle fractures without medial bony injury.

Questions/purposes: The purposes of this study were to (1) evaluate whether posterior malleolar (PM) fracture displacement is associated with deltoid ligament injury in supination-external rotation (SER) ankle fractures and (2) compare the diagnostic accuracy of PM displacement and magnetic resonance imaging (MRI) evaluation of the deep deltoid ligament in identifying fractures with deltoid ligament incompetence.

Methods: Patients with rotational bimalleolar injuries containing lateral malleolar and PM fractures without bony medial injury were included. Read More

J Surg Educ 2021 Mar-Apr;78(2):694-709. Epub 2020 Sep 1.

Department of Orthopaedics and Rehabilitation, School of Medicine, Oregon Health & Sciences University School of Medicine, Portland, Oregon.

Objective: While orthopedic residency training varies among programs, an inevitable phenomenon is a transition for interns from consistent oversight to independent call with indirect supervision. It is therefore crucial to reliably assess trainees' ability to perform basic procedures. The objective of the study was to evaluate the utility of a novel Orthopaedic Intern Skills Assessment (OISA) to assess skill level. Read More

Foot Ankle Spec 2020 Jul 20:1938640020940837. Epub 2020 Jul 20.

Baylor University Medical Center, Dallas, Texas.

The purpose of this study was to investigate social media posts regarding pilon fractures and its relationship to patient injury perception. We evaluated Instagram media posts in patients who have suffered pilon fractures for the following variables: gender, tone, discussion of rehabilitation, activities of daily living (ADL) reference, incision/scar reference, pain, post of radiograph/imaging, external fixation reference, discussion of bracing/splinting, pre- or postoperative swelling, and need for reoperation. Results were determined by comparing each variable to gender and tone of the post to study patient injury perception. Read More

Arch Orthop Trauma Surg 2020 Aug 25;140(8):1133-1141. Epub 2020 May 25.

St Andrews Centre for Plastic Surgery, Broomfield Hospital, Chelmsford, CM1 7ET, UK.

Introduction: Fracture-dislocation and pilon injuries of the proximal interphalangeal joints (PIPJ) continue to pose significant management challenges. Stable fracture configurations can be treated with extension block splinting or pinning. Unstable fractures usually require open or closed reduction and fixation either directly/internally onto the fracture using Kirschner wires, cerclage wires, screws or miniplates or indirectly/externally by ligamentotaxis using external fixators which can be dynamic or static. Read More

J Orthop Trauma 2020 Feb;34 Suppl 1:S1-S8

Division of Orthopedic Surgery, University of Texas Health Science Center at Dallas, Dallas, Texas 75235.

We reviewed thirty-eight cases of open ankle fractures that had been treated with a standard protocol: alignment and splinting of the fracture at the scene of injury if possible, antibiotics administered in the emergency room and continued for forty-eight hours, admission of the patient to the operating room as quickly as possible, copious irrigation and thorough debridement of the wound, immediate rigid anatomical internal fixation, and delayed primary closure at five days. All of the fractures united, but three patients required subsequent ankle fusion because of cartilage damage noted at the initial operation. Of the thirty-five ankles with complete follow-up, the functional result was excellent in twenty-six and fair or poor in nine. Read More

Foot Ankle Int 2020 02 9;41(2):177-182. Epub 2019 Oct 9.

Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Kaufmann Medical Building, Pittsburgh, PA, USA.

Background: Closed reduction and splinting followed by outpatient management is standard of care for temporizing most ankle fractures. However, ankle fracture-dislocation potentially warrants a different approach based on the propensity for loss of reduction. The purpose of this study was to determine the rate of complications associated with closed reduction and splinting of unstable ankle fracture-dislocations. Read More

J Foot Ankle Res 2019 10;12:47. Epub 2019 Sep 10.

3Sport and orthopedic center, Samitivej hospital and Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand.

Background: Fractures of the metatarsal bones account for 35% of all foot fractures. Conservative management of fractures proximal to the metaphyseal-diaphyseal junction of the fifth metatarsal bone (pseudo-Jones) is by protected weight bearing. The methods of protected weight bearing include short-leg casting and splinting (boot cast, Jones's bandage and elastic bandage). Read More

J Burn Care Res 2020 05;41(3):466-471

Division of Plastic Surgery, Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan.

Dorsal foot burns in children often result in contractures with hyperextension of the toes and secondary gait disturbances. Skin grafting a wound bed after contracture release can result in early recurrence. Adequate contracture release often requires tenolysis and/or joint releases that may be prohibitive of skin grafting and require flap coverage. Read More

FP Essent 2019 Jul;482:23-26

Uniformed Services University Department of Family Medicine, 4301 Jones Bridge Road A1038, Bethesda, MD 20814-4799.

Family physicians commonly treat athletes with simple fractures and other musculoskeletal injuries that require temporary immobilization. Certain fractures (eg, intraarticular, multiple, open, associated with dislocations or tendon injury) typically are managed by orthopedic subspecialists. During the healing process, a custom-molded or prefabricated orthopedic support, known as an orthosis, may be used to support the injured area and prevent reinjury. Read More

Clin Rehabil 2019 Jun 27;33(6):1035-1044. Epub 2019 Feb 27.

Brain Injury Unit, Royal Rehab, Sydney, NSW, Australia.

Objective: To determine the effectiveness of a programme comprising serial casting, botulinum toxin, splinting and motor training in contracture management.

Design: A randomized trial with concealed allocation and assessor blinding, a deferred treatment cross-over design within the control group, was conducted.

Setting: Inpatient Brain Injury Unit of a rehabilitation centre. Read More

Foot Ankle Surg 2020 Feb 21;26(2):146-150. Epub 2019 Jan 21.

Department for Foot and Ankle Surgery, Clinic for Orthopedics, Hannover Medical School, Anna-von-Borries Strasse 1-7, 30625, Hannover, Germany.

Background Hallux valgus is a common diagnosis in orthopedics. Only a few studies have analyzed the effects of conservative therapy. Therefore, the current study analyzed the effect of a dynamic hallux valgus splint. Read More

J Orthop Trauma 2019 Jan;33(1):e31-e35

Department of Orthopaedics, University of Cincinnati, Cincinnati, OH.

Techniques for single-provider reductions are valuable methods for provisional stabilization of fractures. In the setting of a lower extremity fracture, these techniques often use stockinette or kerlex to suspend an extremity while a reduction maneuver is performed, cast padding is applied, and a plaster splint is placed with subsequent molding to maintain reduction. Obtaining and maintaining a suitable amount of tension to the soft material while securing the limb to the stretcher or hospital bed continues to make these reduction maneuvers difficult to perform. Read More

J Fam Pract 2018 11;67(11):678-683

Department of Family Medicine, Uniformed Services University of Health Sciences, Bethesda, MD, USA.

Which devices do-and don't-have evidence to support their use when it comes to injuries like carpal tunnel syndrome, "tennis elbow," or an ankle sprain? Read on. Read More

J Foot Ankle Surg 2019 Jan 9;58(1):161-164. Epub 2018 Oct 9.

Orthopedic Surgeon, Tripler Army Medical Center, Honolulu, HI.

The purpose of this study was to determine if clinical palpation and ultrasound determination of apposition compares with magnetic resonance imaging (MRI) findings in patients with an acute Achilles tendon rupture. A review of 18 consecutive patients presenting with an acute Achilles tendon tear was performed. All tears were diagnosed by clinical exam and confirmed by ultrasound. Read More

Foot (Edinb) 2018 Sep 20;36:10-14. Epub 2018 Sep 20.

Orthopaedic Department, University Hospitals of Leicester, Gwendolen Rd., Leicester LE5 4PW, United Kingdom.

Background: Should pre-manipulation radiographs be obtained in ankle fracture-dislocations? This question remains controversial. The twelfth British Orthopaedic Association Standard for Trauma (BOAST-12) published in August 2016 states that 'Reduction and splinting should be performed urgently for clinically deformed ankles. Radiographs should be obtained before reduction unless this will cause an unacceptable delay'. Read More

Indian J Orthop 2018 May-Jun;52(3):258-268

Department of Orthopaedics, Ganga Hospital, Coimbatore, Tamil Nadu, India.

Fractures of talar body are uncommon injuries often associated with fractures of other long bones and in polytraumatized patients. The integrity of the talus is essential for the normal function of the ankle, subtalar, and midtarsal joints. The relative infrequency of this injury limits the number of studies available to guide treatment. Read More

Foot Ankle Int 2018 10 2;39(10):1162-1168. Epub 2018 Jun 2.

2 Department of Orthopaedic Surgery, Regions Hospital, Saint Paul, MN, USA.

Background: Initial treatment for a displaced ankle fracture is closed reduction and splinting. This is typically performed in conjunction with either an intra-articular hematoma block (IAHB) or procedural sedation (PS) to assist with pain control. The purpose of this study was to compare the safety of IAHB to PS and evaluate the efficiency and efficacy for each method. Read More

Physiother Can 2018 ;70(2):152-159

Brain Injury Unit, Royal Rehab, Ryde, N.S.W., Australia.

Serial casting for ankle contractures is traditionally performed in prone, a position that patients may not easily tolerate. Also, although serial casting is effective in correcting contracture, its effect dissipates quickly. This case report describes a procedure for performing casting for ankle contractures in a supine or sitting position. Read More

Foot Ankle Spec 2019 Feb 8;12(1):16-24. Epub 2018 Jan 8.

Department of Orthopedic Surgery, NewYork Presbyterian/Columbia University Medical Center, New York, New York.

Background: Substantial progress has been made in characterizing the benefit of early functional rehabilitation following Achilles tendon repair (ATR). However, standardized ATR rehabilitation guidelines have yet to be produced. Furthermore, as patients increasingly use the Internet to independently retrieve health care content, access to standardized, clinically effective rehabilitation protocols is necessary. Read More

J Orthop Surg (Hong Kong) 2016 12;24(3):354-357

Departments of Orthopedic Surgery, Kyung Hee University Hospital, School of Medicine, Kyung Hee University, Korea.

Purposes: To review the outcome of Z-plasty of the flexor hallucis longus (FHL) tendon at the tarsal tunnel for checkrein deformity in 8 patients.

Methods: Records of 6 males and 2 females aged 14 to 67 (mean, 39.5) years who underwent Z-plasty (lengthening) of the FHL tendon at the tarsal tunnel for checkrein deformity in the first and second toes by a single surgeon were reviewed. Read More

Pediatr Phys Ther 2017 01;29(1):90-94

Arkansas Children's Hospital, Little Rock.

Purpose: The presence of hypertrophic scars, which cross lower extremity joints, can often result in decreased range of motion, limitations in functional mobility, and gait deviations. This article reviews a case and describes a multimodal treatment approach.

Summary Of Key Points: A 6-year-old girl developed aggressive hypertrophic scars following a burn injury. Read More

MedEdPORTAL 2016 Dec 7;12:10514. Epub 2016 Dec 7.

Assistant Professor, Department of Orthopaedic Surgery, Wake Forest University School of Medicine of Medicine of Wake Forest Baptist Medical Center; the Assistant Director of Orthopaedic Trauma, Wake Forest University School of Medicine of Medicine of Wake Forest Baptist Medical Center.

Introduction: Musculoskeletal (MSK) complaints comprise approximately 20% of primary care and emergency department visits annually in the United States. At the same time, there is a shortage of MSK specialists specifically trained to evaluate and treat these conditions. Improper management of patients with MSK diagnoses increases morbidity and undesirable outcomes for patients and leads to higher health care costs resulting from extraneous tests and imaging. Read More

J Emerg Med 2017 Jan 19;52(1):28-33. Epub 2016 Sep 19.

Bronson Orthopedic Trauma, Kalamazoo, Michigan.

Background: Calcaneal fractures are commonly seen and treated in the emergency department. There are subsets of calcaneal fractures that pose a high risk to the adjacent soft tissue of the heel and can result in full-thickness tissue necrosis.

Objective: To identify which calcaneal fractures need to be managed within hours and triaged to the orthopedic team and which can be temporized in a neutral or plantarflexed ankle splint and seen in an outpatient setting. Read More

Eur J Trauma Emerg Surg 2016 Dec 23;42(6):695-700. Epub 2016 Jul 23.

Division of Orthopaedic Trauma, Department of Orthopaedics, Alpert Medical School at Brown University, Providence, RI, USA.

Purpose: Fractures of the lower extremity, particularly of the femur and acetabulum, may be difficult to immobilize with splinting alone. These injuries may be best stabilized with the application of various types of skeletal traction. Often, traction is applied percutaneously in an emergent setting, making the knowledge of both superficial and deep anatomy crucial to successful placement. Read More

Z Orthop Unfall 2016 Dec 7;154(6):612-617. Epub 2016 Jul 7.

Unfallchirurgie und Orthopädische Chirurgie, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main.

Protracted dislocation of the upper ankle joint can lead to substantial damage to the surrounding soft tissue, possibly followed by local complications and longer hospitalisation. Although reposition is usually easy to conduct, it is commonly recommended that this should only be performed by an experienced specialist, as long as there is no neurovascular restriction. There are however no exact data or studies on this problem. Read More