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Eur J Orthop Surg Traumatol 2022 Jun 6. Epub 2022 Jun 6.

Department of Anaesthesia, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia.

Background: Ankle fracture is a common injury that is treated at Addis Ababa Burn, Emergency, and Trauma Hospital. Previous studies show that there are mixed functional outcomes after surgically treated ankle fractures.

Methods: After Ethical clearance was obtained from the ethical review committee of St. Read More

Prim Care 2022 Mar 5;49(1):145-161. Epub 2022 Jan 5.

Department of Family Medicine, Offutt AFB/UNMC Family Medicine Residency Program, University of Nebraska Medical Center College of Medicine, 983075 Nebraska Medical Center, Omaha, NE 68198-3075, USA.

Primary care physicians are often the first to evaluate patients with extremity injuries. Identification of fractures and sprains and their proper management is paramount. After appropriate imaging is obtained, immobilization and determination of definitive management, either nonoperative or operative, is critical. Read More

J Sport Rehabil 2022 05 4;31(4):490-494. Epub 2022 Feb 4.

Context: Plantar heel pain is a common problem affecting foot function, causing pain in the foot under the heel. Plantar fasciitis is commonly treated with conservative treatment, such as joint and soft tissue mobilization, self-stretching home programs, foot orthoses, and night splinting or booting. Dry needling (DN) has shown to be an effective method of treating plantar fasciitis (PF) in multiple randomized control trials. Read More

J Burn Care Res 2022 May;43(3):640-645

Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

Burn scar contracture (BSC) is a common pathological outcome following burn injuries, leading to limitations in range of motion (ROM) of affected joints and impairment in function. Despite a paucity of research addressing its efficacy, static splinting of affected joints is a common preventative practice. A survey of therapists performed 25 years ago showed a widely divergent practice of splinting during the acute burn injury. Read More

Ann Plast Surg 2021 09;87(3):253-259

From the Department of Plastic and Reconstructive Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.

Background: Although external circular frame (ECF) has been widely used for the correction of knee and ankle deformities, few studies reported the use of ECF for the treatment of severe postburn elbow contracture and stiffness (SPECS). The purpose of this retrospective study was to investigate the effectiveness and safety of the distraction using ECF in treating SPECS.

Methods: After institutional review board approval, we implemented a retrospective single-center case series study composed of consecutive patients treated for SPECS at Chinese PLA General Hospital between January 2010 and January 2018. Read More

Int Orthop 2021 12 13;45(12):3243-3251. Epub 2021 Aug 13.

Department of Orthopaedics, General Hospital of Central Theater Command (Wuhan General Hospital of Guangzhou Command, Previously), Wuhan, Hubei Province, People's Republic of China.

Purpose: Several kinds of minimally invasive surgical techniques are applied to acute Achilles tendon rupture. The risks of sural never injury and re-ruptures are still major issues. The purpose of this study was to compare the middle-term results of two different minimally invasive repair techniques for acute Achille tendon rupture. Read More

Wien Med Wochenschr 2021 Aug 12. Epub 2021 Aug 12.

Department of Physical Medicine and Rehabilitation, Orthopaedic Hospital Speising, Vienna, Austria.

Controversy still exists whether conservative treatment may be a useful option for the treatment of pediatric trigger thumbs. We reviewed a random sample patient cohort with regard to success rates depending on whether flexible or fixed trigger thumbs were present. We performed a pilot study of 13 children (15 thumbs), who received a standardized treatment protocol including a custom-made thermoplastic splint for use during sleeping hours for a minimum of 3 months. Read More

J Pediatr Orthop B 2022 Mar;31(2):e202-e207

Pediatric Orthopedics, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.

Forefoot adduction deformity (FAD) (commonly called metatarsus adductus) is reported as the most common congenital foot deformity in newborns. Early diagnosis and treatment are important in rigid cases, as better outcomes have been reported if treatment was initiated before 9 months of age. While casting and splinting is the current standard of care for nonsurgical management of rigid FAD (RFAD), several orthoses have demonstrated equal benefit. Read More

Foot Ankle Surg 2022 Feb 26;28(2):235-239. 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 Oct 16;141(10):1753-1760. 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 2022 Feb 20;15(1):43-49. 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

Foot Ankle Orthop 2020 Apr 11;5(2):2473011420916144. Epub 2020 May 11.

Tufts Medical Center, MA, USA.

Background: Austere fracture immobilization equipment and techniques are often overlooked, with few studies critically evaluating the process. The purpose of this study was to evaluate current austere splinting techniques and equipment used for lower extremity fractures while field testing a new 1-step spray-on foam splint.

Methods: This is a prospective analysis of austere splinting techniques. 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