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J Orthop Sports Phys Ther 2020 Jul;50(7):409

A 22-year-old male US Military Academy cadet fell while sidestepping across the 8-ft-high bar portion of the indoor obstacle course. The cadet, in immense pain, was unable to bear weight immediately after the fall. Following examination by physical therapists within the fitness center, emergency medical service personnel transported the cadet to the emergency department for definitive care. 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

Foot (Edinb) 2019 Oct 24;44:101644. Epub 2019 Oct 24.

Trauma Unit, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands. Electronic address:

Purpose: Avascular necrosis (AVN) after fractures of the talus is a distinct and challenging clinical entity that is associated with poor outcomes. Although several articles are published on the management of posttraumatic AVN of the talus, very little is known about the management of infected AVN after talus fractures. Therefore, three cases of infected AVN were treated successfully by extensive debridement, external fixation and arthrodesis. 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

Foot Ankle Int 2020 Jun 17:1071100720931095. Epub 2020 Jun 17.

Department of Orthopedics and Traumatology, LK Baden-Mödling, Baden, Austria.

Background: The anterocentral portal is not a standard portal in anterior ankle arthroscopy due to its proximity to the anterior neurovascular bundle. However, it provides certain advantages, including a wide field of vision, and portal changes become redundant. The purpose of this study was to evaluate the neurovascular complications after anterior ankle arthroscopy using the anterocentral portal. 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

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

BMC Surg 2020 Jun 9;20(1):125. Epub 2020 Jun 9.

Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900, Monza, Italy.

Background: In children, fracture non-union is uncommon yet, curiously, non-union of distal fibula fractures are rarely reported. Historically, the most common treatment of a lateral malleolus fracture after an ankle sprain is conservative, which usually leads to fracture union. However, even in clinically stable ankles, subsequent pain arising from fracture site could suggest non-union, thereby necessitating reexamination and possible secondary treatment. Read More

Zhongguo Gu Shang 2019 Oct;32(10):947-951

Sichuan Province Orthopaedics Hospital, Chengdu 610041, Sichuan, China.

Objective: To observe the clinical effect of calcaneus V-shape osteotomy for the subtalar joint preservation in the treatment of old calcaneal fractures.

Methods: A retrospective study was conducted on 18 patients (18 feet) with old calcaneal fractures treated by calcaneus V-shape osteotomy from March 2014 to November 2017. Included 13 males and 5 females, aged from 23 to 48 years old with an average of (34. Read More

Foot Ankle Spec 2020 Jun 2:1938640020921571. Epub 2020 Jun 2.

Department of Orthopaedic Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland (HCB, HB, JC-B, FK, MCA).

Static weightbearing radiography can be used to assess stability in ankle fractures by measuring lateral talar shift (medial clear space; MCS). However, the correlation of a stable ankle joint under weightbearing load and the structural integrity of the deltoid ligament has not been shown. In this study, we assessed deltoid ligament integrity on magnetic resonance imaging (MRI) and correlated that with weightbearing and gravity stress test radiography. 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

Foot Ankle Surg 2020 May 5. Epub 2020 May 5.

Professor of Medicine, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, 221009, PR China; Surgical Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, 221009, PR China. Electronic address:

Background: The main purpose of this study was to describe the all-inside arthroscopic technique for repairing anterior talofibular ligament (ATFL) avulsion fractures at the attachment points of the fibula and talus, and to evaluate the functional outcomes during long-term follow-up.

Methods: The data of 78 patients with ATFL avulsion fracture treated in our hospital from August 2013 to November 2016 were analyzed retrospectively. All patients underwent surgery. Read More

J Clin Orthop Trauma 2020 May-Jun;11(3):426-431. Epub 2019 Jun 8.

Yale School of Medicine, Department of Orthopaedics and Rehabilitation, 47 College Street, New Haven, CT, 06510, USA.

Background: Extensive research has been conducted concerning the epidemiology of fractures of the calcaneus and ankle. However, less work has characterized the population sustaining talus fractures, necessitating the analysis of a large, national sample to assess the presentation of this important injury.

Methods: The current study included adult patients from the 2011 through 2015 National Trauma Data Bank (NTDB) who had talus fractures. Read More

Foot Ankle Clin 2020 Jun 5;25(2):239-256. Epub 2020 Apr 5.

University Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, Dresden 01307, Germany.

Severe calcaneal malunions are debilitating conditions owing to substantial hindfoot deformity with subtalar arthritis and soft tissue imbalance. Type III malunions are best treated with a subtalar distraction bone block fusion. Additional osteotomies may be required for severe varus or superior displacement of the calcaneal tuberosity. Read More

Foot Ankle Spec 2020 May 4:1938640020913177. Epub 2020 May 4.

Department of Orthopaedics, Foot and Ankle Surgery, University of Iowa, Iowa City, Iowa.

The association of ipsilateral talar and calcaneal fractures is an uncommon combination and is typically the result of a high-energy trauma. It is often associated with comminution, marked fracture displacement, and soft-tissue compromise. Obtaining satisfactory clinical and radiographic results is very challenging. Read More

Injury 2020 Jul 19;51(7):1669-1675. Epub 2020 Apr 19.

Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, South Korea.

Backgrounds: Although ankle posterior subluxation is one of the major mechanisms by which posterior malleolar fractures (PMF) contribute to a worse prognosis, there is no parameter to address it quantitatively. So, we suggest a method that can evaluate posterior talar subluxation quantitatively in PMF.

Methods: We retrospectively analyzed 37 patients with posterior malleolar fractures. Read More

J Foot Ankle Surg 2020 May - Jun;59(3):625-628

Professor, Foot and Ankle Center Vienna, Vienna, Austria.

The combination of tendon and ligament ruptures with fracture of the talus is very rare. We demonstrate our experience in the acceptable management of a 34-year-old male referred with a closed comminuted fracture of the talar body after falling 7 meters. During the surgery, complete rupture of the peroneus brevis tendon, partial rupture of the peroneus longus tendon, and an avulsed superficial deltoid ligament from medial malleolus were found. Read More

Turk J Med Sci 2020 Apr 27. Epub 2020 Apr 27.

A fracture that does not unite in nine months is defined as non-union. Non-union is common in fragmented fractures and large bone defects where vascularization is impaired. The distal third of the tibia, the scaphoid bone or the talus fractures are furthermore prone to non-union. 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

Cureus 2020 Feb 4;12(2):e6867. Epub 2020 Feb 4.

Trauma and Orthopaedics, Medcare Orthopaedics and Spine Hospital, Dubai, ARE.

Avascular necrosis (AVN) of the femoral head following slipped capital femoral epiphysis (SCFE) is a serious complication that often leads to a permanent disability. Radiological findings of AVN may take up to two years to become apparent. This means painful waiting for children, parents, and treating teams. Read More

J Foot Ankle Surg 2020 Mar - Apr;59(2):399-402

Attending Surgeon, OrthoCarolina Foot and Ankle Institute, Charlotte, NC.

Pediatric talus fractures are rare injuries that generally result from high-energy trauma. The relative elasticity of pediatric bone is thought to contribute to the lower rate of fracture in children. Although these injuries are rare, complications of talar body fractures, including avascular necrosis, collapse of the talar dome, and tibiotalar arthrosis, are well described. Read More

Rev Esp Cir Ortop Traumatol 2020 Jul - Aug;64(4):272-280. Epub 2020 Feb 28.

Consorci Sanitari Integral L'Hospitalet de Llobregat, Barcelona, España.

Descriptive anatomical study of the different surgical approaches to the talus with photographic documentation using a 3-dimensional technique. The objective of this study is to evaluate macroscopic reference points, anatomical planes, structures at risk, field of visualization and possible applicability of each approach to help decision-making at the time of surgical planning in the event of a fracture of the talus. Eighteen fresh specimens and two specimens injected with black latex through the popliteal artery were dissected, performing each surgical approach twice with photographic documentation. Read More

Foot (Edinb) 2020 Mar 24;42:101647. Epub 2019 Oct 24.

Trauma and Orthopaedics Department, Wythenshawe Hospital, Manchester University Foundation Trust, United Kingdom. Electronic address:

Background: Displaced intraarticular calcaneum fractures are associated with late symptomatic hind foot malalignment and painful arthrosis for which distraction subtalar fusion might be considered. During subtalar distraction arthrodesis, a structural graft is often used to fill gaps. Autograft, the current gold standard, is limited in availabilityand is associated with donor-site morbidity and collapse. Read More

Instr Course Lect 2019 ;68:3-12

Over time, what was considered urgent or emergent in orthopaedic trauma has been revisited, and as awareness of factors associated with outcomes has increased, priorities have changed. There are multiple procedures performed urgently in the belief that early intervention allowed for better outcomes for the injury and the patient. Classic examples of conditions for which urgent intervention has been implemented include open fractures, femoral neck fractures in the young adult, talus fractures, and compartment syndrome. Read More

Adv Orthop 2020 3;2020:1852025. Epub 2020 Jan 3.

Albany Medical Center, Albany, NY, USA.

The bony and ligamentous structure of the foot is a complex kinematic interaction, designed to transmit force and motion in an energy-efficient and stable manner. Visible deformity of the foot or atypical patterns of swelling should raise significant concern for foot trauma. In some instances, disruption of either bony structure or supporting ligaments is identified years after injury due to chronic pain in the hindfoot or midfoot. Read More

J Orthop Trauma 2020 Feb;34 Suppl 1:S32-S37

Department of Orthopaedic Surgery, North Shore Private Hospital, St. Leonards, Sydney Australia.

The hindfoot is functionally defined as the articulations between the talus, calcaneus, navicular, and cuboid. It is a biomechanically important peritalar unit for shock absorption and propulsion with the subtalar and talonavicular joint essential to its function. The primary cause of hindfoot arthritis is post-traumatic. Read More

J Orthop Trauma 2020 Feb;34 Suppl 1:S9-S13

Department of Orthopaedic Surgery, Harborview Medical Center, Seattle, WA.

Lateral process fractures of the talus may occur either in isolation or in combination with a talar neck or body fracture. Screw fixation has been well described as a means of stabilization; however, many patients have multifragmentary fragments, unable to be controlled by isolated screw fixation alone. Plate fixation of the lateral process has been yet to be described in detail with presence of a clinical series. Read More

Z Orthop Unfall 2020 Jan 9. Epub 2020 Jan 9.

Department for Trauma Surgery, Otto-von-Guericke University, Magdeburg Medical Faculty.

Background: Talar neck and body fractures are rare. Major posttraumatic complications with a potential reduction in the quality of life are arthrosis and necrosis due to the specific vascular supply. The aim of the study was to evaluate mid-term results of surgery for talar fractures of neck and body. Read More

Malays Orthop J 2019 Nov;13(3):80-84

Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy.

Bilateral fracture-dislocation of the talus is a rare occurrence. It represents 0.06% of the dislocations and 2% of the traumas of the talus. Read More

J Foot Ankle Surg 2020 Jan - Feb;59(1):190-194

Associate Professor, Center for Joint Surgery, Southwest Hospital, Army Military Medical University, Chongqing, China. Electronic address:

Arthroscopic treatment is an effective technique for osteochondral lesion of talus (OLT); however, some patients still suffer pain and limitation of activities after surgery. The purpose of this study was to evaluate the efficacy of extracorporeal shock wave therapy (ESWT) after ankle arthroscopy for OLT. We reviewed the clinical history of a series of 78 patients with OLT who underwent arthroscopic microfracture. Read More

J Bone Joint Surg Am 2020 01;102(1):e3

Kansas City Orthopaedic Institute, Leawood, Kansas.

J Orthop 2020 Jan-Feb;17:87-90. Epub 2019 Jun 4.

Northwestern Memorial Hospital Department of Orthopaedic Surgery, 676 N. Saint Clair, Suite 1350, Chicago, IL, 60611, USA.

Introduction: Treatment of supination external rotation type IV (SER-IV) ankle injuries has focused on reduction and fixation of the fibula and syndesmosis (ORIF), not repair of the deltoid ligament.

Methods: Twenty-one ankles were analyzed with a motion capture system. Uninjured ankles were stressed and compared to ankles with SER-IV injuries, then with ORIF, and finally ORIF and deltoid repair. Read More

Surg Radiol Anat 2020 Jun 21;42(6):685-690. Epub 2019 Dec 21.

Department of Anatomy, All India Institute of Medical Sciences, First floor, Teaching Block, New Delhi, 110029, India.

Purpose: To study the distribution and morphometry of vascular foramina of adult human talus in Indian population.

Methods: The study was carried out by using 56 adult human tali. The location, size, number and foraminal index of vascular foramina on head, neck and body of each bone were examined macroscopically. Read More

Foot Ankle Surg 2019 Dec 5. Epub 2019 Dec 5.

Department of Orthopedic, The First Affiliated Hospital of Jinan University, Guangzhou, China. Electronic address:

Objective: To determine the biomechanical effect of anterior talofibular ligament injury in Weber B lateral malleolus fractures after lateral plate fixation.

Method: A three-dimensional model was established based on CT images from a healthy volunteer. The simulation of lateral malleolus fracture, and the modeling and assembly of plate were completed by referring to characteristics of Weber B lateral malleolus fractures, as well as the technical characteristics of open reduction and internal fixation of lateral plate. Read More

Foot Ankle Int 2020 Mar 13;41(3):324-330. Epub 2019 Dec 13.

Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Background: Talus fractures are severe injuries typically occurring after high-energy trauma. As a result, associated injuries to different anatomic sites and organ systems occur with high frequency. The objective of this study was to determine what injuries occur with high incidence in patients presenting with major fractures of the talus and to identify clinical injury patterns that may warrant special attention in these patients. Read More

Orthop Surg 2019 Dec 26;11(6):1201-1208. Epub 2019 Nov 26.

Trauma Center, The Second People's Hospital of Yunnan Province, Kunming, Yunnan, China.

Objective: To determine the value of Böhler's angle (BA) in a group of Chinese people, analyze possible factors that influence it, and compare BA with that in previous literature.

Methods: A total of 143 cases, aged from 4 to 79 years, were enrolled in the study, including 64 males and 79 females (79 left feet and 64 right feet). Radiographs were independently measured by six observers. Read More

Int J Obes (Lond) 2020 Jun 18;44(6):1319-1329. Epub 2019 Nov 18.

Center for Applied Biomechanics, Department of Mechanical and Aerospace Engineering, University of Virginia, 4040 Lewis and Clark Dr, Charlottesvillle, VA, 22911, USA.

Background: Previous studies have shown that occupants with obesity are at a greater risk of fatality and serious injury than other occupants in motor vehicle crashes.

Objective: To provide a more complete description of the most frequent injuries and the most frequently injured body regions for occupants with obesity.

Methods: Sampled cases (n = 13,470) representing ~4. Read More

Int J Surg Case Rep 2019 16;65:20-26. Epub 2019 Oct 16.

Department of Orthopaedic & Traumatology, Cipto Mangunkusumo National Central Hospital and Faculty of Medicine, Universitas Indonesia, Jalan Diponegoro No. 71, Jakarta Pusat, Jakarta 10430, Indonesia. Electronic address:

Introduction: Ankle fractures are common, with the incidence of up to 174 cases per 100,000 adults per year. The talus, the second largest tarsal bone, has distinctive imaging characteristics and injury patterns. The combination of talar body fracture in sagittal plane along with medial malleolus fracture is an unusual pattern of injury and rarely reported in the literature. Read More

Orthop J Sports Med 2019 Oct 22;7(10):2325967119876238. Epub 2019 Oct 22.

Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

Background: Osteochondral defects (OCDs) of the talus are found subsequent to ankle sprains and ankle fractures. With many surgical treatment strategies available, there is no clear evidence on return-to-sport (RTS) times and rates.

Purpose: To summarize RTS times and rates for talar OCDs treated by different surgical techniques. Read More

Am J Sports Med 2019 12 31;47(14):3429-3435. Epub 2019 Oct 31.

Fortius Clinic, London, UK.

Background: Autologous osteochondral transplantation (AOT) has been shown to be a viable treatment option for large osteochondral lesions of the talus. However, there are limited data regarding the management of large lesions in an athletic population, notably with regard to return to sport. Our investigation focused on assessing both qualitative and quantitative outcomes in the high-demand athlete with large (>150 mm) lesions. Read More

J Foot Ankle Surg 2020 Jan - Feb;59(1):136-141. Epub 2019 Oct 25.

Surgeon, Trauma Unit, Amsterdam University Medical Center, Location AMC, Amsterdam, the Netherlands. Electronic address:

Fracture of the lateral process of the talus (LPFT) is a frequently overlooked injury that can lead to severe complaints if not treated adequately. The aim of this study was to evaluate treatment and long-term outcomes of LPFT through a review of the literature. Furthermore, we propose a modified classification based on severity and intra- or extra-articular location of LPFT. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Nov;33(11):1351-1357

School of Biomedical Engineering, Capital Hospital of Beijing, Beijing, 100069, P.R.China.

Objective: To investigate the safety and effectiveness of anatomical approach osteoligaments repair technique in treatment of pronation ankle fractures.

Methods: The clinical data of 53 patients with pronation ankle fractures between April 2015 and October 2016, who were treated with anatomical approach osteoligaments repair technique applied for fracture reduction and internal fixation, were analysed retrospectively. There were 35 males and 18 females with an average age of 33. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Nov;33(11):1345-1350

Department of Orthopedics, Shanghai Ruijin Hospital, Medicine School of Shanghai Jiaotong University, Shanghai, 200025,

Objective: To investigate the effectiveness of corrective osteotomy for shortened medial foot column after old talar neck fracture.

Methods: The clinical data of 10 patients with shortened medial foot column after old talar neck fracture between June 2012 and May 2017 was retrospectively analyzed. There were 7 males and 3 females with an average age of 45. Read More

Eur J Trauma Emerg Surg 2019 Oct 17. Epub 2019 Oct 17.

Department of Orthopedics Trauma, Trauma Center, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, 650 Xin Songjiang Road, Shanghai, 201620, People's Republic of China.

Purpose: Deltoid ligament injuries appear with isolated or even no displacement of the lateral malleolus fracture which could easily lead to misdiagnosis, which frequently brings about ankle medial instability and talus shift that eventually lead to the occurrence of ankle osteoarthritis. This study is aimed to investigate the value of the tap test for assessing the integrity of the deltoid ligament intraoperatively.

Methods: Ninety-two patients with malleolar fractures and possible acute deltoid ligament injury treated in our hospital from March 2013 to May 2016 were enrolled in this prospective study. Read More

J Am Podiatr Med Assoc 2019 Oct 7. Epub 2019 Oct 7.

Barnet Hospital, Royal Free London NHS Foundation Trust Foot and Ankle Unit.

This manuscript reviews the role of Vitamin D and its deficiency in pathology of the foot and ankle. Vitamin D is an essential vitamin which targets a number of tissues and organs, and plays an important role in calcium homeostasis. Vitamin D deficiency is common, particularly at higher latitudes where there is reduced exposure to ultraviolet B radiation. Read More

Foot Ankle Int 2020 Jan 27;41(1):79-83. Epub 2019 Sep 27.

Department of Orthopaedic Surgery, Nara Medical University, Kashihara-shi, Japan.

Background: Comminuted talar fractures are rare. Generally, this fracture occurs as a result of high-energy injuries. Therefore, this operation is challenging for the surgeon. Read More

Knee Surg Sports Traumatol Arthrosc 2020 Jan 21;28(1):291-297. Epub 2019 Sep 21.

Department of Orthopaedic Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.

Purpose: Osteochondral talar lesions, regardless of their size and/or chronicity, are, at our hospital, now treated by fixation of the fragment if the talar dome cartilage is judged to be healthy. The retrospective study described herein was conducted to assess clinical outcomes of this treatment strategy.

Methods: The study group comprised 44 patients (18 men and 26 women) with 45 such talar lesions. Read More