Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Foot & Ankle 48 articles


Osteodesis for Hallux Valgus Correction: Is it Effective?

Daniel Y. Wu MD, K. F. Lam PhD

Although the etiology of hallux valgus is contested, in some patients it may be failure of the stabilizing soft tissue structures around the first ray of the foot. Because there is lack of effective soft tissue techniques, osteotomies have become the mainstream surgical approach to compensate for the underlying soft tissue deficiency; osteodesis, a soft tissue nonosteotomy technique, may be a third alternative, but its efficacy is unknown.

Bilateral Clubfeet Are Highly Correlated: A Cautionary Tale for Researchers

Kelly Gray B App Sc, Paul Gibbons MBBS, David Little MBBS, PhD, Joshua Burns PhD

Congenital talipes equinovarus, or clubfoot, is a common pediatric orthopaedic condition of unknown origin. In many clubfoot clinical trials, interventions are assigned to a patient, but response to treatment is assessed separately in each foot. Trials commonly report x patients with y feet where y is greater than x (eg, 35 patients with 56 feet). However, common statistical tests assume that each data point is independent. Although data from unilateral cases of clubfoot are independent, it is unknown if each foot of patients with bilateral clubfeet are correlated.

What are the Patterns of Prophylactic Postoperative Oral Antibiotic Use After Foot and Ankle Surgery?

David J. Ruta MD, Anish R. Kadakia MD, Todd A. Irwin MD

The CDC estimates 23% of healthcare-associated infections to be surgical site infections, with alarming prevalence of antibiotic-resistant organisms. While there is consensus regarding preoperative prophylaxis, orthopaedic surgeons’ use of prophylactic postoperative oral antibiotics is less defined.

Botulinum Toxin A Does Not Decrease Calf Pain or Improve ROM During Limb Lengthening: A Randomized Trial

Dong Hoon Lee MD, PhD, Keun Jung Ryu MD, Dong Eun Shin MD, PhD, Hyun Woo Kim MD, PhD

During lower limb lengthening, distraction-induced muscle pain and surrounding joint contractures are frustrating complications for which few effective treatments are available.

An Algorithmic Approach for Managing Orthopaedic Surgical Wounds of the Foot and Ankle

Eugenia H. Cho BS, Ryan Garcia MD, Irene Pien BS, Steven Thomas MS, L. Scott Levin MD, Scott T. Hollenbeck MD

Wound breakdown after orthopaedic foot and ankle surgery may necessitate secondary soft tissue coverage. The foot and ankle region is challenging to reconstruct for orthopaedic and plastic surgeons owing to its complex bony anatomy and unique functional demands. Therefore, identifying strategies for plastic surgery of these wounds may help guide surgeons in defining the best treatment plan.

Lateral Ankle Stabilization After Distal Fibular Resection Using a Novel Approach: A Surgical Technique

David Kevin Monson MD, Saman Vojdani BS, Thad James Dean DO, John Louis-Ugbo MD

After tumor resection involving the distal fibula, the method for recreating stability of the lateral ankle remains controversial. Many reconstructive options exist, including allograft reconstruction and arthrodesis; however, each of these approaches has significant potential disadvantages.

Long-term Results of Comprehensive Clubfoot Release Versus the Ponseti Method: Which Is Better?

Peter A. Smith MD, Ken N. Kuo MD, Adam N. Graf MS, Joseph Krzak PT, PhD, Ann Flanagan PT, Sahar Hassani MS, Angela K. Caudill PT, Fredrick R. Dietz MD, Jose Morcuende MD, Gerald F. Harris PE, PhD

Clubfoot can be treated nonoperatively, most commonly using a Ponseti approach, or surgically, most often with a comprehensive clubfoot release. Little is known about how these approaches compare with one another at longer term, or how patients treated with these approaches differ in terms of foot function, foot biomechanics, or quality-of-life from individuals who did not have clubfoot as a child.

Subungual Exostosis of the Toes: A Systematic Review

Mark P. DaCambra MD, MSc, Sumit K. Gupta MD, Fabio Ferri-de-Barros MD, MSc

Subungual exostosis is a relatively common benign bone tumor that occurs in the distal phalanges of the toes and can be a source of pain and nail deformity. There is controversy about the treatment of these lesions and there are few studies that have synthesized what is known and provided meaningful information on treatment.

Recombinant Human BMP-2 Increases the Incidence and Rate of Healing in Complex Ankle Arthrodesis

Mitchell S. Fourman MPhil, Eugene W. Borst BA, Eric Bogner MD, S. Robert Rozbruch MD, Austin T. Fragomen MD

Although its FDA-approved applications are limited, the pro-osteogenic benefits of recombinant human BMP-2 (rhBMP-2) administration have been shown in off-label surgical applications. However, the effects of rhBMP-2 on ankle fusions are insufficiently addressed in the literature, which fails to include a case-control study of adequate sample size to evaluate the efficacy of rhBMP-2 treatment.

Bone Microarchitecture of the Talus Changes With Aging

Matthias Krause MD, Martin Rupprecht MD, Marcus Mumme MD, Klaus Püschel MD, Michael Amling MD, Florian Barvencik MD

Fractures of the talus in the elderly are rare and usually result from high-impact injuries, suggesting only minor age-related bone structure changes. However, total ankle replacement failures with age often result from talar subsidence, suggesting age-related bone loss in the talus. Despite a number of histological analyses of talar microarchitecture, the effects of age and sex on talar microarchitecture changes remain poorly defined.