Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Foot & Ankle 52 articles


Does Open Reduction and Internal Fixation versus Primary Arthrodesis Improve Patient Outcomes for Lisfranc Trauma? A Systematic Review and Meta-analysis

Nicholas Smith MD, MSc, Craig Stone MD, MSc, FRCSC, Andrew Furey MD, MSc, FRCSC

Although Lisfranc injuries are uncommon, representing approximately 0.2% of all fractures, they are complex and can result in persistent pain, degenerative arthritis, and loss of function. Both open reduction and internal fixation (ORIF) and primary fusion have been proposed as treatment options for these injuries, but debate remains as to which approach is better.

Extrinsic Muscle Forces Affect Ankle Loading Before and After Total Ankle Arthroplasty

Tassos Natsakis PhD, Josefien Burg PhD, Greta Dereymaeker MD, PhD, Jos Vander Sloten PhD, Ilse Jonkers PhD

Joint loading conditions have an effect on the development and management of ankle osteoarthritis and on aseptic loosening after total ankle arthroplasty (TAA). Apart from body weight, compressive forces induced by muscle action may affect joint loading. However, few studies have evaluated the influence of individual muscles on the intraarticular pressure distribution in the ankle.

Morbidity and Readmission After Open Reduction and Internal Fixation of Ankle Fractures Are Associated With Preoperative Patient Characteristics

Bryce A. Basques BS, Christopher P. Miller MD, Nicholas S. Golinvaux BA, Daniel D. Bohl MPH, Jonathan N. Grauer MD

Ankle fractures are common and can be associated with severe morbidity. Risk factors for short-term adverse events and readmission after open reduction and internal fixation (ORIF) of ankle fractures have not been fully characterized.

Does the Subtalar Joint Compensate for Ankle Malalignment in End-stage Ankle Arthritis?

Bibo Wang MD, Charles L. Saltzman MD, Ornusa Chalayon MD, Alexej Barg MD

Patients with ankle arthritis often present with concomitant hindfoot deformity, which may involve the tibiotalar and subtalar joints. However, the possible compensatory mechanisms of these two mechanically linked joints are not well known.

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.