- Economic Analysis of Anatomic Plating Versus Tubular Plating for the Treatment of Fibula Fractures. [Journal Article]
- OOrthopedics 2018 Feb 16; :1-5
- Ankle fractures are among the most common injuries requiring operative management. Implant choices include one-third tubular plates and anatomically precontoured plates. Although cadaveric studies ha...
Ankle fractures are among the most common injuries requiring operative management. Implant choices include one-third tubular plates and anatomically precontoured plates. Although cadaveric studies have not revealed biomechanical differences between various plate constructs, there are substantial cost differences. This study sought to characterize the economic implications of implant choice. A retrospective review was undertaken of 201 consecutive patients with operatively treated OTA type 44B and 44C ankles. A Nationwide Inpatient Sample query was performed to estimate the incidence of ankle fractures requiring fibular plating, and a Monte Carlo simulation was conducted with the estimated at-risk US population for associated plate-specific costs. The authors estimated an annual incidence of operatively treated ankle fractures in the United States of 59,029. The average cost was $90.86 (95% confidence interval, $90.84-$90.87) for a one-third tubular plate vs $746.97 (95% confidence interval, $746.55-$747.39) for an anatomic plate. Across the United States, use of only one-third tubular plating over anatomic plating would result in statistically significant savings of $38,729,517 (95% confidence interval, $38,704,773-$38,754,261; P<.0001). General use of one-third tubular plating instead of anatomic plating whenever possible for fibula fractures could result in cost savings of up to nearly $40 million annually in the United States. Unless clinically justifiable on a per-case basis, or until the advent of studies showing substantial clinical benefit, there currently is no reason for the increased expense from widespread use of anatomic plating for fractures amenable to one-third tubular plating. [Orthopedics. 201x; xx(x):xx-xx.].
- Novel treatment of lateral ankle sprains using the Mulligan concept: an exploratory case series analysis. [Journal Article]
- JMJ Man Manip Ther 2017; 25(5):251-259
- The purpose of this study was to examine the effect of the Mulligan Concept (MC) Mobilization with movement (MWM) in the treatment of clinically diagnosed acute lateral ankle sprains in competitive a...
The purpose of this study was to examine the effect of the Mulligan Concept (MC) Mobilization with movement (MWM) in the treatment of clinically diagnosed acute lateral ankle sprains in competitive athletes.
- Complications of Supine Surgical Achilles Tendon Repair. [Journal Article]
- FAFoot Ankle Int 2018 Feb 01; :1071100718755474
- CONCLUSIONS: The supine position was safe for primary open Achilles tendon repair, with no wound or neurologic complications.
- A Trunk Stabilization Exercise Warm-up May Reduce Ankle Injuries in Junior Soccer Players. [Journal Article]
- IJInt J Sports Med 2018 Feb 15
- The aim of this study was to investigate the efficacy of a trunk stabilization exercise warm-up program in reducing the incidence of lower extremity injuries among male junior soccer players. Two jun...
The aim of this study was to investigate the efficacy of a trunk stabilization exercise warm-up program in reducing the incidence of lower extremity injuries among male junior soccer players. Two junior soccer teams participated in this study. The intervention (INT) team performed three trunk stabilization exercises before practice sessions and games, while a control (CON) team performed their usual warm-up without trunk exercises. Both teams engaged in regular soccer training and games, and were followed for the incidence of injury. As a result, overall injury incidence rates (IRs) were 2.65 injuries/1,000 h and 4.94 injuries/1,000 h in the INT and CON teams, respectively (incidence rate ratio [IRR]=0.54, 95% confidence interval [CI]=0.32-0.89, p=0.013). The IR of acute injuries was significantly lower in the INT team (1.91 injuries/1,000 h) than in the CON team (4.06 injuries/1,000 h) (IRR=0.47, 95%CI=0.26-0.84, p=0.009). Regarding injury sites, the IRs of ankle injuries in the INT team (0.32 injuries/1,000 h) were significantly lower than that in the CON team (2.28 injuries/1,000 h) (IRR=0.14, 95%CI=0.04-0.47, p<0.001). These results suggest that a warm-up program comprising trunk stabilization exercises alone can prevent acute injuries, especially ankle injuries.
- Does the normal four steps weight-bearing rule predict the need for radiography in cases of blunt ankle trauma? [Journal Article]
- MJMed J Islam Repub Iran 2017; 31:32
- Background: Ankle injuries are one of the most common complaints of patients presenting to emergency departments (ED). The Ottawa ankle rules (OAR) was introduced to help physicia...
Background: Ankle injuries are one of the most common complaints of patients presenting to emergency departments (ED). The Ottawa ankle rules (OAR) was introduced to help physicians to decide who may require x-ray for blunt injuries. The present study aimed at validating the four steps weight-bearing rule of OAR as a sole criterion.Methods:This prospective observational study was conducted on 214 patients with acute ankle injury who referred to 3 emergency departments over a 7-months period in 2008. Main outcome measures of this survey included the sensitivity, specificity, positive and negative predictive values, and the likelihood ratios (positive and negative) of the four steps weight-bearing rule.Results:In this study, 34 fractures were found among the patients. The decision rule had a sensitivity of 0.88 and specificity of 0.61 in detecting all midfoot and ankle fractures. Application of this rule by emergency medicine residents resulted in a 47% reduction in the use of midfoot and ankle radiography.Conclusion:Applying a four steps weight-bearing rule as a sole criterion to detect ankle fractures is not as accurate and sensitive as OAR. Solitary application of this rule may lead to an increasing number of missed fractures compared with OAR.
- Outcomes following limb salvage after combat hindfoot injury are inferior to delayed amputation at five years. [Journal Article]
- BJBone Joint Res 2018; 7(2):131-138
- CONCLUSIONS: At five years, patients with reconstructed hindfoot fractures have inferior outcomes to those who have delayed amputation. It is possible to identify injuries which will go on to have particularly poor outcomes.Cite this article: P. M. Bennett, T. Stevenson, I. D. Sargeant, A. Mountain, J. G. Penn-Barwell. Outcomes following limb salvage after combat hindfoot injury are inferior to delayed amputation at five years. Bone Joint Res 2018;7:131-138. DOI: 10.1302/2046-3758.72.BJR-2017-0217.R2.
- Combat-related foot injuries: impact on gait and functional outcome. [Journal Article]
- JRJ R Army Med Corps 2018 Feb 07
- CONCLUSIONS: This study demonstrated that service members with TCN fractures, compared with healthy controls, have altered gait characteristics, specifically lower walking speed and ankle joint ROM, both related to lower physical functioning. Patients with bilateral depressed Böhler's angle had the worse functional performance, and further research is recommended to evaluate the relationship between Böhler's angle and physical performance.
- Reconstruction of a Complex Foot Injury With Free Remodeled Fibular Osteocutaneous Flap: A Case Report and Literature Review. [Journal Article]
- JFJ Foot Ankle Surg 2018 Feb 08
- Management of complex foot injuries, which involve open fractures and severe trauma to soft tissues, represent a challenge to orthopedic clinicians. In the present case report, we treated a complex f...
Management of complex foot injuries, which involve open fractures and severe trauma to soft tissues, represent a challenge to orthopedic clinicians. In the present case report, we treated a complex foot injury with a remodeled fibular osteocutaneous free flap to reconstruct the anterior and lateral areas of the foot. The flap survived completely. At the 9-month follow-up examination, bony union of the graft bone was identified by radiographic examination. The reconstructed foot could bear body weight, and the patient could maintain a bipedal gait without discomfort. The remodeled fibular osteocutaneous free flap provides an option for functional reconstruction of foot defects.
- A new predicting model for syndesmotic injuries? [Letter]
- IInjury 2018 Jan 31
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- Concerns About Ankle Injury Prophylaxis and Acceptance of the Parachute Ankle Brace Among Jumpmaster Students. [Journal Article]
- MMMil Med 2018 Feb 06
- CONCLUSIONS: This survey assessed the attitude and knowledge related to the PAB among jumpmaster students. Results show that despite the benefits of the PAB, a negative attitude exists toward the PAB, and it is not currently being used. This survey clearly demonstrates the need either to educate paratroopers on the existence of the PAB or to explore other designs that may be more readily accepted in the airborne community.