Background: The aim of this study was to define the rate new persistent opioid use and risk factors for after operative nonoperative treatment ankle fractures. Methods: Using a nationwide insurance claims database, Clinformatics DataMart Database, we identified opioid-naïve patients who underwent surgical unstable fracture patterns between January 2009 June 2016. Patients closed distal fibula served as comparative group. We evaluated peritreatment posttreatment prescription fills. primary...

There remains a paucity of data regarding long-term patient-reported outcomes following Lisfranc injuries. We sought to collect clinical outcome injuries using PROMIS Physical Function (PROMIS-PF) and visual analog scale-foot ankle (VAS-FA).A chart review was performed identify all patients who had surgical treatment an acute injury at our institution from 2005 2014. Of the 45 identified, we were able recruit 19 for follow-up clinic visit consisting physical examination, administration...

Recent surgical techniques have focused on anatomic repair of lesser toe metatarsophalangeal (MTP) plantar plate tears, yet it remains unknown whether the has biological capacity to heal these repairs. Therefore, a better understanding vasculature in response injury may provide further insight into potential for healing after repair. Recently, study demonstrated that microvasculature normal is densest at proximal and distal attachments. The purpose this was compare intact network plates...

Plantar dislocation of the first metatarsophalangeal (MTP) joint is exceedingly rare, and in prior reported cases, simple closed manipulation easily enabled reduction. We present here plantar that failed manipulation. also report a technique involving injection saline into to facilitate The insufflation likely relieves buttonholing metatarsal head through dorsal capsule. For MTP dislocations fail reduction with manipulation, we recommend attempting subjecting patient open Levels Evidence:...

Category: Basic Sciences/Biologics; Trauma Introduction/Purpose: Immobilization using lower extremity splints is a ubiquitous tool in orthopaedic care the emergency department, operating room, and outpatient clinic settings. Prolonged use of these may result skin changes or ulceration heel if not padded positioned correctly. There currently no biomechanical study literature measuring posterior contact pressure splints. The purpose our to measure differences with increasing layers cotton...

Category: Sports; Midfoot/Forefoot; Trauma Introduction/Purpose: Return-to-play (RTP) rates of National Football League (NFL) athletes following surgical intervention for numerous foot and ankle injuries has been reported. To our knowledge, no studies have reported on RTP NFL after non-operative operative treatment high-grade turf toe injuries. The purpose this study was to evaluate the in who sustained We hypothesized that requiring would lower longer recoveries than treated non-...

Objectives: Background: Multiple meta-analyses have been published to in efforts determine whether operative or non-operative treatment of Achilles tendon ruptures affords superior outcomes. The results, however, remain varied and inconsistent. Purpose: To perform a systematic review overlapping comparing order which provide the highest level evidence for recommendations. Methods: A literature was performed identify that fit our inclusion criteria. Data extracted from these regarding patient...

Case: Evidence-based surgical strategies to reconstruct the collateral ligament complex of first metatarsophalangeal (MTP) joint are not available. We report a case MTP lateral insufficiency in young, female gymnast with varus laxity and subsequent satisfactory mid-term long-term outcomes. Conclusion: This describes an efficient suture anchor technique for restoring stability because chronic acceptable results both clinically patient-reported outcome scores at follow-ups. suggest that our...

Though ubiquitously used in orthopaedic trauma, lower extremity splints may have associated iatrogenic risk of morbidity. Although clinicians pad bony prominences to minimize skin pressure, the effect joint position on pressure and, more specifically, changing position, is understudied. The purpose this biomechanical study determine various short-leg splint application techniques anterior ankle surface development ulcers.Various constructs extremity, were applied 3 healthy subjects (6 limbs...

There continues to be controversy regarding treatment options for Achilles tendon ruptures (ATR). The aim of our study is compare outcomes between operatively and nonoperatively managed in young adults (age 18-30 years), which has not been previously evaluated.At a single institution, all patients aged years at time injury who underwent an acute ATR from 2014 2021 were evaluated. Medical records reviewed collect demographics, dates treatment, smoking status, body mass index (BMI), Charlson...

Background: Metatarsalgia and plantar plate tears are characterized by forefoot pain toe deformity in severe cases. Conservative management may slow progression of symptoms; however, definitive treatment often requires operative intervention. The purpose this observational study was to evaluate the combination condylectomy surgical imbrication metatarsal neck repair grade 0 injuries. Methods: We retrospectively identified 22 patients with metatarsalgia low-grade lesions (grade 0), operated...

Category: Trauma; Ankle Introduction/Purpose: Our group previously presented a novel protocol for non-operative management of Weber B ankle fractures with medial clear space (MCS) < 7mm on gravity stress (GS) radiographs and within 2mm ipsilateral superior contralateral GS MCS. The goal this study is to recruit an operative cohort comparison clinical, radiographic, patient reported outcomes. Methods: We recruited patients who may have been considered the but underwent surgery instead....

Category: Ankle; Trauma; Other Introduction/Purpose: Though ubiquitously utilized in orthopaedic trauma, lower extremity splints are not without their associated iatrogenic risk of morbidity. In fact, improper splinting only necessitates replacement, but splint-related soft tissue complications the second most common cause for referral to plastic surgery. Improper techniques include inadequate molding plaster/fiberglass splints, padding over bony prominences, excessive compressive forces...

Category: Trauma; Ankle Introduction/Purpose: Lower extremity splints are commonly used in orthopaedic care throughout emergency departments, operating rooms, and outpatient clinics. Although the mainstay of ankle immobilization, they have been associated with ulcers due to high contact pressures over bony prominences anterior ankle. High may occur when splint padding is applied while a plantarflexed position subsequently dorsiflexed as plaster or fiberglass hardens. The purpose this study...

Category: Lesser Toes Introduction/Purpose: toe metatarsophalangeal (MTP) instability is implicated in common forefoot pain and deformities. The plantar plate a major stabilizing structure of the MTP joint with frequently occurring after tear or attenuation this structure. Previous studies have demonstrated that blood supply to proximal comes from both metatarsal fascia. Commonly, McGlamry elevator used strip surface improve exposure joint. vascular consequence stripping not yet well...

Background: Chronic opioid use is a growing crisis in the United States. The authors examined risk factors associated with new persistent patients who had nonoperatively treated ankle sprains and offer evidence-based treatment recommendations for practitioners. Methods: A States insurance claims database was used to select underwent nonoperative of an sprain between January 2008 December 2016. prescribing 1 yr before diagnosis 6 mo after defined as prescription fulfillment 91 180 days...

Summary: Owing to a vascular watershed, zone II and III fifth metatarsal base fractures commonly progress nonunion without operative intervention. This article the accompanying video demonstrate use of intramedullary screw fixation for fracture review treatment decisions involved with management these injuries.