Foot and Ankle Specialist

Introduction: The literature largely addresses questions of diagnostic accuracy and therapeutic accuracy. However, the magnitude of the clinical impact of syndesmosis injury is commonly described in intuitive yet qualitative terms. This systematic review aimed to quantify the impact of syndesmosis injury. Methods: Published clinical outcomes data were used to compute an effect size reflecting the impact of syndesmosis injury. This was done within the clinical contexts of isolated syndesmosis injury and syndesmosis injury with concomitant ankle fracture. Clinical outcomes data included Olerud-Molander (OM) and American Orthopaedic Foot and Ankle Society (AOFAS) scores, visual analog scale for pain, and days missed from sport competition. Parametric data were compared with Student t tests. Effect size was computed using Cohen’s d. Results: In ankle fracture patients, syndesmosis injury demonstrated a large effect size for OM (d = 0.96) and AOFAS (d = 0.83) scores. In athletic populations without concomitant ankle fracture, syndesmosis injury demonstrated a large effect size on days missed from competition (d = 2.32). Discussion: These findings confirm the magnitude of the negative impact of syndesmosis injury in athletic populations with isolated injury and in ankle fracture patients. In ankle fracture patients, this large negative effect remains despite surgery. Thus, syndesmosis repair may not fully mitigate the impact of the injury. Levels of Evidence: Level III: Systematic review

John J. Heifner

Jack E. Kilgore

Jennifer A. Nichols

Christopher W. Reb

Foot & Ankle Specialist

Syndesmosis Injury Contributes a Large Negative Effect on Clinical Outcomes: A Systematic Review

韧带损伤对临床结果产生重大负面影响：一项系统综述

Background. The Jones fracture has been a topic of controversy ever since being first described by Sir Robert Jones himself in 1902. The aim of this review is to summarize the classification, management, outcome, and complications of this particular injury. Methods. The authors conducted a systematic review of the scientific literature regarding the Jones fracture. Results. There was no consistent approach to the Jones fracture classification. The rate of nonunion with nonoperative treatment is high in both acute and chronic cases. Surgical intervention reduces the incidence of nonunion, but the complication rate of surgery is high. Conclusions. Surgical intervention for the acute Jones fracture should be reserved for the athletic individual because there is a clear advantage in terms of time to return to sporting activity. Nonoperative treatment remains a viable alternative to surgery in all acute and delayed cases, providing there is no established nonunion and the patient is aware of the implications. Level of Evidence: Therapeutic, Level IV

Benjamin John Floyd Dean

Alpesh Kothari

Harpal Uppal

Raghubir Kankate

The Jones Fracture Classification, Management, Outcome, and Complications

琼斯骨折分类、治疗、预后及并发症

Background Weightbearing computed tomography (WBCT) has been increasingly employed to evaluate and treat patients with varied pathologies such as progressive collapsing foot deformity (PCFD), posttraumatic deformity, hallux valgus, ankle arthritis, Charcot arthropathy, lisfranc, and syndesmosis injuries. However, little is known regarding its overall availability to foot and ankle providers and how it is being used in clinical practice. The goal of this study is to assess the utilization of WBCT among AOFAS members, identify the indications for use in clinical practice and potential barriers for implementation. Methods A survey was emailed to AOFAS members inquiring about the use WBCT in clinical practice. Practice and demographic information were also collected. A total of 220 responses were collected over a 2-month period. Respondents were queried with respect to the availability of WBCT in practice, indications for use, frequency of use, ownership of the scanner, and barriers to implementation. Results 58% of respondents did not have access to WBCT. Most respondents were in practice 10 years or more (69%). Single-specialty private practice was the most common practice type (39%). Of those with access to WBCT, 5 or fewer scans were ordered per week (57% of respondents). Evaluation of hindfoot/ankle deformity was the most common indication (69% of respondents) with it being used as a preoperative evaluation tool approximately 25% of the time (57% of respondents). Radiology department owned WBCT in most institutions (34%). 75% of respondents with WBCT use it postoperatively less than 25% of the time. Of those without WBCT, 94% stated they would like to have it with cost being the most significant barrier to implementation. Conclusion Most respondents surveyed did not have access to WBCT, with cost being the greatest barrier. However, 94% of those without it would like to have access to it. For those with access, it is used 5 or fewer times per week with evaluation of hindfoot/ankle deformity being the most common indication. Level of Evidence: Level IV (Observational Study)

Sudheer C. Reddy

Cesar de Cesar Netto

Survey of Utilization of Weightbearing Computed Tomography Within AOFAS Membership

AOFAS会员中负重计算机断层扫描利用情况的调查

First tarsometatarsal (TMT) arthrodesis is one of the most common procedures performed each year for the correction of hallux valgus deformity, and nonunion rates for first TMT arthrodesis are commonly reported to be between 4% and 15%. The purpose of this study was to evaluate the effectiveness of an intramedullary nail system in patients requiring first TMT arthrodesis.

Connor C. Ott

Ayush D. Shah

Kayla J. Seiffert

Rebecca Stone McGaver

Paul M. Cammack

Scott M. Holthusen

Jeffrey D. Seybold

John C. Tanner

William M. Engasser

Radiographic and Patient-Reported Outcomes for First Tarsometatarsal Arthrodesis Using an Intramedullary Nail for Hallux Valgus Deformity A Consecutive Case Series

使用髓内钉治疗拇外翻畸形的第一跖跗关节融合术的影像学和患者报告结果：连续病例系列

Background The original English Foot and Ankle Ability Measure (FAAM) is widely adopted to track changes in foot and ankle function. The aim of this study is to translate it to an Arabic version of FAAM (FAAM-A), and then to assess the validity and reliability of the FAAM-A version. Methodology One hundred five consecutive Arabic-speaking participants with different foot and ankle pathologies completed the FAAM-A. Fifty-six males and 49 females with a mean age of 39.8 years; 78.1% respondents have completed high school or higher. Convergent and divergent validities were assessed using correlation coefficients between the FAAM-A subscales and the short form-36 (SF-36), physical function (PF), physical component summary (PCS), mental health (MH), and mental component summary (MCS). Cronbach’s alpha was calculated to assess internal consistency. A subgroup of 20 participants filled the FAAM-A twice to test for test-retest reliability, using intraclass correlation coefficients (ICCs) and minimal detectable changes (MDCs). Results The average FAAM-A was 55.32 and 43.23 for the activity of daily life (ADL) and Sports subscales, respectively. FAAM-A ADL subscale had a moderate correlation with the PF, 0.565; PCS, 0.546; and MCS, 0.447; and a low correlation with MH, 0.34. The sports subscale had a moderate correlation with the PF (0.529), PCS (0.513), and a low correlation with MCS (0. 395) and MH (0. 297). Cronbach’s alpha was 0.97 and 0.95 for ADL and sports subscales, respectively. Intraclass correlation coefficient was 0.99 for both subscales. Minimal detectable change at a 95% confidence level was 6.81 and 8.19 for the ADL and sports subscales, respectively. Conclusion The FAAM-A is proven to be valid and reliable instrument for assessing foot and ankle disability. It is an effective tool for clinical assessment and research within Arabic-speaking populations. Level of Evidence: Level II, Prospective cohort study

Sulaiman A. Almousa

Cross-Cultural Adaptation and Validation of Foot and Ankle Ability Measure (FAAM) for Arabic-Speaking Patients

阿拉伯语患者足踝能力量表（FAAM）的跨文化适应与验证

Background Fixation of the Evans osteotomy for flatfoot correction has been advocated without supporting data to facilitate union and avoid calcaneocuboid subluxation. We examined these issues in the largest reported series of Evans procedures to date. Methods A total of 118 cases from a consecutive series of 137 patients who underwent Evans osteotomy without fixation by a single surgeon were available for review. Average follow-up was 62.5 weeks. Bony union and radiographic measurements including calcaneocuboid subluxation were evaluated. Results Union occurred in 117/118 cases (99.2%). Calcaneocuboid subluxation increased minimally compared to preoperative values (1.5 ± 2.3 mm). The mean wedge size was 7.1 ± 1.4 mm. All radiographic measurements of the longitudinal arch improved. Conclusion The Evans osteotomy without fixation demonstrated near-universal union and minimal calcaneocuboid subluxation. The frequent use of additional osteotomies in our series might have allowed the use of smaller wedges and contributed to our favorable results. Level of Evidence: 4

Solangel Rodriguez-Materon

Megan Miles

Nigel Hsu

Brian Gallagher

Gregory Guyton

Nonunion and Calcaneocuboid Subluxation Are Minimal After Evans Osteotomy Without Fixation

无固定Evans截骨术后不愈合和骰骨舟骨半脱位发生率最低

Fixation for suprasyndesmotic fibula fractures (AO/OTA type 44C, consistent with Weber C) is classically achieved using a single one-third tubular plate. However, these fractures may sometimes require stronger fixation due to the diaphyseal fracture location and the lack of structural support from injured ligaments. To increase stability, 3.5 mm plates can be used, but these plates are bulky and too stiff to contour. As alternative, the authors present the technique and clinical and patient-reported outcomes (PROs) of using stacked one-third tubular plating for suprasyndesmotic fibula fractures to increase stability of fixation. Between 2021 and 2023, 14 patients were treated with stacked one-third tubular plating. All patients healed uneventfully. One patient developed an infection with wound breakdown and exposed hardware after fracture healing. Thirteen patients (93%) responded to PROs. The median Olerud-Molander ankle score was 75 (interquartile range [IQR]: 30-80), the median EQ-5D-5L score was 80 (IQR: 69-81), and the median numeric rating scale (NRS) score was 3 (IQR: 0-5). The use of double-stacked one-third tubular plates is a simple and safe technique that can be used to increase stability of suprasyndesmotic fibula fractures leading to reliable healing rates and satisfactory PROs. Levels of Evidence: Level IV Retrospective Case Series

Robert Kaspar Wagner

Jacob S. Borgida

Alice W. Wong

Bryce Jensen

Derek S. Stenquist

Thuan V. Ly

Double-Stacked One-Third Tubular Plating for Suprasyndesmotic Fibula Fractures Technique Description and Clinical Case Series

双层三分之一管状钢板治疗踝上腓骨骨折的技术描述与临床病例系列

Abbreviation
Journal Impact	1.89
Quartiles(Global)	ORTHOPEDICS(Q2)

ISSN	1938-6400, 1938-7636
h-index	37

Publication Information	Publisher: SAGE Publications Ltd，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2008，Proportion of original research papers: 0.00%，Self Citation Rate:N.A.， Gold OA Rate: 0.00%

Foot and Ankle Specialist

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Syndesmosis Injury Contributes a Large Negative Effect on Clinical Outcomes: A Systematic Review

The Jones Fracture Classification, Management, Outcome, and Complications

Survey of Utilization of Weightbearing Computed Tomography Within AOFAS Membership

Radiographic and Patient-Reported Outcomes for First Tarsometatarsal Arthrodesis Using an Intramedullary Nail for Hallux Valgus Deformity A Consecutive Case Series

Cross-Cultural Adaptation and Validation of Foot and Ankle Ability Measure (FAAM) for Arabic-Speaking Patients

Radiographic and Patient-Reported Outcomes for First Tarsometatarsal Arthrodesis Using an Intramedullary Nail for Hallux Valgus Deformity A Consecutive Case Series

Survey of Utilization of Weightbearing Computed Tomography Within AOFAS Membership

Nonunion and Calcaneocuboid Subluxation Are Minimal After Evans Osteotomy Without Fixation

Double-Stacked One-Third Tubular Plating for Suprasyndesmotic Fibula Fractures Technique Description and Clinical Case Series

Cross-Cultural Adaptation and Validation of Foot and Ankle Ability Measure (FAAM) for Arabic-Speaking Patients