What's New in Foot and Ankle Surgery.

Abstract

This article provides a summary of new research pertaining to orthopaedic foot and ankle surgery, from May 2014 to July 2015. The studies included were published in The Journal of Bone & Joint Surgery and Foot and Ankle International, and some were also presented at Specialty Day at the Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), March 24-28, 2015, in Las Vegas, Nevada, or at the Annual Meeting of the American Orthopaedic Foot & Ankle Society (AOFAS), July 15-18, 2015, in Long Beach, California. The Ponseti method is an effective treatment for clubfoot, as evidenced by the decreasing rate of surgery for clubfoot1-3. However, even among successfully treated patients, continued muscle imbalance can cause relapse. Depending on the pathomechanics involved, repeat cast application or tibialis anterior tendon transfer may be warranted. Identifying the specific aberrations in walking mechanics is important to help guide treatment. In a recent study, Mindler et al. used three-dimensional gait analysis, including the Oxford foot model, to compare the gait mechanics of children who had undergone Ponseti treatment with cast application with those of age-matched controls4. They demonstrated slight deviations from normal in the treated group. Moreover, the use of the Oxford foot model provided biomechanical information that can help clinicians to decide whether additional cast treatment is indicated prior to tendon transfer. Holt et al. corroborated the long-term efficacy of tendon transfer among patients who underwent the procedure for relapse of clubfoot deformity5. After a mean follow-up of 47 years, they found no impairment of function and no relapses requiring additional procedures. Ankle fractures are frequently encountered. The primary indication for operative fixation of ankle fractures is an unstable mortise. Instability is implied in the setting of bimalleolar fractures, or in lateral malleolar fractures …