bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes Following Surgical Fixation of Ankle Fractures in Patients with Moderate-to-Severe Chronic Kidney Disease
Authors: Lalli Trapper , Paterno Anthony , White Beau , Jeffs Alexander , Orders Tanner , Chen Andrew 
Published: December 2024

Category: Trauma; Ankle Introduction/Purpose: There is a high prevalence of Chronic Kidney Disease (CKD) in orthopaedic trauma patients. The purpose of this study was to assess mortality and postoperative complications amongst patients with moderate-to-severe CKD including end stage renal disease (ESRD) following surgical fixation of ankle fractures. We hypothesized that there would not be a significant difference in outcomes in patients with moderate-to-severe CKD. Methods: Patients at an academic Level 1 trauma center between 2008-2019 who underwent operative fixation of an ankle fracture and had a diagnosis of CKD were retrospectively identified. All patients with moderate-to-severe CKD (stages III-V) prior to injury were included. A randomly selected group of patients with mild CKD (stages I/II) served as a control group. Demographics, age adjusted Charlson Comorbidity Index (CCI), fracture type, complications (including deep infection, hardware failure, non-union/malunion, amputation), and mortality within 2 years from surgery were collected. Results were compared using ANOVA and Fisher’s exact tests, and mortality was adjusted for age, race, CCI, and BMI using logistic regression. Results: A total of 42 patients with mild CKD and 47 with moderate-to-severe CKD were included. The overall complication rates were not significantly different between the groups (26% vs 32%, p=0.64), Return to the OR (10% vs 17%, p=0.36) and amputation (0% vs 2%, p=1.0) were not significantly different between the groups. There were higher rates of deep infection, but this was not statistically significant One-year and two-year mortality rates were near equivalent between groups (7% vs 9%, p=1.0 and 10% vs 13%, p=0.74). Conclusion: Following surgical fixation of an ankle fracture, patients with moderate-to-severe CKD do not appear to have increased rates of mortality or overall complications than patients with mild CKD. This data can be useful to counsel patients with ankle fractures and moderate-to-severe CKD and ESRD.
Outcomes Following Suture Button Fixation for the Management of Ligamentous Lisfranc Injuries: A Systematic Review
Authors: Butler James J. , Fur Rachel Lai Fat , DeClouette Brittany , Cole Wendell , Samsonov Alan P. , Kennedy John G. 
Published: December 2024

Category: Midfoot/Forefoot Introduction/Purpose: The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries. Methods: During January 2024, the PubMed, Embase and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following suture button fixation for the management of ligamentous Lisfranc injuries. Data regarding patient demographics, pathological characteristics, subjective clinical outcomes, radiological outcomes, complications and failure rates were extracted and analysed. Results: Ten studies were included. In total, 100 patients (100 feet) underwent suture button fixation for the management of ligamentous Lisfranc injuries at a weighted mean follow-up of 30.5±10.3 months. The AOFAS score improved from a weighted mean pre-operative score of 52.9±11.8 to a weighted mean post-operative score of 89.0±5.4. The VAS score improved from a weighted mean pre-operative score of 7.7±0.6 to a weighted mean post-operative score of 2.1±0.4. In total, 100% of patients returned to sport at a mean time of 22.3±4.8 weeks. The complication rate was 13.5%, the most common of which was residual midfoot stiffness (3.0%). No failures nor secondary surgical procedures were recorded. Conclusion: This systematic review demonstrated improvement in subjective clinical with a moderate complication rate at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries. No failures nor secondary surgical procedures were recorded. Further high quality comparative studies are warranted to determine the optimal role of suture button fixation in the management of ligamentous Lisfranc injuries.
Outcomes Following Treatment of Symptomatic Accessory Navicular with Pes Planus Correction: A Systematic Review
Authors: Jimenez Mosquea Thelma R. , Ubillus Hugo A. , Walls Raymond J. 
Published: December 2024

Category: Midfoot/Forefoot; Other Introduction/Purpose: The presence of an accessory navicular (AN) can disrupt the attachment of the tibialis posterior tendon (TPT), potentially resulting in a flattened medial longitudinal arch. The Kidner procedure aims to alleviate painful AN by correcting the abnormal TPT insertion, thus aiding in arch elevation. Subtalar arthroeresis (STA) serves to prevent excessive subtalar joint eversion, thereby averting arch collapse in flatfoot deformity. Conversely, the addition of a medial column reinforcement through osteotomy has been proposed to further stabilize the corrected foot shape. Literature on AN treatment often overlooks options for flatfoot deformity. This study compares outcomes of Kidner alone, Kidner with STA, and Kidner with medial column reinforcement for symptomatic AN with flatfoot, seeking to provide valuable treatment insights. Methods: In February 2024, a systematic review was conducted on the PubMed, Embase, and Cochrane Library databases to identify clinical studies investigating outcomes of the Kidner procedure alone, Kidner with STA, and Kidner with osteotomies for managing symptomatic accessory navicular (AN) with flatfoot deformity. The level of evidence (LoE) in the included studies was assessed according to the criteria set by the Journal of Bone and Joint Surgery. Information pertaining to subjective clinical outcomes, radiological findings, and complications was gathered and subjected to analysis. Results: This review included 19 studies, comprising one with Level II evidence, thirteen with Level III, and five with Level IV. Among 525 cases, 246 underwent Kidner procedure, 166 the Kidner + STA and 113 the Kidner + medial osteotomy. The weighted mean age was 15.7 ± 3.9 years for the Kidner cohort, 12.4 ± 2.7 years for the Kidner + STA and 25.29 ± 12.1 years for the Kidner + osteotomy, with weighted-mean follow-up of 67.8, 44.06 and 25.01 months, respectively. Pre-operative AOFAS mean scores were 46.0, 56.4 and 52.8, with post-operative scores of 85.5, 89.7 and 89.7, respectively. At final follow-up, Meary’s angle improved 0.7 degrees in the Kidner, 13.2 degrees in the Kidner + STA and 10.86 degrees in Kidner + osteotomy. Conclusion: This review highlights the effectiveness of different procedures in managing symptomatic accessory navicular with flatfoot deformity. The three approaches demonstrated improvements in subjective clinical outcomes and radiological parameters. Kidner alone experienced less radiologic improvement, suggesting that augmentation with either STA or osteotomy may provide better correction. Despite limitations in study design and heterogeneity among included studies, our findings underscore the importance of individualized treatment approaches. Further research with larger sample sizes and longer follow-up periods is warranted to validate these findings and optimize treatment strategies for this challenging condition.
Outcomes of Osteosynthesis of Large Os Subfibulare in Patients with Chronic Lateral Ankle Instability with Large Os Subfibulare
Authors: Yoon Yeo Kwon , Park Kwang Hwan , Shim Dong Woo , Han Seung Hwan , Lee Jin Woo 
Published: December 2024

Category: Ankle; Sports Introduction/Purpose: Os subfibulare is commonly found in patients with chronic lateral ankle instability (CLAI). When performing lateral ligament reconstruction for CLAI, excision of a large OS can cause massive lateral ligament defects.The purpose of this study is to evaluate clinical and radiological outcomes among patients who underwent osteosynthesis of the OS for chronic lateral ankle instability with a large OS (≥10 mm). Methods: A retrospective analysis was performed on 28 ankles with CLAI and a large OS (≥10 mm) that underwent osteosynthesis of the OS between June 2007 and July 2021 and had a minimum follow-up of 2 years. Visual Analog Scale for pain, Karlsson–Peterson ankle score, and Medical Outcomes Study Short Form Health Survey-36 Physical Component Summary (SF-36 PCS), talar tilt angle, and anterior displacement of the talus were used to assess clinical and radiological outcomes. Results: The mean follow-up period was 78.9 months (range, 24.0 to 177.0 months) and the mean OS size was 15.4 mm (range, 12.2 to 21.0 mm). Mean ± SD Visual Analogue Scale for pain, Karlsson–Peterson ankle score, SF-36 PCS, talar tilt angle, and anterior displacement of the talus improved significantly, from preoperative values of 5.3 ± 1.8, 38.4 ± 10.6, 45.6 ± 10.8, 11.1 ± 5.7, and 7.3 ± 1.9, to 0.9 ± 1.4, 88.7 ± 12.6, 80.2 ± 12.3, 3.9 ± 2.0, and 4.8 ± 1.3, respectively, by the last follow-up. The overall complication rate was 10.7% (three ankles); the reoperation rate was 7.1% (two ankles). Conclusion: Osteosynthesis of the OS produced satisfactory outcomes in patients with CLAI with a large OS. This method may be a viable surgical option for patients with this condition.
Outcomes of Tibiotalocalcaneal Arthrodesis in Charcot Neuroarthropathy According to Severity of Preoperative Deformity
Authors: Kim Sunghoo , Choi YoungRak 
Published: December 2024

Category: Diabetes; Hindfoot Introduction/Purpose: Patients who have severe hindfoot Charcot neuroarthropathy and require surgical intervention often present with several medical comorbidities. When they undergo reconstructive surgery (tibiotalocalcaneal arthrodesis), they may inadvertently suffer from various complications, including infections, nonunion, delayed ambulation, and subsequent limb amputation. Therefore, appropriate treatment plans should be established to avoid potential complications, and prognosis should be predicted before surgery. This study aims to explore the influence of the preoperative deformity degree in hindfoot Charcot neuroarthropathy on the outcomes of tibiotalocalcaneal arthrodesis. Methods: Twenty patients who underwent tibiotalocalcaneal arthrodesis because of hindfoot Charcot neuroarthropathy were evaluated retrospectively. They were classified into the severe deformity group if the tibiotalar angle was < 80 degrees or >100 degrees or if they had severe osteolysis of the talar body. Those without such conditions were categorized into the mild deformity group. Their demographics, comorbidity, and various surgical outcomes, including the presence of bony union, ambulation status, and performance of major amputation, were compared between the two groups. Results: With the numbers available, demographics and comorbidity did not significantly differ between the two groups. Postoperative outcomes, including postoperative infections, malalignment, bony union rates, time to union, and the rate of poor clinical outcomes, did not significantly vary between the two groups with the numbers available. The patients with a history of preoperative wound and postoperative infection showed worse clinical outcomes although tibiotalocalcaneal arthrodesis was performed after the preoperative wound was relieved. Conclusion: The severity of preoperative deformity and the osteolysis of the talar body were not associated with the outcomes of tibiotalocalcaneal arthrodesis on hindfoot Charcot neuroarthropathy. The presence of preoperative wound might be related to poor outcomes, and more caution is needed in treating these patients.
Patient Pain and Function after Correction of Posterior Malleolar Malunion
Authors: Zhang Hui , Li Yaxing , Gan Tingjiang 
Published: December 2024

Category: Trauma; Hindfoot Introduction/Purpose: The management of an ankle malunion involving the posterior malleolus remains challenging, and only a few published studies described the operative treatment of complex posterior malleolar malunion. A transfibular approach allows for direct visualization of the articular reduction of the posterior malleolus, but the reports of its use for correcting posterior malleolar malunion are rare. This study aims to evaluate the results of the intra-articular osteotomy via a transfibular approach for correcting an ankle malunion involving the posterior malleolus. Methods: We conducted a retrospective review of 26 patients with a symptomatic malunited ankle fracture involving posterior malleolus were treated with the intra-articular osteotomy via a transfibular approach in our department. Radiographic assessments were performed using plain radiographs and computed tomographic (CT) scans. Clinical outcomes were assessed using the AOFAS ankle-hindfoot score, visual analog scale (VAS), active range of motion of ankle, and the 36-Item Short-Form Health Survey score. Results: Postoperatively, anatomic correction of articular surface and anatomic reduction of syndesmosis were achieved in all patients as judged by CT scans. No evidence of progression had been found in 18 of 26 patients (69.2%) at final follow- up. The median AOFAS score improved from 42.0 to 81.5 (P < .001). Median pain VAS score decreased from 6.0 to 1.0 (P < .001). A favorable clinical outcome was associated with a short time interval from original injury to correction surgery and a lower grade of preoperative arthritis, but not with the posterior malleolar fragment size. However, time interval, the posterior malleolar fragment size, and the grade of preoperative arthritis showed no correlation with the progression of arthritis grade after surgery. Conclusion: An intra-articular osteotomy via a transfibular approach demonstrated an improved function and pain after operative treatment of malunited ankle fracture with a displaced posterior malleolar fragment.
Patient Reported Outcomes Following Triple Arthrodesis for Adult Acquired Flat Foot Deformity: Minimum Two Year Follow Up
Authors: Kelly Tyler , Shah Ashish , Scheinberg Mila 
Published: December 2024

Category: Midfoot/Forefoot; Hindfoot Introduction/Purpose: The posterior tibial tendon (PTT) acts as the primary dynamic stabilizer of the medial longitudinal arch and insufficiency of the PTT can result in a broad range of symptoms from asymptomatic to debilitating arthritis in association with flat foot deformity. Staging of AAFD is based on the degree of deformity and broken into four groups. Triple arthrodesis (TA), a simultaneous fusion of the talonavicular, subtalar, and calcaneocuboid joint, is used for patients with intractable pain, instability, and stage 3-4 deformity due to hindfoot pathology. The purpose of this study was to identify patient-specific variables that independently influence PROMIS, Foot Function Index (FFI), and VAS scores as well as complication rates. Methods: A retrospective analysis was conducted of patients that underwent Triple Arthrodesis at our facility from 2014-2021. Patients were selected if they underwent an isolated triple arthrodesis. All cases included either a gastrocnemius recession versus a percutaneous tendo-achilles lengthening depending on the patient’s Silverskiold examination. The electronic medical record was utilized to collect basic patient demographics, previous foot and ankle surgeries, hardware failures, additional procedures, and surgical complications. To evaluate outcomes, we compared Patient Reported Outcomes Measurement Information System (PROMIS) survey scores with the general population and pre-operative vs. post-operative Visual Analog Scale (VAS) scores. Foot Function Index (FFI) scores and scores were utilized as a validation tool for our results. One hundred and thirty two patients met the criteria for our study with a total of 50 participants completing the PROMIS and FFI surveys. Results: The average time point at which the outcomes were collected was 5.50 years postoperatively, ranging from 1.65 to 7.57 years. The average PROMIS physical function was 38.35, pain interference was 61.52, and depression was 49.82 for this population. The mean FFI scores were 58.56 for pain, 60.07 for disability, 48.07 for activity limitation. There was a significant decrease in preoperative and postoperative VAS scores from 5.4 to 2.55 (p < 0.001). Three patients experienced wound complication related to decreased sensation. Conclusion: Our results indicated that only PROMIS depression scores were within one standard deviation of the population mean following a triple arthrodesis procedure. PROMIS physical function and pain interference were both outside of one standard deviation for the population.
Comparative efficacy of six types of scoliosis-specific exercises on adolescent idiopathic scoliosis: a systematic review and network meta-analysis
Authors: Wang Zhenghui , Zhu Wenpan , Li Guang , Guo Xuejun 
Published: December 2024

Abstract
Background
Adolescent idiopathic scoliosis (AIS) stands as the predominant spinal deformity in adolescents, manifesting symptoms including back pain, functional limitations, cosmetic worries, and respiratory dysfunction. At present, six approaches of scoliosis-specific exercises are globally practiced, encompassing Schroth exercise, the Scientific Exercise Approach to Scoliosis (SEAS), the Dobomed, the side shift exercise, active self-correction, and the Functional Individual Therapy of Scoliosis (FITS). However, there is no systematic review and meta-analysis comparing the efficacy of these six types of scoliosis-specific exercises on adolescent idiopathic scoliosis.

Objective
To evaluate and compare the efficacy of six types of scoliosis-specific exercises on spinal deformity and quality of life in AIS.

Materials and methods
A systematic search was performed on PubMed, EMBASE, and the Cochrane Library from their inception to September 2023. Two independent auditors screened all studies according to predefined inclusion and exclusion criteria. Clinical trials were compiled to investigate the effects of six exercise interventions on spinal deformity and quality of life in AIS.

Results
Twenty-four studies were included, with a sample size of 1069 subjects. After meta-analysis, it was shown that SEAS ranked first in reducing Cobb angles (SUCRA: 84.8%); active self-correction and Schroth significantly improved the angles of trunk rotation in AIS (SUCRA: 86.6% and SUCRA: 79.1%, respectively); active self-correction and Schroth showed significant improvements in quality of life (SUCRA: 76.6% and SUCRA: 76.0%, respectively).

Conclusion
According to the current findings, active self-correction demonstrated superior short-term benefits compared to other exercise interventions in ameliorating spinal deformity and improving quality of life for adolescents with idiopathic scoliosis. Meanwhile, Schroth exhibited long-term effects in improving both spinal deformity and quality of life.

Registration information
This review was registered on PROSPERO on June 20, 2023 (ID: CRD42023433152).
Association of maxillofacial injuries with traumatic brain injuries in paediatric patients: a case–control study
Authors: Suprabha Baranya Shrikrishna , Wilson Michael Lowery , Baptist Joanna , Subramanian Sadhvi Shankar , Shenoy Ramya , Jahanjoo Fatemeh , Radhakrishnan Jeedhu , Kamath V. Mayur , Anagha N. P. , Chaurasia Diksha 
Published: December 2024

Abstract
Background
Traumatic brain injuries (TBIs) are among the most challenging conditions to accurately diagnose in children, and many TBIs are underdiagnosed. Patients with maxillofacial injury may be at risk for TBI. The objective of this study was to analyse the association between maxillofacial injuries and TBI among paediatric patients. Analysis of the factors associated with the occurrence of TBI among paediatric patients with maxillofacial injuries was the secondary objective.

Method
This case-control study included 192 cases defined as paediatric patients with maxillofacial injuries and 192 controls defined as all paediatric patients with traumatic injuries to other body locations and with no maxillofacial injuries. The medical records of patients aged 0–18 years, who underwent treatment at a tertiary care hospital were screened. Patient demographic data, causes of trauma, and the presence, type, and severity of TBI were recorded. For the cases, the presence of facial fracture, type and severity of the maxillofacial injuries were recorded. The odds ratio was obtained to determine the association between maxillofacial injuries and TBI. Multiple logistic regression analysis was performed to study the associations of all the recorded study variables with the occurrence of TBI in patients with maxillofacial injuries.

Results
A statistically significant difference was seen between the cases and controls for TBI occurrence, with 53% of cases recording TBI, compared to 32% among controls, with an odds ratio of 2.5. Multiple logistic regression analysis with the presence/absence of TBI among the cases as the dependent variable revealed a significant association of road traffic accidents (RTA), longer duration of hospital stays, and dentoalveolar fracture with TBI.

Conclusion
Paediatric patients with maxillofacial injuries need to be screened for TBI, as the risk of occurrence of TBI is 2.5 times greater in these patients than in those with injuries involving other parts of the body. RTA and prolonged hospitalization are factors associated with TBI among paediatric patients with maxillofacial injuries. The presence of only dentoalveolar injuries decreases the likelihood of a TBI.