scholarly journals Correlation between Metal Allergy and Treatment Outcomes after Ankle Fracture Fixation

2011 ◽  
Vol 19 (3) ◽  
pp. 309-313 ◽  
Author(s):  
Sarah So ◽  
Ian A Harris ◽  
Justine M Naylor ◽  
Sam Adie ◽  
Rajat Mittal
Keyword(s):  
Stainless Steel ◽  
Internal Fixation ◽  
Positive Reaction ◽  
Patch Testing ◽  
Linear Regression Analysis ◽  
Ankle Fractures ◽  
Foot And Ankle ◽  
Metal Hypersensitivity ◽  
Surgical Scar ◽  
History Of

Purpose. To determine correlation between metal hypersensitivity and long-term foot and ankle function and pain after internal fixation using stainless steel implants. Methods. 60 men and 46 women (mean age, 47 years) who underwent internal fixation for ankle fractures completed a questionnaire 13 to 38 (mean, 26) months after surgery to assess their existing medical condition, history of metal hypersensitivity, problems and outcome of the implant (revision or removal), and the American Academy of Orthopaedic Surgeons (AAOS) foot and ankle score. A subset of 12 men and 15 women then underwent patch testing for metal hypersensitivity to molybdenum, chromium, iron, manganese, and nickel. Patients with positive and negative reactions were compared. Results. 21 of the 106 patients underwent removal of the metal implants. The AAOS score was not associated with any of the variables, except for a history of metal hypersensitivity from dental implants and irritation around the surgical scar. Multiple linear regression analysis showed that only irritation around the surgical scar remained associated with poorer AAOS scores. Five of the 27 tested patients had a positive reaction. The mean AAOS scores did not differ significantly between patients with positive and negative reactions (34 vs. 31, p=0.73). Gender was not associated with the test results (p=0.63). None of the 5 patients with a positive reaction underwent revision surgery or reported any history of asthma or metal hypersensitivity. Of the 27 patients, one of the 8 who reported itching, irritation, redness or rash around the surgical scar had a positive reaction, compared to 4 of 19 patients who reported no such symptoms (p=1). Two of the 27 patients reported development of eczema after fixation, one of whom had a positive reaction. Only one of the 27 patients reported a history of metal hypersensitivity to jewellery, but had a negative reaction‥ Conclusion. Neither a history of metal hypersensitivity nor positive patch testing correlated with poor outcomes after internal fixation for ankle fractures using stainless steel implants.

scholarly journals Arthroscopically Assisted Internal Fixation of Foot and Ankle Fractures: A Systematic Review

2021 ◽  
Vol 6 (1) ◽  
pp. 247301142095021
Author(s):  
Caroline E. Williams ◽  
Peter Joo ◽  
Irvin Oh ◽  
Christopher Miller ◽  
John Y. Kwon
Keyword(s):  
Internal Fixation ◽  
Patient Reported Outcomes ◽  
Case Series ◽  
Ankle Fractures ◽  
Foot And Ankle ◽  
Anatomic Reduction ◽  
Patient Reported ◽  
Arthroscopically Assisted ◽  
Poor Outcomes ◽  
Calcaneus Fractures

Background: Patients undergoing fixation for foot and ankle fractures may experience poor outcomes despite achieving apparent anatomic reduction. Adjunct arthroscopy to identify missed concomitant injuries and subtle displacements has been proposed as a vehicle to enhance functional results for these patients. The purpose of this review is to provide an overview of the literature regarding arthroscopically assisted open reduction and internal fixation (AAORIF) methods for commonly encountered foot and ankle injuries including pilon, ankle, and calcaneus fractures published to date. Methods: A systematic review of the literature was performed using the PubMed database to access all studies reporting on arthroscopically assisted internal fixation methods for pilon, ankle, and calcaneus fractures. Relevant publications were analyzed for details on their respective study designs, the operative technique used, clinical outcomes, outcome instruments used, and reported complications. Results: A total of 32 studies were included in this review. Two studies on pilon fractures, a randomized controlled trial (RCT) and case series with a total of 243 patients, met inclusion criteria. Postoperative articular reductions, bone union, and Mazur scores were found to be significantly better for those using adjunct arthroscopy when compared to those with no arthroscopy use. Patient-reported outcomes were overall reported as excellent for most patients, with no difference in patient-reported outcomes reported in the RCT. For ankle fractures, a total of 17 studies comprising of 2 systematic reviews, 1 meta-analysis, 2 RCTs, 5 retrospective comparative studies, 6 case series, and 1 case-control study met inclusion criteria for this review. Results were mixed, though the overall consensus was that arthroscopy use may help to better visualize concomitant intra-articular injuries and is generally considered safe with at least comparable outcomes to conventional methods. For the calcaneus, 13 studies met the criteria. Two studies were review papers, 8 were case series, and 3 were retrospective comparative studies. A total of 308 patients with 316 fractures formed the basis of analysis. In general, the studies found comparable functional outcomes between with or without arthroscopy use, but found that anatomical reductions were significantly improved with the use of arthroscopy. Conclusions: Arthroscopy shows promise as a valuable adjunct tool for internal fixation of foot and ankle fractures, though definitive conclusions as to its clinical significance have yet to be drawn because of limited evidence. Potential advantages related to the direct visualization of the fracture site and minimally invasive nature of arthroscopy were suggested throughout studies examined in this review. The presence of intra-articular pathology may lead to unexpectedly poor outcomes seen in some patients who undergo surgical fixation of ankle fractures with an otherwise anatomic reduction on postoperative radiographs; the ability to diagnose and address these lesions with arthroscopy, therefore, has the potential to improve patient outcomes. To date, however, available literature has not shown that significant improvements in anatomical reductions and treatment of these intra-articular injuries provide any improvement in outcomes over standard fixation methods. Few prospective randomized controlled studies have been performed comparing these 2 operative techniques, rendering any suggestion that AAORIF improves clinical outcomes over traditional open fixation difficult to justify. Further research is indicated for what may be a potentially promising surgical adjunct prior to advocating for its routine use in patients.

The Foot and Ankle Outcome Score (FAOS) During Early Recovery After Ankle Fracture

2021 ◽  
pp. 107110072110028
Author(s):  
Peter Larsen ◽  
Mohammed Al-Bayati ◽  
Rasmus Elsøe
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Ankle Fracture ◽  
Minimal Clinically Important Difference ◽  
Ankle Fractures ◽  
Foot And Ankle ◽  
Early Recovery ◽  
Clinically Important Difference ◽  
Test Retest Reliability

Background: Several patient-reported outcome measures (PROMs) are available for assessing the outcomes following ankle fractures. This study aimed to evaluate validity, reliability, and responsiveness and detect the minimal clinically important difference of the Foot and Ankle Outcome Score (FAOS) in patients with ankle fractures. Methods: The study design is a prospective cohort study, including all patients treated both conservatively and surgically following an ankle fracture (AO-43A/B/C). Content validity, test-retest reliability, responsiveness, and minimal clinically important difference were evaluated from 14 days to 3 months following the fracture. Results: The study population consisted of 52 females and 24 males. The mean age was 52.0 years (range, 15-75 years). The percentage of patients at 12 weeks reporting the 5 subscales at least somewhat relevant were pain, 77%; symptoms, 75%; activities of daily living (ADL), 64%; sport, 81%; and quality of life (QOL), 88%. High test-retest reliability of the FAOS questionnaire was observed. The interclass coefficients were 0.78, 0.77, 0.71, 0.73, and 0.74 for the pain, symptoms, ADL, sport, and QOL subscales, respectively. Responsiveness was evaluated with high effect size for the symptoms (0.83), ADL (1.19), sport (4.36), and QOL (2.12) subscales. The minimal clinically important difference of the FAOS was 14 (95% CI, 12-17). Conclusion: The FAOS during early recovery after ankle fracture has high reliability and validity. Level of Evidence: Level II, prospective cohort study

scholarly journals Incidence and Risk Factors of Symptomatic Venous Thromboembolism Following Foot and Ankle Surgery

2018 ◽  
Vol 40 (1) ◽  
pp. 98-104 ◽  
Author(s):  
Johanna Marie Richey ◽  
Miranda Lucia Ritterman Weintraub ◽  
John M. Schuberth
Keyword(s):  
Risk Factors ◽  
Hormone Replacement ◽  
Case Series ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Ankle Surgery ◽  
History Of ◽  
Low Incidence ◽  
Predictive Risk

Background: The incidence rate of venous thrombotic events (VTEs) following foot and ankle surgery is low. Currently, there is no consensus regarding postoperative prophylaxis or evidence to support risk stratification. Methods: A 2-part study assessing the incidence and factors for the development of VTE was conducted: (1) a retrospective observational cohort study of 22 486 adults to calculate the overall incidence following foot and/or ankle surgery from January 2008 to May 2011 and (2) a retrospective matched case-control study to identify risk factors for development of VTE postsurgery. One control per VTE case matched on age and sex was randomly selected from the remaining patients. Results: The overall incidence of VTE was 0.9%. Predictive risk factors in bivariate analyses included obesity, history of VTE, history of trauma, use of hormonal replacement or oral contraception therapy, anatomic location of surgery, procedure duration 60 minutes or more, general anesthesia, postoperative nonweightbearing immobilization greater than 2 weeks, and use of anticoagulation. When significant variables from bivariate analyses were placed into the multivariable regression model, 4 remained statistically significant: adjusted odds ratio (aOR) for obesity, 6.1; history of VTE, 15.7; use of hormone replacement therapy, 8.9; and postoperative nonweightbearing immobilization greater than 2 weeks, 9.0. The risk of VTE increased significantly with 3 or more risk factors ( P = .001). Conclusion: The overall low incidence of VTE following foot and ankle surgery does not support routine prophylaxis for all patients. Among patients with 3 or more risk factors, the use of chemoprophylaxis may be warranted. Level of Evidence: Level III, retrospective case series.

scholarly journals Patch Testing for Metal Hypersensitivity Evaluation in Patients With Metal Implants

2017 ◽  
Vol 139 (2) ◽  
pp. AB243
Author(s):  
Sonam Sani ◽  
Luz S. Fonacier ◽  
Mark A. Davis-Lorton ◽  
Marcella Aquino
Keyword(s):  
Patch Testing ◽  
Metal Hypersensitivity ◽  
Metal Implants

P082 Patch testing results in patients with suspected metal hypersensitivity

2016 ◽  
Vol 117 (5) ◽  
pp. S45-S46
Author(s):  
S. Sani ◽  
L. Fonacier ◽  
M. Davis-Lorton ◽  
M. Aquino
Keyword(s):  
Patch Testing ◽  
Metal Hypersensitivity

Effect of Chemical Thromboprophylaxis on the Rate of Venous Thromboembolism After Treatment of Foot and Ankle Fractures

2016 ◽  
Vol 37 (11) ◽  
pp. 1218-1224 ◽  
Author(s):  
Xin Zheng ◽  
Dong-Ya Li ◽  
Yufan Wangyang ◽  
Xing-Chen Zhang ◽  
Kai-Jin Guo ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Ankle Fractures ◽  
Foot And Ankle

scholarly journals Advantages and Disadvantages of using Food Grate Stainless Steel Rods for Internal Fixation of Femoral Transverse Fractures in Rabbits (Review Study)

2020 ◽  
Vol 5 (2) ◽  
pp. 1-7
Author(s):  
Humam H Nazht
Keyword(s):  
Stainless Steel ◽  
Internal Fixation ◽  
Radiological Finding ◽  
Femoral Bone ◽  
Advantages And Disadvantages ◽  
Level Measurement ◽  
Stifle Joint ◽  
Intramedullary Canal ◽  
Chemical Constant ◽  
Transverse Fractures

The present study designed to focus on the advantages and disadvantages of using food grate stainless steel rods (FGSR) as internal fixation methods for induced transverse fractures in the mid shift of the femoral bones in rabbits.200 cases were collected from 2007 to 2020, all these cases were employed to induced transverse fractures in the mid shift of femoral bone, 100 of them used the rods for internal fixation, 80 of the cases used the rods for fixation the natural xen- bony implantation from sheep or calves, and the others 20 cases used the rods for internal fixation of the synthetics nano bony implantation .The physical, chemical, clinical and radiographic parameters were used for evaluation, the physical and chemical analysis showed that the rods not change during sterilization, implantation or when exposed to different types of ray besides the chemical constant is about the same level measurement of the medical intramedullary pins (IMP), while the clinical observation revealed that the rods can used strongly and successfully for fracture fixation and support the animal to bear the weight, the limb used for walking gradually after 24-48 hours p. o. with some cases shown the FGSR pulled from the bone, other suffer from infection with pus formation with lateral deviation of the stifle joint or re-fracture. While the radiological finding revealed that the FGSR insert and fix the fractures fragment and the bony implantation, the pins seemed stable and fit the intramedullary canal and fracture fragments, while some cases shows that the pin not insert properly inside the femoral bone with case of multible and comminuted fractures, other case shown the FGSR pass and penetrate the stifle joint. The conclusion is, there are many advantages with minor or very little disadvantages for using the FGSR as internal fixation of the induced transverse fractures in the mid shift of the femoral bones and for natural and synthetics bony implantation in rabbits.

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