A common methodology in the foot and ankle surgical literature is the retrospective case series. Within this type of study design, the authors generally describe some form of new technique with the potential to advance clinical care (i.e. surgical procedure, fixation construct, indication for an existing procedure, post-operative protocol, etc.). This is typically done in a single group of reasonably similar patients, and a comparison is performed of post-operative to pre-operative outcomes. In the accepted hierarchy of the clinical levels of evidence, retrospective case series are considered ..read more

Surgical site infections (SSIs) are a notable complication following open reduction and internal fixation (ORIF) for ankle fractures. The purpose of this study was to (1) compare baseline demographics of patients who did and did not develop SSIs within 90 days following ORIF for trimalleolar ankle fractures and (2) identify risk factors associated with SSIs in this setting. A retrospective analysis from 2010 to 2020 was completed using a national administrative database. The study group consisted of patients who underwent ORIF for trimalleolar ankle fractures and developed SSIs within 90 days ..read more

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I would like to give congratulations and appreciation for the authors undertaking this task. While I certainly agree with the authors that 2-dimensional radiographs can sometimes present challenges when assessing the triplanar nature of hallux valgus, I however, disagree with their conclusion that the classification system is not valid and lacks prognostic value ..read more

We were interested when we read an article that was recently published online in the journal named Foot and Ankle Surgery entitled “Level of Agreement With a Multi-Test Approach to the Diagnosis of Diabetic Foot Osteomyelitis” (Meyr AJ, Kyung S, Khurana JS, Rachana C, Baidarbhi C. Level of Agreement With a Multi-Test Approach to the Diagnosis of Diabetic Foot Osteomyelitis. J Foot Ankle Surg 57(6):1137-9, 2018). The authors described the level of agreement between several of the commonly forms of diagnostic testing for diabetic foot osteomyelitis using percent agreement and Cohen's standard ka ..read more

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We concur that there are several different ways to objectively measure the concept of "agreement," and that this is an important point for critical readers of the medical literature to appreciate and understand. The big picture concept of this discussion relates to the possibility of "chance." In other words, if 2 people are asked to identify the "presence" or "absence" of a specific trait (essentially a 50/50 choice), then there is a distinct possibility that the 2 people will agree or disagree simply as a result of chance, completely independent of the actual presence/absence of the trait (1 ..read more

Ankle instability, which can be attributed to either the deltoid or lateral ligamentous complex, may be both a cause and a consequence of ankle fractures. This study aimed to assess postoperative ankle instability in patients with displaced ankle fractures. A total of 54 patients with displaced ankle fractures were included. Malleolar fractures were surgically reduced and fixated, and if necessary, the syndesmosis was stabilized. Concomitant deltoid injuries were left unrepaired. Ankle stress radiographs were taken approximately 25.4 months after surgery, with a standard deviation of 20.5 mont ..read more

Lateral Ankle Sprain (LAS) is a common injury in sports and daily activities. The present study aimed to determine the prognostic value of clinical and anthropometric parameters in predicting LAS recovery after physiotherapy. Twenty seven patients with acute LAS were included in this cohort study. First, prognostic factors and anthropometric variables were assessed, along with the time elapsed since the injury, pain score on a Visual Analogue Scale (VAS), navicular drop, ankle Range of Motion (ROM), and ambulation status ..read more