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Introduction/Purpose: Metatarsophalangeal (MTP) joint arthrodesis of the hallux is a common and reliable procedure performed on patients with various pathologies including hallux rigidus and hallux valgus. While the effect of foot pathology on MTP arthrodesis union rates has been previously explored, there is a lack of literature comparing long term patient reported outcomes between pathology types. The purpose of this present study was to compare patient reported and clinical outcomes following MTP fusion between those with hallux valgus and hallux rigidus. Methods: Patients undergoing primary MTP arthrodesis from 2010-2020 were identified. Additionally, Radiographic follow-up of >12 weeks, no ongoing ipsilateral infection, and complete response to a postoperative patient report outcomes (PROMIS AND Foot Function Index (FFI)) survey were required. After these criteria, 112 patients remained and were grouped by hallux valgus (HV, 53) and hallux rigidus (HR, 59). Medical records were examined for patient characteristics, operative variables, and complications. Patients were grouped by indication and compared. Results: Nonunion rates and complications including wound dehiscence, infection, and reoperation were not different between indications. Patients completed the patient reported outcomes instruments a median of 1.9 years (IQR 2.6) postoperatively. All patient reported outcomes measures were not significantly different between pathology groups with PROMIS physical function ((median, IQR) HR 44.6, 9.9 vs. HV 44.1, 12.2), pain interference (HR 52.8, 9.9 vs. HV 52.4, 12.3), FFI pain scale (HR 33.3, 40.0 vs. HV 28.3, 37.0), FFI disability scale (HR 30.0, 41.0 vs. HV 28.9, 41.0), FFI activity limitation scale (HR 10.0, 27.0 vs. HV 10.0, 23.0), and FFI total (HR 25.8, 50 vs. HV 37.4, 37). Conclusion: Arthrodesis of the first MTP joint provides similar nonunion and complication rates between hallux valgus and rigidus groups. At intermediate follow-up, MTP arthrodesis provides comparable validated patient reported outcomes scores between these two groups. Surgeons should be aware of these results when prognosticating the effect of MTP arthrodesis. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: Tarsal Coalition has been known to be associated with pes planovalgus, unrelenting pain, recurrent sprains, and arthrosis due to an abnormal connection between two or more bones of the feet following failure of segmentation during development. Three entities of coalition exist fibrous, cartilaginous and osseous. Most commonly patients present with pain during activity. On exam range of motion is usually limited and there may be valgus or varus malalignment of the hindfoot. Patients are often offered surgical resection following failure of conservative management. Few large cohort studies exist analyzing complications and patient reported outcomes of pediatric patients undergoing operative treatment. Methods: After IRB approval, patients under the age of 18 undergoing excision of tarsal coalition at a single academic center from 2010-2019 were identified. Medical records were reviewed for variables such as demographics, surgical technique, coalition characteristics, postoperative complications, and coalition recurrence. Patients were contacted via telephone to complete a PROMIS Physical Function and Pain Interference in addition to the Foot Function Index. Contact was attempted at least 3 times before a patient was considered non-respondent. A total of 44 patients and 54 feet were included in the analysis with 17 patients (22 feet) completing patients reported outcomes. Results: The median age at the time of surgery was 12 (IQR 3). Thirty-five feet (64.8%) were from male patients, while 19 feet (35.2%) were from female patients. Pain was the presenting symptom in 49 (90.7%) of feet. Pes planovalgus was present in 25 feet (46.3%). Forty feet (74.1%) had calcaneonavicular coalition compared to 12 feet (22.2%) with talocalcaneal coalition and 2 feet (3.7%) with both. Fibrous coalition was found in 19 feet (35.2%) and the most common. Interposition material was used in 49/54 (90.7%) feet. Wound complications or temporary neuropraxias were seen in 7/54 feet (13.0%), and coalition recurrence occurred in 3/54 feet (5.6%). At a median of 6 years (6.0 IQR) postoperatively, the median postoperative outcomes scores were as follows: PROMIS Physical Function 54.7 (17.9 (IQR)), PROMIS Pain Interference 38.7 (10.0), FFI Pain 14.0 (30.0), FFI Disability 1.0 (9.0), FFI Activity Limitation 3.0 (8.0), and FFI Total 6.0 (12.0). Conclusion: Our study investigated complications and long-term patient outcomes following coalition resection. At follow-up, pediatric patients who underwent excision of tarsal coalition had higher physical function and less pain than the average U.S. population (PROMIS population mean is score of 50). Our recurrence rate of 5.6% is lower than reported in literature. Infection rate was similar to reports in literature at 3.1%. Overall, Coalition resection in pediatrics is a well-tolerated procedure that improves both physical and emotional health. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: Preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) scores have been shown to be predictive of postoperative success in orthopedic foot and ankle patients. The purpose of this study was to determine if an association exists between pre-operative PROMIS scores and patients going to the emergency department (ED) in the first 60 days following their operation. Methods: PROMIS scores, including physical function (PF) and pain inference (PI), were collected from 290 patients prior to foot and ankle procedures. Patients with presence of ongoing infection were excluded. Electronic medical record (EMR) data was retrospectively gathered for each patient to determine if they visited the ED for any reason during the first 60 days following their operation. A Backward Stepwise Logistic Regression analysis was conducted for postoperative ED visits with p<0.1 in univariate analysis required for entry into the model. Results: The median age was 50.0 with an interquartile range (IQR) of 20.0, while the median BMI was 33.1 with an IQR of 11.6. In univariate analysis, Preoperative PROMIS PF and PI scores were significantly associated with ED visits within the first 60 days after surgery. Patients who visited the ED had lower preoperative PROMIS PF (median 34.9 (IQR 10.2)) and higher PROMIS PI (median 66.9 (IQR 9.1)) compared to patients who did not visit the ED, PROMIS PF (median 38.0 (IQR 10.2)) and PROMIS PI (63.6 (IQR 9.0)), respectively. In multivariate analysis, only PROMIS PF was associated with lower risk of ED visits OR 0.92 (95% CI.85-.99). Other factors independently associated with ED visits included non-traumatic surgical indication OR 3.7 (95% CI 1.1-12.9), any pulmonary disease OR 4.2 (95% CI 1.4-12.8), ASA classification OR 4.4 (95% CI 1.3-14.9), and wound complications OR 10.2 (95% CI 2.6-39.9). Conclusion: Patients with lower PROMIS PF scores preoperatively were significantly more likely to visit the ED postoperatively. While all of the factors found to be associated with ED visits are not modifiable by the surgeon, preoperative PROMIS scores could quickly and easily be used to identify patients for potential interventions. This study demonstrates the potential of the PROMIS outcomes system outside of quantifying surgical outcomes. Further study is being conducted to investigate the optimal PROMIS PF cutoff for best identifying patients at risk for ED visits. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: High BMI is a known risk factor for development of CAI and intraarticular pathology, but few studies have examined BMI's impact of the outcomes of lateral ligament reconstruction. The open Brostrom-Gould reconstruction, an anatomic repair, is the gold standard for repair of the lateral ligamentous complex. We aim to evaluation the impact of BMI on patient reported outcomes after open Brostrom-Gould repair. Methods: A total of 201 patients who underwent open Brostrom-Gould Repair were identified using CPT code. Patients undergoing repair for acute ligamentous injury were excluded. A completed telephonic survey was required for inclusion yielding 92 patients. The telephone survey included: PROMIS Physical Function (PF), Pain Interference (PI), and Depression domains(D) and the Foot and Ankle Ability Measure (FAAM). Medical records were examined for patient characteristics, operative variables, and complications. Patients were grouped by BMI <30 and BMI >30. Results: A total of 28 males (30%) and 61 females (69%) were including in this study. The average time at completion of survey was 4.1 years (standard deviation of 2.8). The median age was 44 with an interquartile range (IQR) of 20, while the median BMI was 31.5 with an IQR of 13.4. Obese patients had significantly worse PROMIS PF (Median 44.5 IQR 7.4 vs median 48 IQR 16.5) and FAAM Activity of Daily Living subscale scores (Median 61.6 IQR 30.0 vs. median 82.7 IQR.36). Patients' FAAM self-reported overall level of function was significantly lower in obese patients (Median 70.0 IQR 20.0 vs median 85 IQR 29). The BMI groups did not vary by other PROMIS domains or FAAM subscales. Conclusion: At intermediate term follow-up, Obese patients report significantly worse physical function after open Bostrom- Gould repair compared to non-obese patients. Surgeons should be aware of this when prognosticating the outcomes of anatomic ankle reconstruction. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: Torsional injury to the foot and ankle may result in high fibular fracture with disruption of the syndesmotic ligaments, interosseous membrane, and other associated injuries to medial, posterior structures of the ankle. High Fibular Fracture at the fibular neck is referred as Maisonneuve Fracture of Fibula (MFF). These injuries are often missed or misdiagnosed as ankle sprains. Most of the current classification consider MFF a variant of ankle fracture with disruption of syndesmosis and high fibular fracture {Lauge Hansen PER, AO C3, Weber type C}. Only a few articles have described associated injuries and surgical treatment outcomes. The study's primary aim is to evaluate the associated injuries of MFF and the outcomes of our treatment approach. Methods: All patients undergoing syndesmotic fixation (CPT 27829) at a large tertiary academic center from 2012-2020 were identified. In these 748 patients, patient radiographs were reviewed to identify patients with Maisonneuve fractures (AO-44C3). Medical records were reviewed for patient characteristics, energy information of original injury, operative variables, and complications. Radiographic reduction was assessed on standard radiograph with assessment of the tibiofibular clear space and tibiofibular overlap on AP and mortise views, talocrural angle, the medial clear space, shenton line, and fibular station. An abnormality in one of these parameters was considered an abnormal reduction. Patients were contact to complete PROMIS Physical function and Pain Interference postoperatively. A total of 24 patients with Maisonneuve fractures were identified and included in analysis. Eleven patients completed PROMIS outcomes measures for a response rate of 55%, as four patients were deceased or incarcerated at the time of survey. Results: The average age was 45.3 (16 SD) with a mean BMI of 31.3 (10.4 SD). Nineteen patients were male (79.2%) with only 5 females (20.8). The mechanism of injury was low energy in 16/24 patients (66.7%) leaving 8 (33.3%) patients with high energy mechanisms. In addition to the high fibular fracture, a total of 13 patients (54.2%) had a posterior malleolar fracture, 11 (45.8%) had a medial malleolar fracture, and 8 (33.3%) had a deltoid ligament injury. Seven patients (29.2%) received screw fixation compared to 14 patients (58.3%) with tightrope fixation. Three patients (12.5%) received both tightropes and screws. No patient developed wound complications, and two patients underwent reoperation. Abnormal reduction occurred in 5/24 patients (20.8%) at final clinical follow up. At a median of 20 months (25 IQR) postoperatively, the median PROMIS physical function and pain interference scores were 41.2 (13.0 IQR) and 52.8 (4.8 IQR), respectively. Conclusion: Maisonneuve fractures are an extremely rare ankle fracture variant with a diverse subset of injury patterns. Our results show the clinical outcomes of Maisonneuve fractures are largely satisfactory in terms of wound complications and intermediate term outcomes. While 21% of patients were determined to have abnormal reduction postoperatively, we are limited by the inherent difficulties of assessing syndesmosis on plain radiographs rather than advanced imaging. PROMIS outcome scores demonstrate Maisonneuve fractures patients are more impacted by loss of function than pain, but both are within a standard deviation of the population mean. [ABSTRACT FROM AUTHOR]

Information is given about the August 2010 meeting of the American Psychological Association's Council of Representatives (COR) that was held in San Diego, California. The 2011 preliminary revenue and expense budget was approved, a Bylaws amendment concerning allocation of Council seats will be submitted to COR members, and several specialties in professional psychology were recognized.

The article discusses the August 2009 meeting of the Council of Representatives of the American Psychological Association (APA) held in Toronto, Ontario. Topics discussed include: APA budget cutbacks, including reduced funding for the Archives of the History of American Psychology; withdrawal of the APA from the American Council of Learned Societies; and changes to the APA ethical standards.

The article discusses presentations on the history of psychology at two conferences, the 2010 annual meetings of the Southeastern Psychological Association in Chattanooga, Tennessee in March, and the Southern Society for Philosophy and Psychology in Atlanta, Georgia in April. Paper topics discussed include the lives and work of U.S. psychologists such as Irwin Jay Knoft, Dorothy W. Seago, and Lula Stevens.

Information is given about the February 17-20, 2011 meeting of the American Psychological Association's (APA's) Council of Representatives (COR) that was held in Washington, D.C. Agenda items were the triennial reauthorization of the APA's financial allocation to the Archives of the History of American Psychology, proposed membership dues, and the 2011 Budget.

The article presents information on the February 2010 meeting of the Council of Representatives (COR) of the American Psychological Association (APA), held in Washington, D.C. Budget concerns for the Society for the History of Psychology (SHP) were addressed. Funds provided by the APA to the Archives of the History of American Psychology (AHAP) are referenced. The COR will hold its next meeting in San Diego, California.

Information is presented on the 2007 regional meetings of the Southeastern Psychological Association (SEPA) and the Southern Society for Philosophy and Psychology (SSPP), focusing on the symposiums and papers delivered on the history of psychology. The SEPA meeting was held in Atlanta, Georgia, from April 5-7, 2007. The SSPP meeting was held in New Orleans, Louisiana, from February 21-24, 2007.