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Ankle arthrodiastasis provides an alternative surgical treatment of the mild to moderate posttraumatic ankle arthritis. Ankle arthrodesis or ankle implant arthroplasty is usually reserved for the end-stage ankle arthritis and after conservative treatment options have been implicated for a long period of time. Ankle joint destructive procedures are often considered for the older and less active population with strict selected surgical criteria and prolonged rehabilitation. In either ankle joint-sparing or ankle destructive procedures, lower extremity deformity correction will need to be addressed before or at the time of index surgery for the overall patient's successful outcome., (Copyright © 2017 Elsevier Inc. All rights reserved.)

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Ankle fractures account for 5% and foot fractures account for approximately 8% of fractures in children. Some complications are evident early in the treatment or natural history of foot and ankle fractures. Other complications do not become apparent until weeks, months, or years after the original fracture. The incidence of long-term sequelae like posttraumatic arthritis from childhood foot and ankle fractures is poorly studied because decades or lifelong follow-up has frequently not been accomplished. This article discusses a variety of complications associated with foot and ankle fractures in children or the treatment of these injuries., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Introduction: Total Knee Arthroplasty (TKA) is an important treatment for posttraumatic arthritis (PTA), but evidence on outcomes is sparse. The purpose of this study was to evaluate the impact of PTA versus primary osteoarthritis (OA) on postoperative outcomes after TKA., Methods: We queried the entire Medicare database from 2005 to 2012. International Classification of Diseases, 9th revision and Current Procedural Terminology codes were used to identify the procedure, indication, and complications. Patients with minimum two-years follow-up were selected. Odds ratios (ORs), confidence intervals, and p-values (p) were calculated., Results: For PTA, 3509 patients had TKA. For OA, 257,611 patients with TKA served as controls. The average Charlson Comorbidity Index for both groups was five. PTA patients were younger; only eight out of 29 Elixhauser comorbidities were higher. PTA patients had higher incidence of periprosthetic infection (OR 1.72, p<0.001), cellulitis or seroma (OR 1.19, p<0.001), knee wound complications (OR 1.80, p<0.001), TKA revision (OR 1.23, p=0.01), and arthrotomy/incision and drainage (OR 1.55, p<0.001). Blood transfusion rate was lower in PTA patients. There were no significant differences in bleeding complications, prosthetic dislocation, broken prostheses, periprosthetic fracture, osteolysis and polywear, neurovascular injury, and extensor mechanism rupture., Discussion and Conclusion: This study represents, to our knowledge, TKA outcomes in the largest cohort of PTA patients to date. Our findings indicate that these patients are at higher risk for many, but not all, postoperative surgical complications despite being as healthy as patients receiving TKA for primary OA., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Total hip arthroplasty can be a very effective salvage treatment for both failed fracture surgery and hip arthritis that may occur after prior fracture surgery. The rate of complications is significantly increased including especially infection, dislocation, and loosening. Complications are more likely to occur after failed open reduction and internal fixation than after posttraumatic arthritis. Adequately ruling out infection before hip arthroplasty can be difficult. The best predictor of infection is a prior infection. Long-term outcomes can be comparable to outcomes in other conditions if complications are avoided., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: To assess long-term functional outcome after ulnar head excision for distal radioulnar joint dysfunction with prior or concomitant wrist trauma. We hypothesized that long-term outcomes would reflect good functional results with satisfactory pain relief. Methods: A retrospective chart review identified patients who had undergone the Darrach procedure for traumatic or posttraumatic distal radioulnar joint (DRUJ) pathology. We assessed subjective outcomes using a visual analog scale questionnaire to assess pain, wrist stability, and overall satisfaction. We evaluated objective functional outcomes using the Quick Disabilities of the Shoulder, Arm, and Hand and Patient-Rated Wrist Evaluation measures. Final radiographs were compared with preoperative x-rays to investigate the effect of possible ulnar impingement syndrome (convergent instability). Results: A total of 98 patients with 99 wrists met our predetermined inclusion criteria. Of these, 27 patients with a total of 27 wrists were available for final follow-up, 15 of whom were available for final in-office follow-up with radiographs (6–20 y). Patients displayed an average Quick Disabilities of the Shoulder, Arm, and Hand score of 17 and a Patient-Rated Wrist Evaluation score of 14. Final average visual analog scale scores for pain (0–4), pain with activity (0–4), overall satisfaction (0–4), and wrist stability (0–10) were 0.1, 0.6, 3.7, and 1.5, respectively. Final average wrist range of motion was 85°/78° and 41°/45° for pronation-supination and flexion-extension, respectively. A total of 7 patients displayed radioulnar impingement based on dynamic radiography. This ulnar impingement was not associated with clinical reports of pain and did not affect outcome measures in a statistically significant manner. Conclusions: The Darrach procedure provides reliably good long-term subjective and objective results for the treatment of a symptomatic DRUJ after a distal radius fracture. Patients can expect to have excellent forearm range of motion at long-term follow-up. Nearly one-half of patients had dynamic convergence of the DRUJ when stressed radiographically; however, the presence of radiographic dynamic convergence did not influence clinical outcomes. Type of study/level of evidence: Therapeutic IV. [Copyright &y& Elsevier]

Numerous techniques have been described for posttraumatic ankle arthritis with or without an associated lower extremity deformity in the adult population. These surgical procedures may include, but are not limited to, ankle exostectomy with joint resurfacing, ankle arthrodiastasis, ankle arthroplasty, and ankle arthrodesis. Associated deformities may also be addressed with supramalleolar osteotomies, tibia or fibular lengthening, and calcaneal osteotomies. In juvenile patients, surgical treatment options for posttraumatic ankle arthritis can be challenging, especially when an associated deformity is present. This article describes a combined supramalleolar osteotomy and ankle arthrodiastasis for a juvenile patient with posttraumatic ankle arthritis and valgus deformity., (Copyright © 2014 Elsevier Inc. All rights reserved.)