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Update on Treatment for a Variety of Orthopedic Conditions

In the article the editors of The Journal of Bone and Joint Surgery reviewed the latest research in the area of musculoskeletal medicine. Over 100 medical journals were included. A brief summary of 19 foot and ankle conditions are presented.

Bone fractures, ankle sprains, instability, and arthritis are among the various topics. Plantar fasciitis, joint fusion, and tendon rupture are also covered. Symptoms, clinical exam, and special tests for each one are reviewed study by study. Unusual cases and treatment options for each condition are also discussed.

Some of the research ideas included:

  • Management of distal metaphyseal tibial fractures
  • Calcaneal fractures in patients 65 years old and older
  • Use of videotaped versus verbal instructions before ankle fracture surgery
  • Open Reduction and Internal Fixation (ORIF) versus arthrodesis (fusion) for Lisfranc injuries
  • Total contact cast for diabetic neuropathic ulcers
  • Use of high-energy shock-wave treatment for chronic plantar fasciitis
  • Percutaneous osteotomy for hallux valgus (bunions)

    All articles reviewed were recently published. Each one was rated a Level of Evidence of 1. This is the highest level of evidence based on randomized controlled trials (RCTs). This means neither the patients, nor the doctors know which group the subjects are in. Level 1 studies reduce the chances of bias and error. The authors also provide an additional list of articles (summarized but not reviewed) that may be of interest to its readers.

    Wen Chao, MD, and Mark S. Mizel, MD. What's New in Foot and Ankle Surgery. In The Journal of Bone and Joint Surgery. April 2006. Vol. 88-A. No. 4. Pp. 909-922.

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