AANA24 Foot & Ankle All-Access Pass-CONCURRENT SCIENTIFIC SESSION 4D: Foot and Ankle 2

Video Transcription

Video Summary

The transcript covers a comprehensive orthopedic conference focusing on foot and ankle injuries and treatments. Hayley Thornburg presents a systematic review on arthroscopic-assisted reduction and internal fixation of talus and calcaneus fractures, highlighting improved clinical and radiographic outcomes, low complication rates, and advantages of minimally invasive arthroscopic techniques over traditional open surgery. The discussion includes surgical approaches, instrumentation, and patient selection considerations.<br /><br />Next, James Butler discusses in-office Achilles needle tendoscopy for chronic mid-substance Achilles tendinopathy, showcasing promising early results including significant functional improvements, high patient satisfaction, rapid return to sport and work, and low complication rates. The minimally invasive, awake-procedure using a small arthroscope allows debridement, tendon release, and microperforation to stimulate healing. Limitations include small sample size and heterogeneity, but the technique offers an attractive alternative to open surgery.<br /><br />Bill Weiss then presents a medical student project analyzing lower extremity injuries in the English Premier League relative to cleat stud patterns, finding associations between very aggressive and non-aggressive cleats and higher injury odds (especially ankle, hamstring, and knee injuries). While limited by data sources, this research raises awareness about equipment’s role in injury risk.<br /><br />A debate follows on managing deltoid ligament injuries in unstable Weber B ankle fractures with syndesmosis disruption. Eric advocates for fixing both syndesmosis and deltoid ligament using arthroscopic assessment and medial brostrom repair to improve stability and reduce post-traumatic arthritis. Brian counters that the deltoid often heals with anatomic fracture reduction and syndesmosis fixation alone, noting similar outcomes without deltoid repair and reduced costs, supporting a selective approach.<br /><br />Finally, a talk on Jones fractures emphasizes surgical treatment in athletes to optimize healing, recommending large solid screws, prevention of cuboid impingement, metabolic support (vitamin D, Forteo), and adjunct therapies (shockwave, bone stimulators). Complications such as screw breakage are addressed with surgical revisions and grafting. Overall, the session highlights advances in minimally invasive techniques, individualized surgical decision-making, and the interplay of biomechanics, biology, and clinical outcomes in foot and ankle orthopedics.

Asset Caption

Moderators: John G. Kennedy, M.D., Kenneth J. Hunt, M.D.

Keywords

orthopedic conference

foot and ankle injuries

arthroscopic-assisted reduction

talus fractures

calcaneus fractures

Achilles needle tendoscopy

chronic Achilles tendinopathy

lower extremity injuries

deltoid ligament injuries

Jones fractures