What's New in Foot and Ankle Surgery?
Richard A. Miller, MD; Thomas A. DeCoster, MD; Mark S. Mizel, MD

The following is a summary of research related to the subspecialty of foot and ankle surgery that was published or presented between July 2003 and June 2004. The sources of these studies were The Journal of Bone and Joint Surgery, Foot and Ankle International, and the proceedings of the Winter and Summer meetings of the American Orthopaedic Foot and Ankle Society (AOFAS) (held on March 13, 2004, in San Francisco, California, and on July 29 through 31, 2004, in Seattle, Washington).

Ankle Fractures

Functional recovery of the ability to operate the foot controls of an automobile was addressed by Egol et al. with use of a driving simulator1. A group of patients who had undergone operative fixation of a right ankle fracture were compared with normal controls. The patients had been managed with a functional brace, non-weight-bearing, and early range of motion prior to testing, which was done six, nine, and twelve weeks postoperatively. Total braking time was significantly impaired at six weeks, but it had returned to near normal by nine weeks.

Injury to the superficial peroneal nerve may result in persistent pain after ankle fracture. Redfern et al. examined 120 patients with malleolar fractures one to three years after the time of the injury2. A symptomatic superficial peroneal nerve injury was found in 21% of the patients who had been managed operatively and in 9% of those who had been managed with a cast. The mean AOFAS ankle-hindfoot score was decreased in the patients who had a symptomatic nerve injury. None of the patients in the operative treatment group who had been managed with a posterolateral approach to the fibula had a nerve injury. The authors concluded that surgeons should be aware that this nerve is at risk during the lateral approach to the fibula and …

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