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Purpose: Chronic Achilles tendon rupture with a 2–5 cm gap is usually repaired using a V-Y advancement flap. This study examined the clinical outcomes after a V-Y advancement flap for a chronic Achilles tendon rupture and compared the postsurgical muscle strength of the affected limb with the unaffected side using a constant velocity dynamometer. Materials and Methods: Twenty patients (14 male, six female) who underwent a V-Y advancement flap for chronic Achilles tendon rupture between March 2011 and September 2019 were reviewed retrospectively. The following clinical outcomes were evaluated preinjury, preoperatively, and postoperatively: the Foot and Ankle Ability Measure (FAAM) daily living and sports subscales, Thermann score, American Orthopaedic Foot and Ankle Society score, and Achilles Tendon Total Rupture Score. At the last follow-up, the muscle torque at an ankle plantar flexion of 30°, 60°, and 120° was measured on both sides using a constant velocity dynamometer (HUMAC® ) to determine the gastrocnemius-soleus complex strength. Results: The postoperative average deficiency of plantar flexion strength in the affected side was 10.40% for plantar flexion peak torque at 30°/s, and 15.89% for peak torque at 120°/s. The mean FAAM daily living subscale improved to 98.81±1.54 from 94.28±5.48 pre-injury (p<0.001). On the other hand, the mean FAAM sports subscale decreased to 85.28±4.47 from 95.71±4.27 pre-injury (p<0.001). Conclusion: Chronic Achilles tendon rupture repair by a V-Y advancement flap leads to successful return to pre-injury daily life activities without additional treatment. [ABSTRACT FROM AUTHOR]

Purpose: Ankle sprains are among the most common musculoskeletal injuries, and many videos have been shared with patients through YouTube. YouTube allows the easy sharing of information, but there are accuracy and reliability issues due to the lack of verification processes for video producers. This study evaluated ankle sprain videos on YouTube and the correlation between the video scores and viewer preferences using “the number of likes and views”. Materials and Methods: For analysis, the words “ankle sprains”, “ankle exercise”, and “ankle rehabilitation” were searched on YouTube. Only videos taken in Korean were analyzed, and videos with less than 10,000 views and for commercial purposes were excluded. For 31 videos, two orthopedic surgeons and one orthopedic resident used one evaluation tool to evaluate the video quality with up to 30 points for subcategories. The scores between each evaluator were then averaged to evaluate the video quality. To reflect the viewer preferences, “the number of likes and views” were analyzed, and the relationship between the video score and “the number of likes and views” of the video was analyzed statistically. Results: The average score for the video was 9.33. The average scores for subcategories were anatomy and symptoms, 0.90; biomechanics and trauma-mechanism, 0.61; imaging quality, 0.95; clinical evaluation and physical examination, 0.61; treatment, 1.41; rehabilitation, 2.39; prevention and after effects, 0.89; and overall video quality, 1.61. The average of “the number of views” was 50,218.35 times, and “the number of likes” was 893.77 times. No correlation was observed between the video scores and “the number of likes and views”. Conclusion: Most videos posted on YouTube did not provide high-quality medical information on ankle sprain, and there was no correlation between the video scores and viewer preferences. This suggests that incorrect medical information is being transmitted to patients, which can be harmful. Therefore, it is necessary to present the latest trend treatment and rehabilitation protocols for ankle sprains in an expert council and promote it through various channels. [ABSTRACT FROM AUTHOR]

Purpose: This paper reports the surgical treatment results of open calcaneal fractures performed at the author's clinics focusing on open calcaneal fractures to help understand the appropriate treatment and realistic outcomes. Materials and Methods: This study was conducted on 22 cases out of 30 patients who visited the hospital from February 2009 to December 2019 and were followed up for more than one year. In open fractures, the fracture was classified using the Gustilo-Anderson classification and was evaluated using the soft tissue status at the time of visit. Intra-articular calcaneal fractures were classified using Sanders classification. The radiological parameters were measured for the Böhler angle, Gissane angle, calcaneal length, height, and width before and after surgery, and at the last follow-up. The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and investigated complications. In addition, statistical analysis of the incidence and associated factors of posttraumatic arthritis was conducted. Results: In all cases, the surgical treatment was performed by minimally invasive surgery. The AOFAS ankle-hindfoot scale conducted for a clinical evaluation of the final follow-up was averaged 72.5 points. In the classification of open fractures, the Gustilo-Anderson classification type IIIA was the most common, and the Sanders type III was the most common. Of the 22 cases after surgery, 15 cases had complications, 11 cases had posttraumatic arthritis, eight cases had an infection, and 4 cases had both complications. Only the Sanders classification showed a statistically significant correlation with the incidence of posttraumatic osteoarthritis (p-value 0.032). Conclusion: In treating open calcaneal fractures, internal fixation by a minimally invasive approach showed relatively satisfactory results. However, follow-up research will be needed, including the results of a long-term follow-up through a large number of cases and comparative studies with other surgical methods. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the results of dual plate fixation for periprosthetic femur fracture after total knee arthroplasty (TKA). Materials and Methods: From October 2007 to February 2013, 23 cases of periprosthetic femur fracture after TKA were treated at the author’s hospital. There were 13 cases of fixation using a medial and lateral dual plate when the stability of the fracture site could not be achieved by one side fixation with a follow-up of more than one year. The cases included no loosening of the femoral component in fractures that were categorized as Lewis–Rorabeck classification II and supracondylar comminuted fractures and elongation of the fracture line to the lateral epicondyle of the femur or stem in the medullary canal. The mean age was 72 years (65–82 years), and 11 cases were female. Three cases had a stem due to revision. The mean bone marrow density was -3.2 (-1.7 to -4.4), and the mean period from primary TKA to periprosthetic fractures was 28 months (1–108 months). The mean follow-up period was 23 months (12–65 months). The medial fracture site was first exposed via the subvastus approach. Second, the supplementary plate was fixed on the lateral side of the fracture using a minimally invasive plate osteosynthesis technique. The average union time, complications, and Hospital for Special Surgery Knee Score (HSS) at the last follow-up were evaluated. Results: The mean union time was 17.4 weeks (7–40 weeks). Two cases showed delayed bone union and nonunion occurred in one case, in whom bone union was achieved three months later after re-fixation using a dual plate with an autogenous bone graft. The mean varusvalgus angulation was 1.67 degrees (-1.2–4.9 degrees), and the mean anterior-posterior angulation was 2.86 degrees (0–4.9 degrees) at the last follow-up. The mean knee range of motion was 90 degrees, and the HSS score was 85 points (70–95 points) at the last follow-up. Conclusion: Dual plate fixation for periprosthetic femur fractures that had not achieved stability by one side plate fixation after TKA showed a good clinical result that allowed early rehabilitation. [ABSTRACT FROM AUTHOR]