Orthopaedic Articles - Articles for Orthopaedic Practice

Orthopaedic articles on current trends, tips & tricks and best evidence from top orthopaedic specialists.

The Top 4 Ways to Prevent Ankle Sprains

Kolten Tea


Ankle sprains are common amongst athletes young and old and is one of the top reasons athletes miss playing time. The most common type of ankle is sprain is an ankle inversion sprain, or where your foot rolls and stretches the ligaments on the outside of the ankle. The best way to recover from an ankle is to prevent it from occurring in the first place as even mild-to-moderate sprains can turn into chronic ankle instability. As high as 61% of soccer player sustained recurrent ankle sprain after a mild ankle and 38% of those resulted in mechanical instability or actual structural damage (1). Let’s look at the top 4 strategies to prevent ankle sprains used in the Physical Therapy clinic.

This is the #1 Mistake Car Accident Victims Make

Lauren Bridges


This is the #1 Mistake Car Accident Victims Make

Are you aware of who to call first following an automobile accident? Read on to learn how to improve your recovery and personal injury claim.

Calcaneus Fractures: To Fix Or Not To Fix - Is That Really The Question?

Mohit Bhandari


Calcaneus Fractures: To Fix Or Not To Fix - Is That Really The Question?

Brad A. Petrisor, MSc, M.D., FRCSC
Associate Professor, Division of Orthopaedic Surgery,
Department of Surgery, McMaster University
Hamilton Health Sciences: General Hospital

Mohit Bhandari, M.D., PhD, FRCSC
Professor, Canada Research Chair in Musculoskeletal Trauma
Academic Chair, Division of Orthopaedic Surgery,
Department of Surgery, McMaster University
Hamilton Health Sciences: General Hospital
Hamilton, ON

To Fix or Not? A PubMed search inquiry using the term "calcaneus fracture" produces 2666 "hits" going back to 1948, including a 1950 article written by Dr. F. Day from Edmonton published in the Canadian Medical Journal1,2. The debate over calcaneal fractures however, started in the late 1800's. Move forward to 2013 and there are now over 600 patients with displaced intra-articular calcaneus fractures who have been randomized in over five trials to non-operative or operative management and six systematic reviews on the subject including a recent Cochrane Collection. In this latter review, the authors state that "there is insufficient high-quality evidence relating to current practice to establish whether surgical or conservative treatment is better for adults with displaced intra-articular calcaneal fracture." The data from systematic reviews on this subject is muddled by the inclusion of trials using different outcome measures and having differing risks of bias3. The largest and most robust trial done by the Canadian Orthopaedic Trauma Society with 424 patients randomized and 309 patients followed for two years, inevitably influences the results of these meta-analyses7. They and others have observed no significant difference in functional outcomes between the operative and non-operative groups with some differences noted in subgroup analysis4,5.









Calcaneus Fractures: Non-operative Management Pearls

Mark Glazebrook


Calcaneus Fractures: Non-operative Management Pearls

Sam C. Roberts, MBChB, FRCSEd (Tr&Orth)
Fellow, Foot and Ankle Surgery, Orthopaedic Surgery,
Dalhousie University

Chad P Coles, M.D., FRCSC
Associate Professor, Orthopaedic Surgery
Dalhousie University

Mark Glazebrook MSc, PhD, M.D., FRCSC
Associate Professor, Orthopaedic Surgery
Dalhousie University
Halifax, NS

The treatment of calcaneal fractures remains a significant challenge and frequently results in poor outcomes. Calcaneal fractures are not a single entity, and like many fractures, both patient and fracture characteristics may affect the outcome. An understanding of these factors is critical in deciding the best course of treatment for your patient.








Calcaneus Fractures: Long-term Outcomes - What Can Patients Expect?

Timothy R. Daniels


Calcaneus Fractures: Long-term Outcomes - What Can Patients Expect?

Sagar J. Desai, M.D., FRCSC
Clinical Fellow, Foot and Ankle Reconstruction
University of Toronto

Timothy R. Daniels, M.D., FRCSC
Head, Division of Orthopaedic Surgery, St. Michael's Hospital
Associate Professor, University of Toronto
Head, Foot and Ankle Program
Toronto, ON

Historically, displaced intra-articular calcaneal fractures are associated with a prolonged recovery with a variable prognosis. Whether to treat operatively or non-operatively has been discussed; the purpose of this section is to assess long-term outcomes.







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