Journal ArticleDOI
Risk Factors Associated With Nonunion After Elective Foot and Ankle Reconstruction: A Case-Control Study
TLDR
A greater prevalence of endocrine abnormalities, in particular, vitamin D deficiency and insufficiency, was associated with nonunion after elective foot and ankle reconstruction, and patients with such abnormalities appear to have a greater risk of developing non union after arthrodesis procedures.Abstract:
Postoperative nonunion is not uncommon in the lower extremity, and significant morbidity can be associated with nonunion of the foot and ankle after surgical reconstruction. For the purposes of the present study, we retrospectively reviewed and compared a cohort of patients who had undergone elective foot and ankle reconstruction to better assess the modifiable risk factors associated with postoperative nonunion. We hypothesized that the presence of endocrine and metabolic abnormalities are often associated with nonunion after foot and ankle surgical reconstruction. We formulated a matched case-control study that included 29 patients with nonunion and a control group of 29 patients with successful fusion to assess the prevalence of certain modifiable risk factors known to have an association with nonunion after foot and ankle arthrodesis. The modifiable risk factors assessed included body mass index, tobacco use, diabetes mellitus, vitamin D abnormality, thyroid dysfunction, and parathyroid disease. A statistically significant (p < .05) difference was found between the 2 groups for endocrine and metabolic disease diagnoses in the medical records of the 58 patients identified. Thus, 76% versus 26% (p < .05) of patients experienced nonunion in the endocrine disease group versus the nonendocrine disease group, respectively. Patients with vitamin D deficiency or insufficiency were 8.1 times more likely to experience nonunion (95% confidence interval 1.996 to 32.787). No statistically significant differences were found between the groups in terms of age, sex, tobacco use, body mass index, or procedure selection (p = .56, p = .43, p = .81, p = .28, and p = 1.0, respectively). A greater prevalence of endocrine abnormalities, in particular, vitamin D deficiency and insufficiency, was associated with nonunion after elective foot and ankle reconstruction. Patients with such abnormalities appear to have a greater risk of developing nonunion after arthrodesis procedures.read more
Citations
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Journal ArticleDOI
1,25-Dihydroxyvitamin D suppresses M1 macrophages and promotes M2 differentiation at bone injury sites
Samiksha Wasnik,Charles H. Rundle,David J. Baylink,Mohammad Safaie Yazdi,Edmundo E. Carreon,Yi Xu,Xuezhong Qin,Xuezhong Qin,Kin-Hing William Lau,Kin-Hing William Lau,Xiaolei Tang +10 more
TL;DR: The data support 2 conclusions: (a) M1 macrophages are important for the recruitment and osteogenic priming of MSCs and, hence, are necessary for fracture repair, and (b) under vitamin D-sufficient conditions, 1,25(OH)2D treatment is unnecessary and can be detrimental if provided during the proinflammatory stage of fracture healing.
Journal ArticleDOI
Complications after Metatarsal Osteotomies for Hallux Valgus: Malunion, Nonunion, Avascular Necrosis, and Metatarsophalangeal Osteoarthritis.
Jorge Filippi,Jorge Briceno +1 more
TL;DR: Avascular necrosis, nonunion, malunion, and metatarsophalangeal (MTP) osteoarthritis following hallux valgus osteotomies, as well as pathophysiology, diagnosis, prevention strategies, and treatment are discussed in this article.
Journal ArticleDOI
Current concepts in the management of ankle arthritis.
TL;DR: There is a wide variation in the management of patients with ankle arthritis, and an overview of the current evidence based management is presented.
Journal ArticleDOI
Is There a Correlation Between Preoperative or Postoperative Vitamin D Levels with Pseudarthrosis, Hardware Failure, and Revisions After Lumbar Spine Fusion?
Chester J. Donnally,Jonathan I. Sheu,Kevin J. Bondar,Joelle N. Mouhanna,Deborah J. Li,Alexander J. Butler,Augustus J. Rush,Joseph P. Gjolaj +7 more
TL;DR: Both preoperative and postoperative vitamin D levels were not significantly associated with an increased or decreased risk of pseudarthrosis, revision surgery, hardware failure, or 1-year VAS pain score after lumbar spine fusion surgery.
Journal ArticleDOI
Triple Arthrodesis for Adult-Acquired Flatfoot Deformity:
TL;DR: The purpose of this review is to highlight advances in the procedure and its application to the rigid planovalgus foot.
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