DR. TODD ANDREW IRWIN, MD

Plain English
This study looked at two surgical methods for treating midfoot Charcot arthropathy, a foot condition that can occur in people with diabetes. Researchers found that when using intramedullary compression nails, 91.7% of patients had successful bone healing, compared to only 50% with traditional "beaming" methods. Additionally, only 12.5% of patients with IM nails experienced hardware failures, while 66.7% of those with beaming did, indicating that the IM nails are a more reliable option. Who this helps: This research benefits patients with midfoot Charcot arthropathy by providing them with more effective surgical treatment options.

Plain English
This study looked at Achilles tendon injuries among pickleball players compared to those from tennis and other sports over five years. Researchers found that pickleball injuries mainly affected older adults, with a median age of 60, and cases jumped from 0.5% in 2018 to 6.7% in 2021, indicating more older players may be getting injured as the sport's popularity grows. It's important because it helps identify a specific at-risk group and informs potential prevention strategies. Who this helps: This helps older adults who play pickleball, as well as their doctors.

Plain English
This study looked at the complications that can arise after surgery for Achilles tendon ruptures, comparing three different surgical methods: open surgery, percutaneous surgery, and suture anchor fixation. Out of 1,035 patients, the overall complication rate was 15.7%, and major complications required follow-up surgery in 3% of cases. Those treated with the suture anchor method faced significantly more complications, with a 26.3% complication rate, compared to 14.3% for percutaneous and 14.4% for open surgeries, highlighting that the choice of surgical technique can affect recovery. Who this helps: This benefits patients with Achilles tendon injuries and their doctors by providing clear information on which surgical methods may lead to fewer complications.

Plain English
This study examined how effective nitinol staples are in helping fractures heal after surgery for Lisfranc injury, compared to traditional plates and screws. It found that the joints treated with nitinol staples had a significantly lower nonunion rate of just 1.3%, compared to 9.0% for those with plates and screws. Additionally, surgeries using staples were quicker, taking about 67 minutes on average, compared to 105 minutes for plates and screws. Who this helps: This benefits patients with Lisfranc injuries by increasing the chances of successful healing and reducing surgery time.

Plain English
This study examined two types of devices used in surgery for a foot condition called Charcot arthropathy: midfoot fusion nails and midfoot fusion bolts. The researchers found that the nails generated much greater compressive force (751.7 N) compared to the bolts (139.0 N), which indicates the nails may offer stronger support. However, when looking at overall performance, both devices performed similarly in terms of strength and stiffness during testing. Who this helps: This research benefits doctors and surgeons who treat patients with midfoot Charcot arthropathy by providing insights on the best devices for surgical fixation.

Plain English
This study looked at two ways to manage pain for patients undergoing foot surgery: one group received standard treatment with opioids, while another group received an opioid-free pain management plan. The results showed that the opioid-free group had significantly lower pain levels at 24 hours (median score of 2 compared to 6) and at 2 weeks after surgery (median score of 2 compared to 4), with over 85% of patients satisfied with their pain management at 2 weeks and 90% at 6 weeks. This is important because it shows that patients can have effective pain control after surgery without relying on opioids, which helps combat the opioid crisis. Who this helps: This benefits patients undergoing forefoot surgery by providing safer pain management options.

Plain English
This study looked at the long-term success of a specific type of ankle replacement surgery called the INBONEII total ankle arthroplasty (TAA). After following 75 surgeries for an average of about 6 years, researchers found that 8% of the implants failed, while 81% of patients needed no further surgeries. Understanding these results is important for guiding doctors in choosing the right implant and helping patients prepare for what to expect after surgery. Who this helps: This benefits patients undergoing ankle replacement surgery and their doctors.

Plain English
This study looked at how well a new surgery technique called the sinus tarsi approach works for treating fractures in the heel bone (calcaneus). Among 22 patients evaluated a year after their surgery, 91% showed very little movement in the fracture (0 to 2 mm), and all patients healed completely without major complications. This matters because it suggests that this less invasive technique can successfully treat heel fractures while minimizing the risk of complications, which is better for patient recovery. Who this helps: This benefits patients with calcaneus fractures looking for effective treatment options.

Plain English
The study looked at a surgical procedure called open ankle arthrodesis, which is used to treat ankle arthritis, particularly when there is a deformity present. Researchers found that this surgery generally leads to good results, with high success rates in healing and improved function for patients. Understanding the type of deformity before surgery helps doctors choose the best approach, leading to better patient outcomes after the procedure. Who this helps: This helps patients with ankle arthritis and deformities.

Plain English
This study looked at patients who had undergone transmetatarsal amputation (TMA), a type of foot surgery, to find out how often they later needed more serious amputations or died. Out of 265 patients studied, 27% needed a higher-level amputation afterward, and 40% died within about 27 months. The research highlighted that certain factors, like being female or having conditions such as kidney disease or heart problems, significantly increased the risk of these outcomes. Who this helps: This information benefits doctors and patients facing foot surgeries, allowing for better planning and management of potential risks.

Plain English
This study looked at different surgical options for treating hallux rigidus, a condition that affects the big toe and causes pain and stiffness. The researchers found that while joint-preserving techniques may lead to ongoing arthritis and pain, arthrodesis (a procedure that fuses the bones) can have good results if done carefully, though it carries risks like improper healing. They recommend a specific approach called distraction bone block arthrodesis with structural autograft to address complications when other methods fail. Who this helps: This helps patients suffering from hallux rigidus and orthopedic surgeons.

Plain English
This study looked at how well patients do after having a two-stage surgery to fix ankle joint infections that developed after an artificial ankle replacement. Out of 12 patients, 11 were followed for about three years, and most (90.9%) were able to walk with their new ankle joint, but more than half (63.6%) needed another surgery. These results indicate that while this surgical option can help, patients may not recover as well as expected, which is important for understanding their long-term care needs. Who this helps: This helps patients with chronic ankle joint infections and their doctors in making informed treatment decisions.

Plain English
This study looked at how to fix problems when ankle ligament surgery doesn't work, which can happen in some people. The researchers found that factors like foot shape and joint flexibility can cause these failures, and they emphasized that doctors need to consider these issues during follow-up surgeries. They recommended using specific surgical techniques, like a modified procedure or a graft, to improve outcomes for patients who experience ankle instability after the first surgery. Who this helps: This benefits patients with ankle instability issues, especially those needing additional surgeries.

Plain English
This study looked at how 15 sessions of hippotherapy (therapy involving horses) affected the gross motor skills of 2- to 3-year-old children with developmental delays compared to children without delays. The children with developmental delays showed a significant improvement, with their motor skills scores improving by an average of 24.1 points after the therapy, while the scores of the children without delays remained the same. This is important because it shows that hippotherapy can noticeably help young children with developmental delays improve their movement skills during a crucial time for their development. Who this helps: This helps young children with developmental delays and their families.

Plain English
This study looked at how effective a specific type of ankle surgery, called revision total ankle arthroplasty, was for patients who previously had unsuccessful ankle replacements. Out of 18 patients, about 78% had successful outcomes with their new implants after an average follow-up of just under four years. This is important because it shows that using this specific implant can be a good option for patients needing a second chance after their first ankle surgery failed. Who this helps: This helps patients who have had failed ankle replacement surgeries.

Plain English
This study examined whether the degree of initial displacement in Lisfranc injuries affects the likelihood of losing proper alignment after surgical fixation. Researchers looked at 45 patients and found that those with a greater initial displacement of 4 mm or more had a loss of reduction rate of 40%, compared to 27% in those with less than 4 mm displacement, which was not a significant difference. This matters because it shows that even severely displaced injuries can still be properly managed and maintained after surgery. Who this helps: This helps patients with Lisfranc injuries and the doctors treating them.

Plain English
This study examined three different ways to stitch a part of the foot called the plantar plate, which can become unstable and painful in lesser toes. Researchers tested the strength of these stitches using human cadaver samples and found that the horizontal mattress stitch held up the best, with an average force of about 115.5 Newtons before failing, compared to the other methods. This is important because stronger repairs could lead to better outcomes for patients with toe instability. Who this helps: Patients suffering from lesser toe instability.

Plain English
The research looked at how well orthopedic surgery interns learn a key surgical skill called open reduction and internal fixation (ORIF) through practice with simulations. After participating in a training module that included hands-on simulations, the interns showed significant improvement in their skills, achieving higher success rates and better strength in their fracture repairs, with an average strength increase of 256 newtons. This is important because it demonstrates a practical and affordable way to effectively train future surgeons, which can lead to better patient outcomes. Who this helps: Patients undergoing orthopedic surgery benefit from better-trained surgeons.

Plain English
This review looked at how doctors prevent blood clots, known as venous thromboembolism (VTE), in patients undergoing foot and ankle surgery. The findings showed that the actual occurrence of VTE after these surgeries is low, and guidelines suggest that routine prevention methods like medication aren't necessary for many patients. However, up to 98% of surgeons still use some form of prevention for patients they consider high-risk, even though many do not follow the latest recommendations. Who this helps: This information benefits patients and doctors by highlighting the need for careful assessment of risks before using blood clot prevention methods.

Plain English
This research focused on a complex problem called overcorrected flatfoot, which can happen after surgery to fix flat feet in adults. The study found that patients often experience symptoms similar to another foot condition and that specific surgical corrections can help, with some patients needing more drastic surgery if their condition is severe. Understanding this issue helps doctors choose the right treatment to relieve pain and improve mobility for affected patients. Who this helps: Patients suffering from complications after flatfoot surgery.

Plain English
This study looked at how a specific type of exam, called an Objective Structured Clinical Examination (OSCE), can help evaluate orthopedic residents and meet requirements for graduate medical education. The results showed that fourth-year residents performed better on assessments before and after a foot and ankle rotation, with a statistical significance of p < .03, while second-year residents improved their written exam scores after completing the rotation (p = .03). This is important because it demonstrates a cost-effective way to assess medical trainees’ skills, potentially leading to better training methods across various medical specialties. Who this helps: This benefits medical residents and their instructors.

Plain English
This study looked at how distractions affect the performance of orthopedic surgery residents during a simulated knee surgery. It found that when distracted, the residents completed fewer tasks on a checklist—only 89% of junior residents finished compared to 97% of senior ones. Senior residents also performed better overall, with faster completion times and fewer mistakes. This matters because distractions can harm a surgeon's performance, even from simple questions, highlighting the need for focus during surgery. Who this helps: This study benefits both patients and surgeons by emphasizing the importance of minimizing distractions during surgical procedures.

Plain English
This study looked at how to determine the stability of a specific type of ankle fracture (Weber B) in 51 patients who were treated without surgery. The researchers found that using weight-bearing X-rays helped accurately assess stability, and patients had good recovery outcomes with high scores on functional tests—averaging around 93 out of 100 for daily activities and low pain levels. This is important because it shows that many of these fractures can heal well without surgery, which can lead to less risk and lower costs for patients. Who this helps: Patients with Weber B ankle fractures.

Plain English
This study examined the technique called "two-finger tightness" used by medical residents to safely tighten screws in bones without damaging them. Researchers found that the amount of torque applied by residents varied greatly, with junior residents being less consistent compared to more experienced ones, yielding average torque values that did not reliably match the ideal threshold for successful screw placement. This variability may undermine the effectiveness of using the two-finger method as a teaching tool, suggesting that medical training programs need to improve hands-on skills training for residents. Who this helps: This helps medical residents and their trainers.

Plain English
This study looked at how an intensive training program, called a boot camp, can help new orthopedic surgical interns quickly learn essential clinical skills. Researchers found that after completing this 3-month program, the first-year residents significantly improved their skills in areas like sterile technique and wound closure, matching the abilities of second-year residents. This matters because it shows that early and focused training can help interns become more competent faster, benefiting patient care. Who this helps: This helps orthopedic surgical interns and their future patients.

Plain English
This study examined how heat builds up during repeated drilling into bone, specifically using two types of drills. Researchers found that drilling with a K wire raised the bone temperature from 5°C after the first hole to 20°C after the sixth hole, while standard drills caused a smaller temperature increase. This matters because high temperatures can harm bone tissue, so understanding this heat buildup can help improve drilling techniques and reduce injury during surgeries. Who this helps: This helps surgeons and their patients by providing insights to prevent bone damage during surgical procedures.

Plain English
This study looked at how much heat is produced when drilling into bone using different tools: twist drills, K wires, and a cannulated drill. It found that twist drills generated the least heat, while the cannulated drill created more than double the heat of a twist drill of a similar size. This matters because excessive heat during drilling can damage the bone, so understanding which tools produce less heat is important for patient safety. Who this helps: This helps surgeons and their patients by providing information on safer drilling techniques in orthopedic surgery.

Plain English
This study looked at how the method of drilling holes in bones affects the heat produced and potential damage to the bone tissue. Researchers found that using twist drills instead of Kirschner wires led to less heat damage, and that shorter time intervals between drilling steps helped reduce heat exposure. Understanding these factors is important because minimizing heat damage can prevent complications in patients undergoing joint fusion surgeries. Who this helps: This benefits patients who need joint surgeries, as well as the doctors performing these procedures.

Plain English
This study looked at issues with stiff feet and ankles, often caused by certain medical conditions, and how to treat them. Researchers found that while non-surgical options like braces and medications can work well, surgery is sometimes necessary when these don't help. The most common surgical methods, tendon transfers and lengthening, are effective for improving movement and comfort. Who this helps: This helps patients with foot and ankle deformities and their doctors.

Plain English
This study looked at two rare cases of Tillaux fractures in adults, which normally happen in younger people. The researchers found isolated Tillaux fractures in a 47-year-old man and a 37-year-old man, showing that this type of injury can also occur in adults, though it's not commonly documented. Recognizing and treating these fractures properly is important to avoid complications like instability and arthritis later on. Who this helps: This helps doctors and adult patients who may experience this type of fracture.

Plain English
This study looked at how often orthopedic surgeons give patients antibiotics after foot and ankle surgeries to prevent infections. It found that 75% of surgeons reported using these antibiotics, with most prescribing them to only a few patients, typically for 5 to 7 days. Despite this common practice, there was no difference in infection rates between those who prescribed the antibiotics and those who didn’t. Who this helps: This information benefits orthopedic surgeons and their patients by highlighting the need for guidelines on antibiotic use after surgery.

Plain English
This study looked at the ankle medial clear space (MCS), which is important for assessing ankle stability after injuries, and how it varies by a person's height and sex. Researchers analyzed X-rays from 49 patients, finding that men had a wider MCS (averaging around 3.3-3.8 mm) compared to women (averaging 2.3-3.0 mm). These differences mean that using the same MCS measurements for diagnosis might lead to incorrect conclusions, particularly for taller men who might be wrongly diagnosed with ligament injuries. Who this helps: This helps doctors accurately diagnose ankle injuries in patients, especially considering their height and sex.

Plain English
This study looked at fractures of the posterior malleolus, a part of the ankle, which often occur alongside other ankle injuries. Researchers found that when these fractures are treated effectively, particularly in larger or more complex cases, patients can avoid complications and see better recovery outcomes. However, the criteria for deciding when to treat these fractures with surgery varies widely among doctors, leading to inconsistent care. Who this helps: This helps patients with ankle fractures and their healthcare providers.

Plain English
This study looked at how the width of a specific space in the ankle, called the medial clear space (MCS), varies based on measurement techniques and between men and women. Researchers analyzed X-rays from 73 people without ankle problems and found that on average, the MCS measured 3.2 mm in one direction and 2.6 mm in another, with a notable difference between genders (p < .001). These findings suggest that relying on a single measurement to determine ankle problems could lead to incorrect diagnoses and unnecessary surgeries. Who this helps: This research benefits doctors and patients with ankle injuries by improving treatment accuracy.

Plain English
This study looked at how ankle arthritis affects the outcomes for patients undergoing surgery to fix problems with their lateral ankle ligaments and foot alignment. It involved 22 patients, and those with no to minimal arthritis (14 patients) had better results—improving their scores significantly after surgery—compared to those with moderate to severe arthritis (8 patients) who had poorer outcomes. This is important because it shows that patients with less arthritis before surgery tend to recover better and be more satisfied with their treatment. Who this helps: This benefits patients with ankle instability considering surgery, especially those with minimal arthritis.

Plain English
This study looked at how to treat serious damage to the ankle joint in young adults. Researchers found that using fresh osteochondral allografts (donor tissue) can be a better option than the common practice of ankle fusion, which typically leads to long-term issues. This matters because younger patients deserve treatments that don’t limit their future options as much as traditional methods do. Who this helps: This helps young adults with severe ankle injuries.