Background: Midfoot osteotomy is often used in the surgical treatment of foot deformities. The percutaneous Gigli saw osteotomy (PGSO) technique has many advantages compared with known osteotomy techniques. We aimed to show the efficacy and reliability of the PGSO technique in the midfoot of fresh frozen cadavers without using an image intensifier.
Methods: Four mini-incisions were performed on the dorsomedial, dorsolateral, plantar medial, and plantar lateral regions of the midfoot. Subperiosteal tunnels were then opened with a thin bone elevator, and the four incisions were combined with each other. The Gigli saw was tied to suture material and passed through the tunnels. The PGSO was performed in the midfoot of 12 feet of the cadaver specimens without using an image intensifier. Cadaver specimens were dissected, and injured structures were noted.
Results: The mean ± SD (range) cadaver age was 81.16 ± 10.38 years (65–93 years) and weight was 60.86 ± 12.39 kg (49.8–81.6 kg). All of the osteotomies were adequate as planned in the cuboid-cuneiform level and all of them were complete osteotomy .Incomplete osteotomy was not observed in any cadaver specimens. In one specimen, a complete injury of the peroneal tendons (peroneus longus and brevis) was detected. In another specimen, an incomplete tibialis anterior tendon injury was detected. There was no iatrogenic neurovascular injury in the specimens.
Conclusions: The PGSO technique is recommended for use even by inexperienced surgeons owing to its minimal risk of soft-tissue injury, provision of a complete osteotomy line, and easy application with limited incisions.
We compared postoperative outcomes in adolescent patients who did and did not undergo plate-screw fixation of at least one of the lateral, medial, or posterior malleoli in ankle fractures. It was hypothesized that using plate-screw fixation would not negatively affect postoperative outcomes.
All of the preoperative data and postoperative outcomes for 56 patients with ankle fractures aged 12 to 15 years who underwent surgical treatment between January 1, 2007, and December 31, 2017, were reviewed retrospectively. Patients were grouped into plate-screw fixation (n = 15) and non–plate-screw fixation (n = 41) groups and as high- and low-energy trauma patients.
There were no significant differences in postoperative outcomes between the plate-screw fixation and non–plate-screw fixation groups. The mean American Orthopaedic Foot & Ankle Society score of high-energy trauma patients was significantly lower than that of low-energy trauma patients (P < .001), and the rate of degenerative change in high-energy trauma patients was significantly higher than that in low-energy trauma patients (P = .008). There were no significant differences between high- and low-energy trauma patients with respect to other postoperative outcomes.
If anatomical reduction is performed without damaging the growth plate, postoperative clinical outcomes may be near perfect regardless of screw-plate fixation use. Postoperative outcomes of adolescent ankle fracture after high-energy trauma, independent of Salter-Harris classification and surgical treatment methods, were negative.