Comparison of Responses from ChatGPT-4, Google Gemini, and Google Search to Common Patient Questions About Ankle Sprains: A Readability Analysis.

Introduction: Ankle sprains are among the most common injuries treated by foot and ankle specialists. Despite increasing online health information-seeking behavior, existing information on ankle sprains has been criticized by physicians for poor quality and readability. ChatGPT-4 and Google Gemini are artificial intelligence chatbots known for their accessible interfaces and versatility, making them popular for patient self-education.

The Lateral Drawer Test: A New Clinical Test to Assess Mortise Instability in Weber B Fibula Fractures.

Background: Assessment of mortise stability is paramount in determining appropriate management of ankle fractures. Although instability is readily apparent in bimalleolar or trimalleolar ankle fractures, determination of instability in the isolated Weber B fibula fracture often requires further investigation. Prior authors have demonstrated poor predictive value of physical examination findings such as tenderness, ecchymosis, and swelling with instability.

The Lateral Fibular Stress Test: High Variability of Force Applied by Orthopaedic Surgeons in a Biomechanical Model.

Background: The lateral fibular stress test (LFST), also known as the hook or Cotton test, is commonly performed to assess syndesmotic instability intraoperatively. Several studies have used 100 N as the force applied when performing the LFST to detect syndesmotic instability, though no evidence-based requisite force has been described for the test. We hypothesize that surgeons do not apply force uniformly or consistently when performing the LFST and that substantial variation exists.

Revision Strategies for the Aseptic, Malaligned, Surgically Treated Ankle Fracture.

Although surgical fixation can take many forms depending on ankle fracture morphology, the goals of open reduction internal fixation are to restore fracture alignment, re-establish ankle stability, and achieve an anatomic mortise. A subset of patients may present postoperatively with evidence of suboptimal open reduction internal fixation. Increased contact pressures across the tibiotalar joint, increased talar shift, and pathologic joint loading leading to the development of post-traumatic arthritis are common sequela of the malaligned mortise.

Are SER-II Ankle Fractures Anatomic? Computed Tomography Demonstrates Mortise Malalignment in the Setting of Apparently Normal Radiographs.

Background: Ankle fracture treatment is predicated on minimal displacement, leading to abnormal joint contact area. The purpose of this investigation is to determine whether computed tomography (CT) detects subtle mortise malalignment undetectable by x-ray in supination-external rotation-II (SER-II) injuries.

Methods: A total of 24 patients with SER-II injuries, as demonstrated by negative gravity stress radiography, were included.

Reliability of Fifth Metatarsal Base Fracture Classifications and Current Management.

Background: Classification of fifth metatarsal base fractures has been a source of confusion since originally described by Jones in 1902. Zone classifications have been described but never evaluated for reliability. The most recent classification, metaphyseal vs meta-diaphyseal, may be unknown to many surgeons.

Using the DASH to Model Clinical Recovery Trajectory After Operative Management of Distal Radius Fracture.

Purpose: There is a paucity of literature examining the trajectory of meaningful clinical improvement after distal radius fracture (DRF) fixation. We sought to answer the following questions: (1) When do patients meet the minimum clinically important difference (MCID) in the -Disabilities in Arm, Shoulder, and Hand questionnaire (DASH) score change after DRF fixation? (2) What gains in terms of number of MCIDs achieved (as measured by DASH) do patients make as they recover from DRF fixation? (3) What patient and injury factors are characteristic of patients who meet or do not meet the average recovery trajectory?

Methods: We performed a retrospective review of an institutional database of DRF patients treated with operative fixation. The change in DASH scores from before surgery to approximate follow-up intervals of 0 to 2 months, 3 to 6 months, and a minimum of 9 of 12 months was assessed, in which a delta of 14 reflected the MCID.

The Ischemic toe following forefoot surgery: A review of current practices and a proposed approach for management.

Toe hypoperfusion is a commonly encountered concern following forefoot surgery, yet there is limited clinical guidance available to surgeons to aid in management of this scenario. This work aims to review the etiology, pathophysiology and current strategies to address a perioperative ischemic toe. The authors review various interventions to approach this problem based on available evidence and clinical experience.

Upper Extremity Fragility Fractures.

The population of elderly patients is rapidly increasing in the United States and worldwide, leading to an increased prevalence of osteoporosis and a concurrent rise in fragility fractures. Fragility fractures are defined as fractures involving a low-energy mechanism, such as a fall from a standing height or less, and have been associated with a significant increase in the risk of a future fragility fracture. Distal radius fractures in the elderly often present earlier than hip and vertebral fractures and frequently involve underlying abnormalities in bone mass and microarchitecture.

Early Results of Single-plug Autologous Osteochondral Grafting for Osteochondritis Dissecans of the Capitellum in Adolescents.

Background: Osteochondral autologous transplantation surgery (OATS) has been advocated for unstable osetochondritis dissecans (OCD) lesions of the adolescent capitellum, though limited information is available regarding clinical and radiographic results in North American patients. We hypothesize that single-plug OATS is safe and effective in alleviating pain and restoring function in unstable OCD.

Methods: Twenty-eight patients with unstable OCD treated with single-plug OATS were evaluated.