Introduction: To ascertain the incidence of early complications in the posterolateral approach to open reduction and internal fixation of posterior malleolar fractures and identify possible risk factors related to occurrence of these complications. Methods: Retrospective study carried out in three tertiary hospitals. Patients who underwent open reduction and internal fixation of posterior malleolus fractures via the posterolateral route were divided into two groups: with versus without delayed postoperative healing. To assess risk and protective factors for the outcome of delayed healing, we evaluated the time between trauma and surgery, whether the patient had a fracture-dislocation of the ankle, and whether external fixation was performed before surgery. We also evaluated whether improvement in operative technique led to a reduction in complication rates. Results: A total of 43 individuals who underwent surgical correction of posterior malleolus fractures via the posterolateral route between 2013 and 2018 were included. Of these, 19 (44.2%) had skin complications that led to delayed healing. Skin complications occurred more frequently at the beginning of the learning curve of the surgeons involved; the incidence up to the year 2016 was 56.3%, decreasing significantly to 37% from 2017 onward. Conclusion: Patients who undergo open reduction and internal fixation of posterior malleolus fractures via the posterolateral route at the beginning of the learning curve are a greater risk of developing skin complications, demonstrating the importance of this approach being restricted to more experienced surgeons. Level of Evidence III; Prognostic Studies; Retrospective Study.

Objective: To evaluate and quantify, through physical examination, loss of ankle mobility in patients undergoing subtalar fusion, in comparison to the contralateral side. Methods: A total of 12 patients who underwent unilateral isolated subtalar arthrodesis for different conditions were selected. The assessment was performed with the aid of a goniometer, measurements of the bilateral range of motion of the tibiotarsal joint, in closed chain weight-bearing and open chain non-weight-bearing. The same foot and ankle surgeon performed all measurements. Results: The operated side achieved significantly lower range of motion values in the closed chain weight-bearing test compared to the contralateral side, with a mean difference of 5.4° (p=0.029) for dorsiflexion and 7.6° (p=0.006) for plantar flexion. No statistically significant difference was found in the open chain test. Conclusion: Isolated subtalar joint arthrodesis leads to reduced range of motion in the ipsilateral ankle. Level of Evidence III; Therapeutic Study; Comparative Retrospective Study.

Objective:The aim of this study was to perform the translation and cultural adaptation of the Olerud-Molander Ankle Score (OMAS) in Brazilian Portuguese, in addition to determining its validity and reliability. Methods: This was a cross-sectional case-series study. The translation and adaptation processes were conducted in 5 stages: initial translation (2 bilingual Brazilians); synthesis of translations; back translation (2 bilingual Brazilians not involved in the first part of the study); consensus version and assessment (technical committee); and testing phase. The test-retest reliability and construct validity of the Brazilian Portuguese version of the OMAS (OMAS BrP) were evaluated in a sample of 40 participants. Construct validity was determined based on the correlations of the OMAS-BrP to the Foot Function Index (FFI) and Short-Form 12 (SF-12). Results: The OMAS-BrP had excellent test-retest reliability (ICC=0.99). The OMAS-BrP showed moderate and weak correlations with the SF 12 PCS and SF-12 MCS (r=0.68 and p<0.001; r=0.38 and p=0.014, respectively). The correlation coefficient between the OMAS-BrP and the FFI was graded as excellent (r=-0.846 and p<0.001). There was a strong correlation between the OMAS-BrP, the SF-12 PCS, and the FFI. Conclusion: The OMAS-BrP is a valid and reliable questionnaire, with psychometric parameters that are similar to those of its original version and other cross cultural adaptations. The OMAS-BrP is a useful patient-reported outcome (PRO) measure to evaluate Brazilian Portuguese-speaking patients with ankle fractures. Level of Evidence IV; Therapeutic Studies; Case Series.

Category: Hindfoot Introduction/Purpose: Objective: To evaluate and quantify the loss of ankle mobility in patients undergoing subtalar arthrodesis compared to the contralateral side, through physical examination. Methods: A total of 12 patients who had only the subtalar arthrodesis procedure from various causes in one foot were selected. The same foot and ankle surgeon performed all measurements of bilateral tibiotarsal range of motion, with loaded closed-chain and unloaded open-chain tests. Then, to assess whether there was a difference between the operated and the non-operated side, statistical analysis was performed with the Mann-Whitney test (Hollander and Wolfe 1999). Results: On the loaded closed-chain test, the operated side had a significantly lower range of motion than the contralateral side, with a mean difference of 5.4 degrees for dorsal flexion and 7.6 degrees for plantar flexion. The open-chain tests showed non- significant differences of 3 degrees for dorsal flexion and 5.3 degrees for plantar flexion. Conclusion: Subtalar joint arthrodesis was shown to cause a loss of mobility in the ipsilateral ankle, which is greater in plantar flexion movement.