The sub-specialty of foot and ankle is evolving fast

Mangwani, Jitendra; Vaishya, Raju

doi:10.1016/j.jcot.2020.04.003

Cited by 1 publication

(1 citation statement)

References 14 publications

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“…Horst 30 revealed that rates of subspecialty fellowship training in orthopaedic surgery increased from 76% in 2003 to 90% in 2013, with over 80% of procedures completed in the foot or ankle performed by surgeons with subspeciality training. This trend is consistent throughout the world, [31][32][33] and is certainly reflected in Australia, with more fellowships on offer for foot and ankle compared to some other subspecialties, 34 as well as greater importance afforded to the Australian Orthopaedic Foot and Ankle Society. With this increase in subspecialisation, TMTJ injuries are likely more often referred to subspecialist surgeons with advanced skillsets who may consider operative intervention in patients who may have otherwise been treated non operatively by their more generalist colleagues.…”

Section: Discussionsupporting

confidence: 59%

Trends in management of adult tarsometatarsal joint injuries in a contemporary Australian context: a nationwide study of claims data over 20 years

Fung

Sivakumar

Jiang

et al. 2023

ANZ Journal of Surgery

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Background: Traumatic tarsometatarsal joint (TMTJ) injuries are uncommon, but can cause significant morbidity due to delayed or missed diagnosis. Recent evidence highlights the importance of achieving anatomical reduction via operative management. This study aims to analyse trends in rates of open reduction internal fixation (ORIF) for Lisfranc injuries in Australia according to Nationwide claims data. Methods: Claims according to the Medicare Benefits Schedule (MBS) on ORIF of traumatic TMTJ injuries were collated for the period from January 2000 to December 2020. Paediatric patients were excluded. Two negative binomial models were utilized to analyse the trends in TMTJ injuries over time after controlling for sex, age group and population changes. Results were absolute and per 100 000 population. Results: 7840 patients underwent TMTJ ORIF over the period studied. There was a mean yearly increase of 12% (P < 0.001). Age group (P < 0.001) and year (P < 0.001) were significant predictors for TMTJ fixation, whilst sex was not (P = 0.48). Patients older than 65 years were noted to have a 53% lower rate of TMTJ ORIF per person, when compared to the reference group of 25-34 year-olds (P < 0.001). Five-year block analysis revealed increases in rate of fixation for all age groups. Conclusion: Rates of operative fixation for TMTJ injuries are increasing in Australia. This is likely due to improved diagnostics, understanding of optimal treatment goals, and increased orthopaedic subspecialisation. Further studies with clinical and patient reported outcomes, as well as comparing rates of operative intervention to incidence, will be useful.

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Section: Discussionsupporting

confidence: 59%