Background: The aim of this study was to evaluate the efficacy and safety of injection of allogeneic growth factors in patients with plantar fasciitis. Methods: This study included 150 patients who were randomly divided into 2 equal groups; the patients were locally injected with allogeneic growth factors (GFs) (treatment group) or with saline 0.9% (control group). The patients were assessed using visual analog scale (VAS) and Foot Function Index–Revised short form (FFI-Rs) scores preinjection and 1, 3, 6, and 12 months postinjection. The patients were questioned about their satisfaction. Any adverse effects were recorded. Results: At baseline, there was no significant difference between both groups regarding the mean VAS and FFI-Rs scores. At 3-month follow-up, the reduction in mean VAS score was 87% in the treatment group and 55% in the control group ( P < .001), and the reduction in mean FFI-Rs score was 62% in the treatment group and 40% in the control group ( P < .001). Treatment group and study visit were significant factors affecting both VAS and FFI-Rs scores. Overall, 92% were satisfied in the treatment group, and 78.2% in the control group. Postinjection pain occurred in 5 patients in the treatment group. Conclusion: This study provides Level I evidence regarding the efficacy and safety of allogeneic GF injection in patients with plantar fasciitis. However, additional studies are needed to evaluate their adverse effects, immunogenicity, and microbiological safety. Level of Evidence: Level I, prospective randomized controlled case series.

Background: One of the major disabilities of the lower limb is fixed knee flexion deformity. Post-polio residual paralysis is the main etiology, but there are others. This study evaluated the outcome of treatment of long-standing fixed knee flexion deformity with the Ilizarov external fixator without soft-tissue intervention or osteotomy in a certain age group. Methods: Thirty patients (33 knees) with knee flexion deformity were enrolled in this study. There were 11 women and 19 men. Three patients had bilateral lower limb affection. The etiology was post-polio residual paralysis in 11 patients (14 knees), four patients had brain insult, eight patients had post infectious etiology, and seven patients had failure of open reduction and internal fixation of tibial plateau fractures. An Ilizarov fixator was applied in all patients for deformity correction with no soft-tissue release or osteotomies. Results: The mean age of the patients was 28.7 yr (18-55 yr), the mean preoperative flexion knee angle was 77.87 degrees (50-130 degrees). The mean preoperative arc of motion was 17.1 degrees (0-50 degrees), the mean time since the deformity was well established was 9.4 yr (4-30 yr), the mean time needed for correction of the deformity was 49.2 days (27-120 days) at the end of the procedure. All patients achieved full correction of the deformity. Conclusions: The Ilizarov external fixator is an effective tool in the treatment of severe long-standing fixed knee flexion deformity in adults with minimal complications and good outcomes. Level of Evidence: Level II.

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Background: This study examined the effectiveness of the Taylor Spatial Frame (TSF) in the treatment of deformity and limb shortening caused by distal tibial physeal arrest and the effectiveness in maintaining alignment and stability by reconstruction of the medial malleolus and the medial collateral ligament using an autogenous iliac crest graft and attached sartorius muscle-tendon. Methods: Thirteen pediatric patients with angular deformity of the distal tibia were enrolled in this prospective study. The mean age was 8.3 yr (range, 6 to 12 yr). All patients had open fractures with skin loss. Ten patients had Salter-Harris type IV physeal fractures, while three had Salter-Harris type V physeal injury. All patients had a varus ankle deformity (range, 15 to 33 degrees) and limb shortening (range, 1.9-cm to 3.3-cm). All patients were treated by a supramalleolar osteotomy and TSF for deformity correction for limb-length equalization. The absent medial malleolus was treated by medial malleoplasty with a graft from the ipsilateral iliac crest. Results: The mean follow-up period was 30 mo. The mean preoperative shortening of the tibia in relation to the fibula was 2.6 cm (range, 1.9 cm to 3.3 cm). The length of the short tibia was restored in all patients, and correction of the ankle deformity and stability were restored with a satisfactory outcome. Conclusions: TSF is highly effective in the treatment of distal tibial deformity in pediatric patients due to traumatic physeal arrest. Reconstruction of the medial malleolus and its ligamentous attachment is crucial for ankle joint stability. Level of Evidence: Level IV.