Objective: To analyze the use of an anesthetic ankle block in the immediate postoperative period in patients undergoing foot surgery to evaluate the quality of postoperative recovery and in-hospital opioid use. Methods: Presentation of the preliminary results of a randomized, placebo-controlled, double-blind trial conducted from May 2016 to January 2017, with 16 patients undergoing surgery to correct foot pathologies. The patients in the intervention group were treated with an additional ankle block and compared to a control group. Results: The intervention group included eleven patients, of whom ten had mild pain, with a mean visual analog pain scale (VAS) score of 3 and a mean quality of post-surgical recovery (QoR-40) of 194; none of these patients required the use of opioids. The control group included five patients. Of these, one patient had severe pain and two showed moderate pain. The mean VAS score in this group was 4, and the mean QoR-40 was 190. Three patients from this group required opioids. Conclusion: The use of an ankle block in the 24 h immediately post-surgery reduced pain scores and the need for opioid use and improvedpostoperative recovery. Level of Evidence I; Therapeutic Studies; Randomized Clinical Study.

Objective: To demonstrate the patterns of syndesmosis reconstruction in ankle fractures via the measurement of pre-established and universally accepted parameters. Methods: In a retrospective study, fractures with radiographic images obtained during the postoperative period showing fixation of the distal tibiofibular syndesmosis were selected. After this selection, fracture reduction and syndesmosis fixation were evaluated by measuring radiographic parameters in the selected cases. Results: Twenty-three patients (63.8%) were male. Fourteen fractures (38.8%) were operated on by a senior surgeon (foot and ankle specialist). All syndesmoses were fixed with only 1 screw, and 35 patients (97.2%) had syndesmosis fixation involving 3 cortices. The mean syndesmosis fixation height from the articular surface was 2.20cm. Four fractures (11.1%) presented radiographic signs of medial ligament reconstruction. Regarding measurement of the tibiofibular space, in the anteroposterior (AP) view, 33 patients (91.6%) had values within the normal range. Regarding the tibiofibular overlap, in the AP view, 19 patients (52.7%) had measurements with values greater than 10mm (normal). In the evaluation of tibiofibular overlap, in the true AP view, all patients (100%) presented measurements greater than 1mm (normal). Regarding the measurement of the talocrural angle, only 1 patient did not have normal parameters. Regarding the medial clear space, only 2 patients (5.5%) had values above normal during the postoperative period. Conclusion: The adoption of objective parameters, in a standardized manner and relative to the contralateral side, adds additional value to the evaluation and ensures an accessible and reproducible method for the evaluation of these injuries. Level of Evidence II; Prognostics Studies; Retrospective Study.

Objective: To demonstrate the patterns of syndesmosis reconstruction in ankle fractures via the measurement of pre-established and universally accepted parameters. Methods: In a retrospective study, fractures with radiographic images obtained during the postoperative period and showing fixation of the distal tibiofibular syndesmosis were selected. Fracture reduction and syndesmosis fixation were evaluated by measuring radiographic parameters in the selected cases. Results: Twenty-three patients (63.8%) were male. Fourteen fractures (38.8%) were operated on by a senior surgeon (foot and ankle specialist). All syndesmoses were fixed with only one screw, and 35 patients (97.2%) had syndesmosis fixation involving 3 cortices. The mean syndesmosis fixation height from the articular surface was 2.20 cm. Four fractures (11.1%) presented radiographic signs of medial ligament reconstruction. Regarding the measurement of the tibiofibular space, in the anteroposterior (AP) view, 33 patients (91.6%) had values within the normal range. Regarding the tibiofibular overlap, in the AP view, 19 patients (52.7%) had measurements with values greater than 10 mm (normal). In the evaluation of tibiofibular overlap, in the true anteroposterior (AP) view, all patients (100%) presented measurements greater than 1 mm (normal). Regarding the measurement of the talocrural angle, only 1 patient did not have normal parameters. Regarding the medial clear space, only 2 patients (5.5%) had values above normal during the postoperative period. Conclusion: The adoption of objective, standardized parameters relative to the contralateral side adds value to the evaluation and ensures an accessible and reproducible method for evaluating syndesmotic ankle fractures.