Introduction Modified Brostrom-Gould surgery (MBG) aims to repair the lateral ligaments of the ankle in patients with ligamentous laxity and chronic instability. Brostrom-Gould surgery-the Brostrom technique associated with Gould augmentation-is currently the gold standard surgical option for chronic ankle instability worldwide. Chronic lateral ankle instability caused by lateral ankle sprains is one of the most common sports-related injuries, and Brostrom-Gould surgery is commonly recommended as the operative treatment. While arthroscopic surgery is becoming the more heavily favored approach of choice, open Brostrom-Gould surgery is still pertinent for patients for whom arthroscopic repair is unsuitable. Aim This paper discusses a modified mini-open approach of the open Brostrom-Gould surgery with a smaller incision (1.5 cm) and aims to study the outcomes of this modified approach on patients' post-operative pain, stability, and functional outcome. Methods Forty-two patients were followed up for a mean of 2.6 years after undergoing modified mini-open Brostrom-Gould surgery. The Visual Analog Scale (VAS), the Foot and Ankle Outcome Score (FAOS), and Karlsson scores were used to monitor their post-operative recovery. The Wilcoxon signed-rank test and the SPSS Statistics (v.28.0.1) software were used for data management and analytics. Results The results showed a mean Karlsson score of 83.4, a mean FAOS score of 69.7, and a mean VAS score of 1.33. These results are comparable to studies conducted on conventional open Brostrom-Gould repair. Conclusion The modified mini-open Brostrom Gould provides a favorable functional outcome with a reduction in pain and suggests no decrease in efficacy with the modified approach. This is coupled with the added advantages of a smaller wound, better wound healing outcomes, and availability to patients not suited to arthroscopic repair.

Background: One of the World Health Organisation strategies to achieve patient centered care is for patients to be able to effectively give informed consent. Well-informed patients are also likely to be more compliant and have better treatment outcomes. Aims and Objectives: Our study looks at using anatomical models as adjuncts in consultations to determine if they would be useful in improving patient understanding and satisfaction. Study Design/Methods: A survey of patients was carried out at a single Orthopaedic foot and ankle clinic in Singapore, to investigate if patients felt that the use of anatomical models aided in their understanding of their medical condition, foot and ankle anatomy, and surgical procedures offered, if any. 2 different anatomical models were used, depending on the context of the consultation. All conditions encountered were included. Institutional Review Board approval was not required for this study. Results: 30 patients were surveyed in total, all of whom agreed that the models were useful in helping them understand their medical condition and foot and ankle anatomy better. Of the 19 patients who were counselled regarding surgery, 18 felt that the models improved their understanding of the proposed procedures. 26 patients would like similar models to be used in other Orthopaedic clinics, although 3 would not, and 1 was not sure. On the whole, 19 patients found the models very useful, and 11 patients found them useful. Conclusion: Anatomical models are a cost-effective method of contributing to patient education compared to other alternatives, and we would advocate the use of models in other Orthopaedic clinics during consultations for counselling and taking informed consent.

Introduction Hallux rigidus (HR) refers to osteoarthritis of the first metatarsal phalangeal joint, resulting in stiffness, pain, and limitation in daily function. Surgery of HR is indicated in those who have failed a trial of non-operative management and is typically divided into joint-preserving (JP) and joint-sacrificing procedures. Cheilectomy is the most commonly practiced JP procedure, often done in conjunction with associated procedures for HR. Our paper aims to report the clinical outcomes after cheilectomy and cheilectomy done with subchondroplasty (SCP) performed for HR. Methods All patients who underwent cheilectomy for HR between 2017 and 2022 were identified and had their outcomes evaluated at the time of this review. The patients had their pre-operative radiographs and clinical and operative notes analyzed for the grading of HR. Functional outcomes were assessed with the use of the visual analog scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores, as well as comparing the pre-operative and post-operative degree of dorsiflexion of the affected first metatarsophalangeal joint. This study was approved by the SingHealth Institutional Review Board (IRB) Institution with approval number 2021/2629. Results A total of 19 patients and 20 feet were included in our study at a mean follow-up of 29.8 months. There was an increase in dorsiflexion of the first MTP joint by 27.2 degrees (p-value = <0.0001) . Patients who underwent cheilectomy alone (Group 1) had a mean improvement in VAS scores of 5.46 ( p-value = <0.0001 ). Patients who underwent SCP of the first metatarsal head along with cheilectomy (Group 2) had an improvement in VAS scores by 5.78 ( p-value = 0.0007 ). There was a mean improvement in AOFAS scores of 25.6 ( p-value = <0.0001 ) for patients in Group 1. Patients in Group 2 had a mean improvement in AOFAS scores of 31.0 ( p-value = 0.0003 ). Conclusion Both cheilectomy and cheilectomy performed with SCP for HR show good outcomes at short-term follow-up (mean 29.8 months). Cheilectomy is a viable alternative to arthrodesis for the surgical treatment of HR even in patients with higher grades. The use of SCP should be further explored as an adjunct in the surgical treatment of HR.

IntroductionHallux rigidus (HR) is a degenerative condition affecting the first metatarsal phalangeal joint, causing stiffness and pain. Surgery is indicated for those who have failed a trial of conservative management. The purpose of this paper is to evaluate the functional outcomes at short and medium term after surgery for HR. MethodsAll patients who underwent surgical treatment for HR between 2017 and 2022 at the time of this study were identified and invited to return for a follow-up evaluation. Outcomes were assessed by comparison of preoperative and post-operative visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores. ResultsA total of 26 patients were included in our study with a mean follow-up of 31 months. There was a mean improvement in VAS score by 5.6 (p-value < 0.0001) and 5.7 (p-value = 0.0012) in patients who underwent joint-preserving (JP) and joint-sacrificing (JS) surgery, respectively. Patients who underwent JP surgery had a mean increase of 28.1 points (p-value < 0.0001) in the AOFAS Hallux score, while patients who underwent JS surgery had a mean increase of 27.29 points (p-value = 0.0066). ConclusionFunctional outcomes after surgical management for HR are good at short-and medium-term follow-up. Good outcomes are seen with both JP and JS procedures. JP procedures should be considered as a first-line surgical option for HR as it allows revision procedures if required.