Recent research on pediatric ankle fractures has centered on the accurate prediction and prevention of growth arrest following fractures of the distal tibia. Another source of discussion is the necessity and benefit of CT scanning in classification and treatment approach. Pediatric ankle fractures continue to pose clinical challenges for orthopedic surgeons. While open anatomic reduction and internal fixation continue to produce good outcomes for intra-articular fractures, outcomes of physeal injuries are more difficult to predict. More studies are needed to determine which patients may benefit more from surgical treatment of physeal injuries.

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Category: Midfoot/Forefoot; Other Introduction/Purpose: There has been an increased use of Cartiva implant in patients with first MTP arthritis. There are limited studies analyzing patient reported outcomes (PROs) with Cartiva implant. The goal of this study is to analyze validated patient reported outcomes on Cartiva patients. Methods: From a multi-center single institution, we analyzed patients who received the Cartiva implant and submitted PROs from December 2016 to December 2019. The following outcomes were analyzed: Foot and Ankle Ability Measure (FAMM), Global Rate of Change (GRC), and Patient Acceptable Symptom State (PASS). The PROs were analyzed by examining the postoperative score at any time interval after the procedure, a difference between preoperative score and postoperative time interval score (delta score), and at different time periods 0-2 months and >2 months after the procedure. Results: Of the 175 Cartiva patients, the average age was 57.1 years with 68% females and 32% males. The overall mean delta FAMM score was 5.5. The mean FAMM score at 0-2 months were 61.6 with the mean delta score -9.2. At > 2 months, the mean FAMM score was 74.7, and the mean delta score was 10.9. With GRC scores, overall GRC score 45.6 % report better, 35.1% report no change, 11.9% report worse. At 0-2 months, 38.1% report better, 42.9% report no change, and 19.1 % report worse. At > 2 months, 41.2% report better, 35.3% no change, 23.5% report worse. As for PASS scores, 53.3% said no, and 46.6% said yes. Conclusion: Overall FAMM scores with Cartiva implant overall show improvement compared to preoperative score. FAMM scores at 0-2 months are worse than preoperative but are better at >2month timeframe. There is a minimal difference between patients feeling better or no change after their procedure in GRC and PASS scores and analyzing at 0-2 and >2 month timeframes. Further studies are needed.