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February 24, 2021 ACFAS.org | FootHealthFacts.org | JFAS | Contact Us

News From ACFAS


FASTRAC Wants Your Research
Submit your research now to Foot & Ankle Surgery: Techniques, Reports & Cases (FASTRAC) the ACFAS’ new Open Access journal.

FASTRAC is looking for the latest advances in cutting-edge surgical techniques for correction of foot and ankle disorders. The journal’s streamlined submission process allows ACFAS members and other foot and ankle surgeons around the world to stay up to date on the best clinical practices. With FASTRAC, you can submit your research your way, in any format, and once accepted your paper will be reformatted to fit the journal's template. ACFAS members will receive a 25 percent discount on the author fee charged upon acceptance of a paper.

Get your latest research ready and submit it today. Visit acfas.org/FASTRAC for more information.
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Catch Another #WebinarWednesday Tonight!
Webinar Wednesday is back with our Trauma Case-Based Webinar Series tonight! Next up in this four-part series is Deconstructed Ankle Fracture Dislocation. This installment brings you more case-based presentations focusing on syndesmotic injury, posterior malleolar and arthroscopically assisted fractures and deltoid injuries.

Wednesday, February 24
Deconstructed Ankle Fracture Dislocation
8pm CT | CME: 1 Credit
Fees: Member $20 | Non-Member $30

You can keep building your bundle by picking any three available (live or recorded) webinars for the price of two. Visit acfas.org/OnDemand to register today and stay tuned for Deconstructing Diabetic Forefoot Fractures coming up next on March 24.
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A New Update is Hitting Mailboxes
Another issue of ACFAS Update is coming your way! Get the inside scoop on the latest news from the College, including the new Open-Access journal FASTRAC going live and accepting article submissions, information on the AAFAO’s Skeletal Fixation Training Program, updates on the CPME 320/330 draft re-write and much more!

The newest issue is hitting mailboxes soon, but if you can’t wait to read it, visit acfas.org/Update. If you missed an issue you can catch up with archived issues at acfas.org.
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Foot and Ankle Surgery


A Fibular Notch Approach for the Treatment of Ankle Fractures Involving the Distal Tibial Plafond
The study presents an innovative fibular notch approach for the treatment of some specific ankle fractures. Twenty-two patients with distal tibial plafond fractures with concomitant fibular and distal tibiofibular syndesmosis injuries were treated through a fibular notch approach in this retrospective study. The quality of fractures and syndesmosis reduction was examined using CT scans and lateral stability of the ankle was assessed by physical examination and stress radiographs, among other measurements. Researchers determined that all surgeries were successfully performed via the fibular notch approach as the primary approach with excellent intraoperative visualization. Postoperative radiography revealed satisfying restoration of all fractures and syndesmosis. All fractures healed with an average time of 17.3 weeks. Mild post-traumatic osteoarthritis was present in four patients. The average American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale score was 88.8 at the last follow-up.

From the article of the same title
Journal of Orthopaedic Surgery and Research (02/08/21) Liu, Tong; Cheng, Yiheng; Qu, Wenqing
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Fresh Osteochondral Allograft Transplantation for Osteochondral Lesions of the Talus: A Systematic Review
Authors of this study conducted a systematic review of clinical outcomes after fresh osteochondral allografts transplantation of the talus. A literature search yielded 12 eligible studies that evaluated outcomes after fresh osteochondral allograft transplantation for osteochondral lesions of the talus were included. Clinical outcomes according to standardized scoring systems, such as the American Orthopaedics Foot and Ankle Society (AOFAS) Ankle/Hindfoot Scale and the Visual Analog Scale (VAS) were compared across studies. A total of 191 patients were included with an average age of 37.5 years and average follow-up of 56.8 months. The AOFAS Ankle/Hindfoot score was collected in six of the studies and showed significant improvement in each. The VAS pain score was evaluated in five studies and showed significant decreases from pre- to postoperatively. While there were no reported short-term complications, 21.6 percent of patients required minor subsequent procedures, most commonly arthroscopic debridement and hardware removal. The aggregate graft survival rate was 86.6 percent.

From the article of the same title
Journal of Foot & Ankle Surgery (02/09/21) Pereira, ,Greg F.; Steele, John R.; Fletcher, Amanda N.; et al.
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ICAM-1 Levels in Patients with Covid-19 With Diabetic Foot Ulcers: A Case-Controlled, Prospective, Cohort Study in Southeast Asia
The study evaluated serum intracellular adhesion molecule-1 (ICAM-1) levels before and after debridement in patients with diabetic foot ulcers (DFUs) who were also diagnosed as COVID-19 positive compared with those who were COVID-19 negative. Twenty patients with DFUs were screened for COVID-19 and then divided into COVID-19 positive and negative groups according to the results. ICAM-1 levels in patients with DFU in the COVID-19-positive group were significantly higher than those in the COVID-19-negative group. Serum levels of ICAM-1 reduced significantly in patients with DFU in the COVID-19-positive group were significantly higher than those in the COVID-19-negative group after debridement.

From the article of the same title
Annals of Medicine and Surgery (02/15/21) Oley, Mendy Hatibie; Oley, Maximillian Christian; Kepel, Billy Johnson; et al.
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Individual Variation in Achilles Tendon Morphology and Geometry Changes Susceptibility to Injury
The study demonstrates how changing the degree of sub-tendon sliding greatly affects the mechanical behavior of the Achilles tendon. In-vitro testing revealed distinct sub-tendon mechanical properties in keeping with their mechanical demands. An in silico study based on measured properties, subject-specific tendon geometry and modified sliding capacity demonstrated age-related displacement reduction similar to our in vivo ultrasonography measurements. Peak stress magnitude and distribution within the whole Achilles tendon are affected by individual tendon geometries, the sliding capacity between sub-tendons and different muscle loading conditions.

From the article of the same title
eLife Sciences (02/16/21) Yin, Nai-Hao; Fromme, Paul; McCarthy, Ian; et al.
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Practice Management


EHR Burnout Greater Than Anticipated More Than a Decade Ago
In a recent survey from the American Medical Informatics Association (AIMA), participants say between 11 percent and 60 percent of their burnout is tied to their electronic health record system. AIMA conducted the survey at its 2020 annual meeting to assess whether the organization’s 2009 predictions on the burnout impact of the HITECH Act being enacted. They found that the association most underestimated the decrease in data quality due to copy/paste behaviors, while they most overestimated the impact that false positives from abuse and fraud detection algorithms would harm physicians and/or patients. All of the participants said that the problems today are greater than anticipated in 2009. Furthermore, the participants found that only three recommendations the association made in 2009 were half or more completed, while the majority of recommendations were found to have no significant action taken or some small amount of work over the past 11 years.

From the article of the same title
Medical Economics (02/18/21) Reynolds, Keith A.
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How Physicians Can Address Burnout
Over 50 percent of physicians in North America were reporting significant symptoms of burnout even before COVID-19. The first step to both understanding and addressing burnout is acknowledgement and designation of resources. It can help to offer services centered around cognitive therapy and stress reduction, though in-person approaches can bring increased per capita costs and some may prefer remote care. Medical groups and employers can also take steps to help physicians experiencing burnout, such as forming a peer-represented wellness committee to help organize resources and committing to an annual budget for this committee. Employers should also ensure that confidential mental health and counseling benefits are part of benefits packages for clinicians. They may want to consider partnering with community organizations to provide confidential in-person, counseling, digital mindfulness training and educational opportunities.

From the article of the same title
Physicians Practice (02/16/21) Vahamaki, Veko
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Health Policy and Reimbursement


ACA Sign-Ups Reopen
HealthCare.gov's market for subsidized health plans reopened February 15 for a special three-month sign-up window. Advancing on a parallel track, the new COVID-19 relief bill in the House would offer temporary, increase in subsidies for people covered by the Affordable Care Act. The Center on Budget and Policy Priorities estimates a family of four making $50,000 would pay $67 a month in premiums for a standard plan, instead of an average of $252 currently, while also qualifying for help with deductibles and copays. The boost in premium assistance would be available for this year and for 2022. Similarly, a single person making $30,000 a year would pay $85 a month for a standard plan instead of the current $195.

From the article of the same title
Associated Press (02/14/21) Alonso-Zaldivar, Ricardo
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Biden Picks Another Obama Veteran to Oversee Medicare, Medicaid
President Biden has selected Chiquita Brooks-LaSure to lead the US Centers for Medicare and Medicaid Services (CMS), according to insiders. Brooks-LaSure served in the Obama administration as a senior CMS official who helped implement parts of the Affordable Care Act (ACA). The CMS is central to Biden's healthcare goals, which include buttressing ACA, widening the role of Medicaid and lowering the age at which people can join Medicare from 65 to 60. During the presidential transition, Brooks-LaSure served as a lead for Biden's US Department of Health and Human Services review team.

From the article of the same title
Washington Post (02/17/21) Diamond, Dan; Goldstein, Amy
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Medicine, Drugs and Devices


As Drug Prices Keep Rising, State Lawmakers Propose Tough New Bills to Curb Them
State governments are increasingly taking steps to rein in drugmakers for unjustified price increases. Gov. Charlie Baker of Massachusetts, for example, included a penalty on price hikes for a wider range of drugs as part of his new budget proposal, projecting it would generate $70 million in its first year. Colorado, Florida and several New England states previously passed laws allowing the importation of drugs from Canada. Those programs are still being developed and would require federal approval. A recent Rand Corp. report estimates that average list prices in the United States for prescription drugs in 2018 were 2.56 times higher than the prices in 32 other developed countries, while brand-name drug prices averaged 3.44 times higher.

From the article of the same title
Kaiser Health News (02/12/21) Meyer, Harris
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Big Data Can Help Assess Risk Prediction for Osteoporosis, Fractures
A multidisciplinary research team led by Lero, the Science Foundation Ireland Research Centre for Software found that using big data can reduce osteoporosis-related bone fractures and the resulting healthcare costs by targeting vulnerable patients for low-cost interventions. The researchers plan to assess current diagnostic classification and risk prediction algorithms for osteoporosis and fractures via the Irish dual-energy X-ray absorptiometry Health Informatics Prediction project, a study of 36,590 patients who underwent bone mineral density scans between January 2000 and November 2018. Lero's John J. Carey said, "Cost-effective, innovative forms of data interrogation such as AI [artificial intelligence] will enable the timely identification and treatment of patients vulnerable to osteoporosis fractures, providing them with better care and using precious resources efficiently. There will be many opportunities to provide better patient outcomes and save billions of euro."

From the article of the same title
News-Medical Life Sciences (02/15/21)
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Major Hospitals Form Company to Capitalize on Their Troves of Health Data
Fourteen hospitals systems have joined forces to launch Truveta Inc., which will collect and sell access to anonymized data on millions of patients across 40 states. Said Providence's Rod Hochman, whose health system is part of the initiative, "Instead of just farming off all our data to a technology company somewhere, we've formed our own." The data held by Truveta, headed by former Microsoft executive Terry Myerson, will account for 13 percent of the clinical care provided in the United States. Myerson said the company aims to make the data available for "all ethical research," and Hochman indicated that a focus will be on research related to health equity and improving medical treatment. Truveta's pricing plans are in the works, with Myerson noting that fees will vary based on the type of entity seeking the data.

From the article of the same title
The Wall Street Journal (02/11/21) Mathews, Anna Wilde
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This Week @ ACFAS
Content Reviewers

Caroline R. Kiser, DPM, FACFAS

Elynor Giannin Perez DPM, FACFAS

Britton S. Plemmons, DPM, AACFAS


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This Week @ ACFAS is a weekly executive summary of noteworthy articles distributed to ACFAS members. Portions of This Week are derived from a wide variety of news sources. Unless specifically stated otherwise, the content does not necessarily reflect the views of ACFAS and does not imply endorsement of any view, product or service by ACFAS.

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