Eitan Ingall

@UMich alum • HCORP • OrthoCarolina fellowship • Foot and Ankle Orthopedic Surgeon @BSWHealth

[Eitan Ingall @EitanIngall]

@Macropulse01 @grok is this video what it claims to be?

[Eitan Ingall @EitanIngall]

@orthotraumamd @orthotraumamd
Need more info.
Hindfoot varus?
Medical comorbidities?
Any antecedent pain?
Generally- in a non pro athlete
WBAT boot x 6weeks, re-eval. So long as pain is improving, continue non op. If they have persistent probs at 8-10weeks—> screw.

[Eitan Ingall @EitanIngall]

@InvictaOrtho Do you have any pics of the fracture site? I’ve tried both femoral distractor and traveling traction and have always found that it never gets the reduction quite right. Often slightly angulated or translated. It’s probably operator error on my part, but curious how you dial it in

[Eitan Ingall @EitanIngall]

@InvictaOrtho And you also medialized the calcaneus (look at the relationship of the tuberosity to the plafond on the pre and post op AP) and so this tensioned the CFL

[Eitan Ingall @EitanIngall]

@InvictaOrtho you effectively lengthened the tibia independent of the fibula (fibula looks like it is in the same position and wasn’t osteotomized). So you tensioned all of the lateral structures… maybe can see this in the post op XRs where the fibula now looks a little “short”

[Eitan Ingall @EitanIngall]

@InvictaOrtho I’ve excised and reefed the deltoid up with a 3.5 anchor a couple times here. Always seems to over tighten… and if just anterior colliculus your point above about the deep deltoid is well taken.

[Eitan Ingall @EitanIngall]

@InvictaOrtho Cool. What size screw here?

[Eitan Ingall @EitanIngall]

@SamuelEFord Totally agree. Hate putting holes in cartilage. Plan is to fuse. However, reduced well enough that it’s tempting to just fix that big sustentacular piece, isnt it?!

[Eitan Ingall @EitanIngall]

50 yo healthy fall off ladder. Came in 7pm. Lateral skin not tenting but clearly stretched and tuber piece directly abutting skin. Plan? Temporize? Fix? Fuse? Approach? #orthotwitter @BostonFootAnkle @FootAndAnkleMD @InvictaOrtho @clareau @SamuelEFord

[Eitan Ingall @EitanIngall]

Interesting article from 2021 FAI

[Eitan Ingall @EitanIngall]

Because of beat up lateral soft tissues, felt he needed a reduction.
Shanz pin laterally- Distract, valgus and medial translation. 3 wires to hold. Will come back once soft tissues are ready.

[Eitan Ingall @EitanIngall]

@northwoods1980 You really can’t tell anything from that XR. It’s important to understand this IMO. That medial clear space could be “wide” for several reasons, none of which are clear from this image. Could be rotational/projectional from XR, syndesmosis, deltoid, or fibula is fixed too short.

[Eitan Ingall @EitanIngall]

@candacern59217 @OGdukeneurosurg Can you please cite something that says that topical abx “are the answer” for purulence around a vac’d open abdomen?

[Eitan Ingall @EitanIngall]

@BostonFootAnkle @FootAndAnkleMD @footankle @InvictaOrtho If a (physiologically) young, active patient— ankle scope, A-P wire with P-A screw, likely perc medial mal screws. Would then stress, don’t expect talar shift, but if it did, agree with tightrope/screw laterally. Splint 2 wks, then to boot early motion, NWB total 4 weeks.

[Eitan Ingall @EitanIngall]

@OGdukeneurosurg @Muriu It’s called a Jacobs ladder. It’s actually to prevent skin creep. Keeps some tension on the skin edges to prevent them from retracting so you can come back and close another day

[Eitan Ingall @EitanIngall]

@BostonFootAnkle @BostonFootAnkle do you evaluate the deltoid arthroscopically in these cases?

[Eitan Ingall @EitanIngall]

@InvictaOrtho That’s an awesome observation. Great thing to keep in mind

[Eitan Ingall @EitanIngall]

@DrMarecek Looks money

[Eitan Ingall @EitanIngall]

@DrMarecek Complete AP, lateral and mortise radiographs would strengthen your case sir

[Eitan Ingall @EitanIngall]

@BostonFootAnkle Why IB augmentation?