Journal of Orthopedic Education

Background: A Lisfranc’s injury is a tarsometatarsal fracture dislocation is characterized by Traumatic disruption of Medial cuneiform and base of the second matatarsal. Incidence 0.2% of foot injury, Common in males, in third decade, mechanism of Injury fall from height & in Athletic injuries, Injuries range from sprains to severe dislocations. Aim: Ligamentous Vs bony injury pattern has treatment indications. Lisfranc equivalent injuries present with proximal metatarsal fracture or tarsal fractures, can involve multiple tarsometatarsal (TMT) fractures and joints1. In Anatomy mainly involvement Lisfranc ligament, it is a interosseous ligament that goes from medial cuneiform to base of 2nd metatarsal on planter surface, critical to stabilizing the 1st & 2nd tarsometatarsal joints and maintenance of the midfoot, second ligament is plantar tarsometatarsal ligament which is between medial cuneiform and the second and third metatarsals along with its lisfranc ligament is necessary to give from severe instability. Third Dorsal tarsometatarsal ligaments which is weaker therefore bony displacement with injury is often dorsal and forth intermetatarsal ligaments between second to fifth metatarsal bases. Material & Result: On Radiograph fleck Sign small bony fragment, often seen on AP view of the foot, indicating avulsion fracture Lanfranc ligament. This fragment is typically located in the Lanfranc space between based of 1st & 2nd metatarsal bones and is very subtle but important finding suggesting of Lanfranc injury. Step off sign in Lanfranc injury refers to the dorsal displacement of the second metatarsal base creating a visible step or a gap on the dorsal (top) surface of the foot when viewed on lateral x-ray, this sign is indicative of Lanfranc injury which involves damages to the ligament and bone in the midfoot, Radiograph findings may be subtle so stress radiographs or CT may be needed in complex cases.

Steroid injections, while effective for short term pain relief, can weakness tendons and increase risk of rapture corticosteroid suppress inflammation, which can impair tendon healing and reduce its tensile strouth. They may also delay tendon healing and cause degeneration making them more prove to rapture for that the risk is higher with long-term or high dose steroid use, especially in older patients or those with pre-existing tendinopathy and the use of certain antibiotics risk fluoroquinelones therefore corticosteroids can inhabit the body’s natural ability to repair and strengthen tendon including the Achilles tendon. They can suppress inflammation and reduce rollagen production weakening the tendon structure. Corticosteriods which are commonly used trendy are analugs of harmones synthesized in the laboratory. In humans corticosteroid harmones are produced by the adrenal glands and relased in the body in response to stress, they controls the protein, fat and carbohydrates metabolism and further more exert an important ant-inflammation activity by preventing phospholipid realse, decreasing the effect of eosinophils and proinflmmtion cytokines and through a number of other mechanisms on reducing the vascularisation. Clinical presentation: Rapture often present with sudden pain, a possible audible snap and an inability to bear weight, some patient may experience chronic pain and notice the injury whom daily tables, like climbing stairs becomes difficult. Treatment surgical repair is often necessary for Achilles tendon raptures, especially resulting steroid use or chronic degenerative.

The move towards DDDM may signal a new administration in orthopaedic healthcare that is even more systematic and evidence-based to be applied in areas related to patient care and resource management. Advanced analytics can make leaders take decisions that not only push for better clinical outcomes but may also work well for smoother operations. This data-centric approach can lead to customisable care plans, the potential to predict complications post-surgery, and chronic condition management improvement through all this, especially osteoarthritis. Analytics can also lead to efficient use of resources schedule operating room operations more intelligently, make better allocation decisions with staff, and ensure timely maintenance of needed equipment, with the bottom line being fewer delays and reduced costs. Predictive tools, and thus artificial intelligence, exemplify an important application that provides forecasts in terms of patient needs, surgical risks, and complications likely to be encountered, hence supporting timely interventions and proactive patient care. Huge challenges, however, still abound in various issues related to data accuracy, compatibility among systems, and a change necessarily needed in organisational culture. Issues related to data privacy and security also have to be taken with care. While these are indeed significant challenges, embracing DDDM is becoming vital to the improvement of both the quality of patient care and the efficacy of operations. This paper explores how data analytics is revolutionising orthopaedic care, focusing upon its potential contributions to patient and resource management as well as the practical problems inherent in more fully adopting that approach.

Osteoporotic fractures often show up as the first noticeable sign of a condition that has been lurking in the shadows for a long time. While tools like DEXA scans provide reliable diagnostic benchmarks, they aren’t always easy to access or used early enough. That’s where the concept of retinal imaging comes into play and it’s actually starting to gain some attention. The retina, with its intricate network of blood vessels, might reveal early systemic changes that also impact bone health. Some studies indicate that changes in the retinal icrovasculature like decreased vessel density or increased tortuosity could be linked to low bone mineral density. It’s not conclusive just yet, but it’s definitely intriguing enough to warrant further investigation. Technologies like OCTA and traditional fundus photography, when combined with artificial intelligence, present themselves quite literally into possible early signs of osteoporosis. Could a simple eye exam someday flag patients at risk before a fracture occurs? Possibly. It seems plausible that such interdisciplinary tools could be folded into primary care or orthopaedic settings. But then again, there are barriers: access, cost, standardisation, and the need for more research. Still, the potential is there. By merging retinal imaging with systemic risk assessment, clinicians might just gain an edge in catching bone deterioration before it manifests catastrophically. It’s an exciting frontier not without its flaws, but worth pursuing.