New York State Medical Treatment Guidelines for

Ankle and Foot Fractures in workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Ankle and Foot Fractures.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Ankle and Foot Fractures

A patient with an ankle injury should undergo an initial evaluation to look for conditions that need to be treated right away. These ailments include vascular disease and open fracture. Joint dislocation, compartment syndrome, and compromise.

In general, non-operative treatment is used for undisplaced or minimally displaced injuries. While surgical intervention is used to address misplaced or unstable wounds. ankle complications and foot fractures include discomfort, post-traumatic osteoarthritis, reduced range of motion, prolonged discomfort despite removal of hardware, developing talar instability, and malunions with simultaneous syndesmotic widening

The kind of injury (displaced or nondisplaced) determines the initial course of therapy for foot and ankle fractures. steady, open, or closed) as well as simultaneous soft tissue damage. Closed and stable wounds are generally non-operative treatments.

Emergent debridement is necessary for open fractures, and antibiotic prevention. Most closed unstable fractures need to be operated on. Initiate treatment for skin conditions, compartment syndrome, and significant swelling. integrity degradation due to blisters from fractures.

Diagnostic Studies for Ankle and Foot Fractures in workers compensation patients

  1. Diagnostic Studies for Ankle and Foot Fractures for X-Rays

    Diagnostic Studies for Ankle and Foot Fractures for X-Rays is recommended as a first-line study.

    Indications: Suspicion of fracture.

    Rationale for Recommendation: The first line of treatment is X-ray.

    imaging examination for a possible fracture.

     

  2. MRI for Distal Lower Extremity and Ankle Fractures

    MRI for Distal Lower Extremity and Ankle Fractures is recommended for the purpose of examining ankle and distal lower limb fractures.

    Indications: To assess soft tissue for acute or subacute fracture comminuted or complicated displaced fracture with tissue/ligament damage, or if the fracture’s stability is questionable and an MRI will help with management decision.

    Rationale for Recommendation: MRI should not be used as a first-line imaging method. In the event that shifted, comminuted, or MRI might be a crucial diagnostic tool for the unstable fracture examination of potential soft tissue damage involving the distal fibular, fractures of the tibia and malleoli, such as those to the syndesmotic ankle ligament complex, the tibial nerve, the deltoid ligament, or the extensor tendons. MRI is highly suggested in certain specific cases.

     

  3. CT for Diagnosis and Classification of Ankle Fractures

    CT for Diagnosis and Classification of Ankle Fractures are recommended for the purpose of examining ankle and distal lower limb fractures.

    Indications: suspected concealed and complicated ankle fractures; to clarify the location of the fracture. Axial views are advised in addition to any coronal views if intra articular displacement is being taken into account.

    Rationale for Recommendation: When using an x-ray, consider using a CT. Despite the bad perceptions, physical evidence points to an occult conspiracy. A fracture is highly likely. CT could be helpful for assessing complicated comminuted fractures that better represent the distal femur involvement of the tibial articular surface, placement of the fragment, and diagnostic a subluxation of.

    Ultrasound Imaging for Diagnosing Ankle Fracture

    Ultrasound Imaging for Diagnosing Ankle Fracture is recommended for determining whether certain misplaced fractures or suspected malleolar stress fractures have caused soft-tissue damage.

    Indications: Evaluation of soft-tissue damage related to specific Displacement fractures to determine a fracture’s stability, particularly the medial and bimalleolar fractures in the deltoid ligaments, and in detection of occult or stress fracture suspicion. also employed for possible stress the distal tibia breaking.

    Rationale for Recommendation: Using ultrasound imaging could be helpful. In addition to clinical evaluation of patients in the selection of Further radiological testing is therefore advised in some circumstances. patients.

Medications for Ankle and Foot Fractures

  1. Pre-Operative Antibiotic Prophylaxis for Ankle Fractures

    Pre-Operative Antibiotic Prophylaxis for Ankle Fractures is recommended for ankle fracture surgery, either open or closed.

     

  2. Use of Nasal Spray Calcitonin for Post-fracture Osteopenia

    Use of Nasal Spray Calcitonin for Post-fracture Osteopenia is not recommended for the prevention of osteopenia following fracture.

     

  3. DVT Prophylaxis of Ankle and Foot Fractures

    See the section on DVT prevention in Achilles tendon rupture. Section.

     

  4. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Acetaminophen

    Ibuprofen, naproxen, or other NSAIDs from an earlier generation are suggested as first-line treatments for the majority of patients. For patients who are not candidates for NSAIDs, acetaminophen (or the analogue paracetamol) may be a viable alternative, even if the majority of research indicates it is just marginally less effective than NSAIDs. There is proof that NSAIDs are less dangerous and just as effective in treating pain as opioids, such as tramadol.

     

  5. Non-Steroidal Anti-inflammatory Drugs (NSAIDs) for Acute Ankle Fracture Analgesia

    Non-Steroidal Anti-inflammatory Drugs (NSAIDs) for Acute Ankle Fracture Analgesia is recommended for the purpose of treating pain brought on by an ankle fracture.

    Indications: For an ankle fracture that is post-operative or chronic, NSAIDs are advised as a therapy. agents sold over-the-counter (OTC) may be adequate and ought to be attempted first.

    Frequency/Duration: Many Patients may find it reasonable to use as needed.

    Indications for Discontinuation: resolution of ankle/foot discomfort, absence effectiveness, or the emergence of unfavourable effects that are necessary discontinuance.

     

  6. NSAIDs for Patients at High-Risk of Gastrointestinal Bleeding

    NSAIDs for Patients at High-Risk of Gastrointestinal Bleeding is recommended concurrent use of cytoprotective medication classes: Histamine Type 2 receptor blockers, misoprostol, sucralfate, and proton People with a high risk of gastrointestinal bleeding should take pump inhibitors.

    Indications: For patients who additionally have a high-risk factor profile, the use of NSAIDs and cytoprotective drugs should be taken into account, especially if longer-term treatment is being discussed.

    At-risk Patients having a background of previous gastrointestinal bleeding, older people, people with diabetes, and smokers.

    Frequency/Dose/Duration: Misoprostol, proton pump inhibitors, Sucralfate and H2 blockers are advised. dosage and repetitions per manufacturer. There isn’t typically thought to be anything there. varying degrees of effectiveness in preventing gastrointestinal bleeding

    Indications for Discontinuation: Intolerance, the emergence of negative effects, or the stopping of NSAIDs.

     

  7. NSAIDs for Patients at Risk for Cardiovascular Adverse Effects

    NSAIDs for Patients at Risk for Cardiovascular Adverse Effects is recommended the first-line treatment options of acetaminophen or aspirin seem to be the safest in terms of cardiovascular side effects. It is advised to use non-selective NSAIDs rather than COX-2-specific medications if necessary.

    To reduce the chance that an NSAID will negate the protective effects of low-dose aspirin in individuals receiving it for primary or secondary cardiovascular disease prevention, the NSAID should be taken at least 30 minutes after or eight hours before the daily aspirin.

     

  8. Acetaminophen Treatment of Acute, Subacute, or Chronic Pain with Acetaminophen Acute Pain From Ankle Fracture

    Acetaminophen Treatment of Acute, Subacute, or Chronic Pain with Acetaminophen Acute Pain From Ankle Fracture are recommended for the treatment of acute ankle fracture pain, whether it be acute, subacute, or chronic, especially in individuals who have NSAID contraindications.

    Indications: Acute, subacute, and chronic foot/ankle pain in all individuals chronic and following surgery.

    Dose/Frequency: Depending on the manufacturer’s guidelines; applicable on a need-to-know basis. Hepatic toxicity is demonstrated when greater than 4 g/day.

    Indications for Discontinuation: relief from discomfort, negative effects, or intolerance.

     

  9. Limited Use of Opioids for Acute and Postoperative Pain Management

    Limited Use of Opioids for Acute and Postoperative Pain Management are recommended for brief (less than seven days) usage for urgent emergency postoperative pain control as a complementary therapy for more efficient Treatments.

    Indications: Acute injury and post-op pain treatment require the use of short opioid prescriptions as supplements to more effective treatments (particularly NSAIDs, acetaminophen, elevation, and bracing) necessary, especially at night.

    Frequency/Duration: throughout the day as necessary, then only at nighttime later, until entirely weaning off.

    Rationale for Recommendation: Some people experience too little pain. NSAIDs can provide relief, therefore using opioids responsibly may be beneficial. especially for use at night. Opioids are advised for limited, specific use in recovering patients, with nighttime use being the main goal Postoperatively.

     

  10. Tetanus Immunization Status for Open Fractures

    Tetanus Immunization Status for Open Fractures is recommended updating of tetanus immunisation status as Necessary.

    Indications: Those wounds that have not healed after more than five years elapsed since the last tetanus shot.

    Rationale for Recommendation: Due to the negative implications of not vaccinations can be harmful, tetanus vaccination updates for open wounds is advised. Those with burns or dirty wounds should if it has been more than five years since the last vaccination, requiring vaccination, instead of ten years. Patients who have not finished their vaccination series should receive tetanus immune globulin along with each of the three shots. immunisation.

     

  11. Analgesia for Non-Operative Reduction Ankle Fractures

    Analgesia for Non-Operative Reduction Ankle Fractures is recommended for performing non-operative closed reduction of ankle fractures.

    Rationale for Recommendation: The best strategy should be chosen depending on the expertise and preferences of the doctor, the patient’s history of medication intolerance or level of anxiety, and the availability of supplies and equipment.

Treatments of Ankle and Foot Fractures

Mobilization / Immobilization of Ankle and Foot Fractures

  1. Cast Immobilization for Ankle Fractures

    Cast Immobilization for Ankle Fractures is recommended in order to treat ankle fractures. Any ankle fracture is a sign.

    Frequency/Duration: Immobilization generally for six to eight weeks.

    Rationale for Recommendation: Cast-induced immobility is advised for all patients, and the application depends on patient and doctor preferences.

     

  2. Early Mobilization for Ankle Fractures

    Early Mobilization for Ankle Fractures is recommended in the management of postoperative and stable non-operative ankle fractures.

    Indications: with or without stabilised malleolar fractures Surgical and properly fixed closed ankle fractures stabilisation, too.

    Frequency/Duration: The early mobilisation process can begin. between one and three days after surgery.

    Rationale for Recommendation: For the majority of patients with a stable or healed malleolar ankle fracture, early mobilisation is advised.

     

  3. Early Postoperative Weight-bearing for Ankle Fractures

    Early Postoperative Weight-bearing for Ankle Fractures is recommended early weight bearing after surgical fixation ankle fractures following surgery.

    Indications: with or without stabilised malleolar fractures Surgical and properly fixed closed ankle fractures stabilisation, too.

    Rationale for Recommendation: premature weight-bearing may produce short-term benefits in functional recovery, do not seem to lead to an increase in unfavourable events.

    Immobilization, early mobilisation, and its Use Early Weight-bearing for Fractures of the Ankle

Rehabilitation of Ankle and Foot Fractures

  1. Electrical Stimulation for Prevention of Muscle Atrophy

    Electrical Stimulation for Prevention of Muscle Atrophy is not recommended in order to stop muscular atrophy in care of foot and ankle fractures.

     

  2. Therapy for Patients with Functional Deficits after Cast Removal

    Therapy for Patients with Functional Deficits after Cast Removal is recommended after the removal of the ankle cast.

     

  3. Manual Therapy as Part of a Post-ankle Fracture Rehabilitation Program

    Manual Therapy as Part of a Post-ankle Fracture Rehabilitation Program is recommended as a vital component of a rehabilitation programme following an ankle fracture.

     

  4. Passive Stretching for Contractures After Immobilization of Ankle Fractures

    Passive Stretching for Contractures After Immobilization of Ankle Fractures is not recommended treating contractures following ankle fracture immobilisation.

    Frequency/Dose/Duration : The frequency of visits is frequently based on how severe the constraint is. Two to three visits per week are usual throughout the first two weeks of a fitness programme.

    With verification of objective functional progress, the total number of visits may range from two to three for mild deficits to twelve to fifteen for more severe deficits.

     

  5. Ultrasound to Stimulate Bone Healing for Ankle and Foot Fractures

    Ultrasound to Stimulate Bone Healing for Ankle and Foot Fractures is not recommended – for ankle and foot fracture Management.

     

  6. Hyperbaric Oxygen for the Management of Ankle or Foot Fractures

    Hyperbaric Oxygen for the Management of Ankle or Foot Fractures is not recommended for management of ankle or foot Fractures.

Fracture Care of Ankle and Foot Fractures

Malleolar Ankle Fractures

In the past, non-displaced and stable fractures have been managed been ineffective with positive outcomes. There is ongoing discussion on the treatment of certain types of fractures for which there is uncertainty either stable or unstable.

The distal fibula fracture rarely fails to heal, so support for a conservative management experiment using non-displaced and cracks with steady displacement Failure to reduce or a delayed union may require the use of surgery. Frequently, posterior malleolar fractures occur. highly unpredictable and frequently missed.

  1. Immobilization for Non-displaced Ankle Fractures

    Immobilization for Non-displaced Ankle Fractures is recommended for the care of non-displaced individuals and decreases in stable ankle fractures.

     

  2. Immobilization and Reduction for Closed Displaced Ankle Fractures

    Immobilization and Reduction for Closed Displaced Ankle Fractures is recommended for a few closed displaced non-comminuted ankle fractures.

    Indications: Ankle that is not fractured and is dislocated. fractures that are smaller than two to three mm after reduction less than 25% of the posterior malleolus articular width and three minimal involvement.

     

  3. Operative Fixation for Closed Displaced Ankle Fractures

    Operative Fixation for Closed Displaced Ankle Fractures is recommended for an ankle that is closed and dislocated. Fractures.

    Indications: medial lateral fracture that is typically severe participation of the malleoli. ankle that is fractured and dislocated. fractures that have a displacement of more than 2 to 30% of the posterior malleolus articular diameter and 3mm only minor involvement

    Rationale for Recommendations: Unless there is a severe the outcomes of an open reduction, systemic comorbidities, and for individuals with malleolar fractures, internal fixation Those younger than 60 are essentially the same, whereas When unstable fractures are not operated on, it results in much worse results.

    Consequently, the overall Surgery indications for older individuals shouldn’t change from patients who are younger. therapy for individual fractures depending on the condition of the skin, the quality of the bones, Comorbidities and patient functional demands.

    To avert complications, they must be taken into account and treated. concomitant conditions include osteoporosis and diabetes.

Tibial Shaft Fractures (Diaphyseal)

  1. Operative Fixation for Tibial Shaft Fracture (Closed, Diaphyseal)

    Operative Fixation for Tibial Shaft Fracture (Closed, Diaphyseal) is recommended Displaced, comminuted distal tibial shaft Fracture.

    Indications: Distal tibial shaft that is displaced and fractured Fracture.

     

  2. Cast Immobilization for Tibial Shaft Fractures (Closed, Diaphyseal)

    Cast Immobilization for Tibial Shaft Fractures (Closed, Diaphyseal) is recommended in some patients. The tibia has a closed, stable fracture.

     

  3. Operative Fixation (i.e., Fracture Plating, Intramedullary Nail) for Distal Tibial Extra-Articular Fractures

    Operative Fixation (i.eFracture Plating, Intramedullary Nail) for Distal Tibial Extra-Articular Fractures is recommended in select patients.

    Indications: Open fractures, initial shortening greater than 15mm, and angular deformity following initial manipulation greater than 5 in any plane.

     

  4. Cast Immobilization for Distal Tibial Extra-Articular Fractures

    Cast Immobilization for Distal Tibial Extra-Articular Fractures is recommended for distal extra articular tibial fractures under specific conditions.

    Indications: Closed uncomplicated fractures with an initial shortening of 15mm and an angular deformity of 5 in either plane following the initial manipulation.

    Tibial Plafond (Pilon) Fractures

     

  5. Non-operative Management of Tibial Plafond and Pilon Fractures

    Non-operative Management of Tibial Plafond and Pilon Fractures is Recommended in select patients.

    Indications: Stable fracture that is neither displaced, comminuted, or unstable; capacity to achieve proper fracture alignment with closed reduction.

     

  6. Operative Management of Tibial Plafond and Pilon Fractures

    Operative Management of Tibial Plafond and Pilon Fractures is recommended for some tibial plafond fractures Patients.

    Indications: Displaced, comminuted, or inability to obtain acceptable fracture alignment with closed reduction.

    Rationale for Recommendations: fractures in the distal lower leg that press the talus against the articular surface include referred to as plafond fractures. It is noted that these fractures having significant incidence of complications from surgical weight loss, Fixation.

Syndesmotic Ruptures for Ankle and Foot Fractures

Operative treatment of unstable syndesmotic injury to restore the tibiofibular relationship.

  1. Operative Fixation for Syndesmotic Ruptures

    Operative Fixation for Syndesmotic Ruptures is recommended for unstable syndesmotic rupture.

    Indications – ankle fractures that are closed but unstable AO fracture type C, syndesmosis, and/or pathologic widening of the syndesmosis at intraoperative of more than 2mm Testing.

     

  2. Non-operative Management of Syndesmotic Injuries

    Non-operative Management of Syndesmotic Injuries is recommended for stable syndesmotic injury.

    Indications: Absence of other destabilising injury including ankle fracture or deltoid ligament injury.

    Rationale for Recommendations: Some experts believe that not all syndesmotic ankle injuries result in ankle instability and may not require correction if there are no associated destabilising injuries. If there is a fracture, fixation is necessary.

    For some patients, non-operative care is advised. For non-stable injuries, such as most syndesmotic rupture with concomitant fractures or deltoid ligament injury, surgical treatment is advised.

Fibular Fracture of Ankle and Foot Fractures

Operative Fixation for Displaced Distal Fibula Fractures

Operative Fixation for Displaced Distal Fibula Fractures is recommended for a fractured distal fibula.

Indications: Unsatisfactory closed fracture of the distal fibula shaft Reduction.

Rationale for Recommendation: Surgical fixing is indicated for distal fibular fractures that are unstable and displaced.

Arthroscopy with ORIF of Distal Fibular Fractures

Arthroscopy with ORIF of Distal Fibular Fractures Use of Arthroscopy Assisted ORIF for Distal Fibular Fractures

Arthroscopy with ORIF of Distal Fibular Fractures Use of Arthroscopy Assisted ORIF for Distal Fibular Fractures is not recommended for fractures of the distal fibula. Arthroscopy Evaluation During Distal Tibia Fracture Fixation ORIF: Evidence for Use

Deltoid Ligament Repair with ORIF of Lateral Ankle Fracture

Deltoid Ligament Repair with ORIF of Lateral Ankle Fracture Deltoid Ligament Repair Concurrent with ORIF for Unstable Ankle Fractures

Deltoid Ligament Repair with ORIF of Lateral Ankle Fracture Deltoid Ligament Repair Concurrent with ORIF for Unstable Ankle Fractures is recommended for those who suffer with deltoid ligament significant fibular fractures or in patients with disruption simultaneous syndesmotic fixation

Other of Ankle and Foot Fractures

  1. Pneumatic Compression for Treatment of Ankle and Foot Edema

    Pneumatic Compression for Treatment of Ankle and Foot Edema is recommended for patients who have sustained serious postoperative Edema.

    Indications: excessive swelling following surgery for an ankle fracture.

     

  2. Interferential Therapy for Treatment of Ankle Edema

    Interferential Therapy for Treatment of Ankle Edema is not recommended in order to treat postoperative post ORIF for a dislocated malleolar fracture, edema.

What our office can do if you have Ankle and Foot Fractures

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.

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15:02 02 Mar 23
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21:23 25 Feb 23
Dr Vaksha was so kind and helpful. He took extra time with us and explained things so thoroughly. Highly recommend. Office very clean.
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20:20 19 Feb 23
Dr Vaksha, is a great doctor very professional knows what he talking about. Treat patient with upmost respect. Thank You
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16:46 19 Jan 23
Dr. Karkare is an amazing doctor, very caring and attentive, the girl at the front desk is very kind and helpful. .elizabeth .thank you so much .
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21:32 26 Oct 22
Been going to this place before my accident and after I had my knee surgery. So happy how I been treated and how well I am getting. Thank you all and specially Dr. VAKSHA for everything and getting back on track.
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19:01 25 Oct 22
Love this place From the minute I called I was treated kindly. When I arrived The Dr saw me right away he was compassionate and ordered the appropriate tests for me. I came back in for my follow up and had the same great experience.
Christine Rostock
21:28 23 May 22
Dr Vaksha and Dr karkare are 2 of the best orthopedic doctors around my wife Susan had a very serious broken ankle in March of 2019 she didn't think she was going to walk again Dr vaksha did an excellent surgery on her ankle he said it was his toughest he ever did he put a lot of hardware in her ankle and told her she would be alright she made remarkable recovery thanks to his surgery as of now she regained 100 percent use of her ankle she would highly recommend him to anyone. My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best.
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23:31 19 May 22
Complete orthopedics is a wonderful place to go when you hurt or injured a great staff and wonderful doctors very knowledgeable and helpful I would recommend this place to all of my family and friends that is in me of orthopedic care I give them 10 thumbs up
Wayne Pemberton
17:39 18 May 22
The staff is very professional and helpful. Dr. Vaksha is excellent. He takes time to listen and offer suggestions to help you get better. I’m very thankful and happy to be a patient here at Complete Orthopedics.
Phoenix Rising
19:54 16 May 22
Dr.Karkare is the best. He listens to everything and explains everything I recommend him to everyone. I am so happy he is my doctor.
Myrna James
00:48 13 May 22
Dr.Kuo is amazing very attentive,caring,and passionate and staff is awsome too.Thank you for everything Dr.kuo.
Erick Murillo
23:17 12 May 22
I was in a car accident November 1 I was referred to Dr. Vaksha For shoulder surgery . I he was amazing he made me feel very comfortable and explained everything that was going to happen from surgery all the way through my physical therapy highly recommend Dr. Vaksha
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19:37 09 May 22
My appointment with Dr. Vaksha was amazing. Dr. Vaksha was very thorough and kind. I would refer this office to anyone who needs a great orthopedic doctor.
John Senechal
19:54 05 May 22
Scheduling my appointment was quick and easy. The staff was super friendly and down to earth. I was seen on time. The appropriate test, “x-rays” were taken before the conversation with doctor, something I really liked, test for analysis and conversation was done upfront. Dr. V had a great personality and was no BS, straight forward diagnosis and a play on next steps. I am happy I found them and would refer them to friends and family.
Sam
00:46 03 May 22
I have seen Dr. Kuo two times already and he's awesome along with his staff. Very friendly office and I'm glad to be a patient here.
Camaris A
20:01 28 Apr 22
Amazing team!! Very caring, profesional, and friendly!! Dr. Kevin Kuo, you are the best, very passionate, caring, and helping thank you for getting me better and being so kind to me! Elizabeth you the best thank you for you help always and you big smile and positive actitud❤️🙏🏼
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19:01 22 Apr 22
The staff is truly exceptional, they make you feel comfortable and welcomed. The doctors are amazing,always professional, compassionate and great listeners.
Elizabeth Collado
03:25 09 Apr 22
What a great place! The place is clean and organized.The staff is wonderful. Setting up physical therapy is right there as well.I'm so glad I found this place.
Donna Anne
22:45 05 Apr 22
This was my 1st time breaking something in my 27 years on this planet. I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. Would highly recommend
tyron davis
16:06 01 Apr 22
Brand new office, same great doctors! Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. Thank you!
Emily B
02:49 24 Mar 22
Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs
Mirna Caballero
14:53 03 Mar 22
Great staff. Dr. Vaksha is awesome and takes the time to listen to his patients. He is very compassionate. I would highly recommend this office.
Bebe Doyle
01:24 23 Feb 22
After suffering from a severe ankle injury Dr. V was able to help me heal and return back to work completely to a job where I stand for 12 hours a day. The office is very clean and I appreciated the reminders of my appointments via phone call and through text. The patient portal made it easy for me to access all my documents including work notes. The office staff is wonderful and Rebecca was able to schedule me with a busy schedule and awesome at answering all of my questions including referring me to a great physical therapy office. I highly recommend this office to anyone who’s looking for knowledgeable and kind orthopedic office.
Elizabeth Birchwell
21:31 28 Jan 21
The staff here are great, I was seen at the time of my appointment and was well taken care of!
Shaun Berry
18:14 07 Jan 21
They are an excellent practice. The front and back office people are amazing and so helpful. Rebecca is such a kind and understanding person. I had an issue with paperwork and she cleared it right up. Dr. Karkare is very knowledgeable, helpful, and caring.
Matt S.
19:31 18 Nov 20
Rebecca K. - What a true burst of sunshine. Very friendly and definitely an asset to the practice!
Laura Aston
18:17 17 Nov 20
Great experience, the Doctor is nice but the staff is incredible. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Complete Ortho should be complimented for having such a person on their staff.I highly recommend this place!!!
Joe Allen
17:26 17 Nov 20
Linda and Becca they are so good ever time I come they are very nice I would tell everyone I no to come to this office..
Barbara Victor
16:45 17 Nov 20
I was rear ended in an auto accident , Dr Vashka was recommended by a friend of mine .I was experiencing Back , neck , and shoulder pain . After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . The staff at Complete Ortho is extremely attentive and show great care when making an appointment and are very friendly and i never waited more than 5 minutes for my appointment . So I would strongly recommend Complete Orthopedics for any aches and pains that one might be experiencing.....
Bill Becht
04:44 17 Nov 20
It was the afternoon of Friday Sept. 24. We were in Pt. Jefferson and my wife, Mary Ann, broke her hip. We went to Mather Hospital and it was determined that she would have to have an operation to have it repaired. This would be her third time under the knife in the past year. It just so happened that we were very fortunate enough to have Dr. Karkare, who was on standby, perform the surgery. He put in a rod and two screws in her hip. She spent a few days in the hospital and then went to Gurwin rehabilitee for another few weeks.It has now been almost six weeks and we both worked the election the other day. If it wasn’t for Dr. Karkare’s expertise she never would have been able to work. She is able to walk with a walker and is doing physical therapy three times a week.We can not thank the doctor enough for the compassion and dedication that he puts into his work. It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. I know that with her will, perseverance and the great work that the surgeon performed she will be back on her feet in no time.Sincerely:John V. PlumpEast Northport, NY 11731
Jack Harris
14:36 06 Nov 20
In the year of 2018 I was referred to Dr. Karkare because I was experiencing severe knee joint pain. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. Total knee replacement was the only viable option. Dr. Karkare made my decision easy as he walked me through the whole process from surgery to recovery.On 12/13/19 ( Friday the 13th) I enter Lenox Hill Hospital in great hands. From the time I entered Dr. Karkare’s office for the first time until now, his staff has been amazing. Andrea the medical coordinator walked me through all the paper work and necessary preparations for the surgery. Courtesy and kind would be an understatement. Dr. Karkare went over and beyond from the wellness checks and phone calls all to assure me that I was important to him. This was the right decision no pain and no limp. Complete Orthopedics should be your choice!
Kenneth Randolph
22:18 25 Sep 20
Dr. Vadshka has a great bedside manner. He really takes his time and explains treatment options.
T Lee
12:33 09 Sep 20
I suffered with pain in both knees for years. My orthopedic doctor kept recommending knee replacement . I fought it for years, as I was just afraid. When I had no choice and could barely walk , it was recommended I see Dr. Karkare. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. He explained everything to us, and the office staff set everything up for us and made the process easy. So about one month after our initial meeting I had the first knee done. I was up walking mere hours after the surgery, and on the workout machines the next morning. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! Three months later I had the other knee done and went home the very next day. Dr. Karkare put my fears to rest . I would highly recommend him. His expertise gave me my life back. Thank you Dr. Karkare.SincerelyVito Congro
Ethel Congo
23:58 12 Aug 20
Dr Rhodin really cares for his patients. When I see him he makes sure to review my progress in detail.
Micki Cahill
15:03 08 Feb 20
My mom had a total hip replacement by dr karkare. He is the BEST orthopedic doctor.Her incision is almost invisable.She is going back for her other hip next week. The office staff is the best, love Andrea.You wont find a better doctor.
Ryan Brigandi
21:06 13 Jul 18
There is no better Orthopedic doctor you will find. Broke my ankle three places on a Saturday. Called Dr. Karkare. He had is team ready at the hospital and operated on me within 6 hours after my injury. Now After 3 months of great care by him and his staff, I am walking to normalcy.
Spacecom Tel
04:13 23 Mar 18
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I am fellowship trained in joint replacement surgery, metabolic bone disorders, sports medicine and trauma. I specialize in total hip and knee replacements, and I have personally written most of the content on this page.

You can see my full CV at my profile page.