Trauma-informed Approaches to Substance Use Interventions with Indigenous Peoples: A Scoping Review

Indigenous Peoples experience disproportionately higher rates of problematic substance use. These problems are situated in a context of individual and intergenerational trauma from colonization, residential schools, and racist and discriminatory practices, policies, and services. Therefore, substance use interventions need to adopt a trauma-informed approach. We aimed to synthesize and report the current literature exploring the intersection of trauma and substance use interventions for Indigenous Peoples. Fourteen databases were searched using keywords for Indigenous Peoples, trauma, and substance use. Of the 1373 sources identified, 117 met inclusion criteria. Literature on trauma and substance use with Indigenous Peoples has increased in the last 5 years (2012-2016, n = 29; 2017-2021, n = 48), with most literature coming from the United States and Canada and focusing on historical or intergenerational trauma. Few articles focused on intersectional identities such as 2SLGBTQIA+ (n = 4), and none focused on veterans. There were limited sources (n = 25) that reported specific interventions at the intersection of trauma and substance use. These sources advocate for multi-faceted, trauma-informed, and culturally safe interventions for use with Indigenous Peoples. This scoping review illuminates gaps in the literature and highlights a need for research reporting on trauma-informed interventions for substance use with Indigenous Peoples.

Calcaneal osteotomy for the treatment of posterior tibial tendon dysfunction

The surgical treatment of PTTD has been well-discussed in the literature. The calcaneal displacement osteotomy is a powerful, yet relatively easy, procedure that accomplishes a significant amount of frontal plane correction in the surgical treatment of PTTD. It can be performed as a straight medialization osteotomy for moderate hindfoot valgus, and must be performed with a resectional wedge in the treatment of large valgus angles. To achieve optimal correction, it must be coupled with procedures that address the triplanar nature of the deformity. When used in combination with other reconstructive procedures, it provides a valuable alternative to other more joint-destructive procedures.