Foot最新文献

{"title":"Effect of plantar sensory exercises on balance and fall risk in nursing home elderly","authors":"Müyesser Cavlak ,&nbsp;Emre Ata ,&nbsp;Z. Candan Algun","doi":"10.1016/j.foot.2025.102156","DOIUrl":"10.1016/j.foot.2025.102156","url":null,"abstract":"<div><h3>Background</h3><div>Loss of balance and consequent falls are leading causes of mortality and morbidity in the geriatric population. In terms of ease of application, plantar sensory-based exercises seem to be superior to other balance development exercises. Our study's objective is to examine the effects of plantar sensation education-based exercises on balance and falls.</div></div><div><h3>Materials and methods</h3><div>16 healthy, voluntary nursing home residents with the average age 77.50 ± 5.5. Individuals had plantar sensory exercises 40 min sessions for 3 days/week during eight weeks. The study was planned as a self-controlled prospective study. Functional balance was evaluated using Berg Balance Scale, dynamic balance was evaluated using 30 Second Chair Stand Test, static balance and fall risk were assessed using Biodex Balnce System.</div></div><div><h3>Results</h3><div>The measurements of static balance and fall tests with the Biodex balance device after 8 weeks of plantar sensation exercises program showed significant improvement compared to the results before the treatment (p &lt; 0.05). The measurements of the Biodex balance device before the treatment were 3.45 ± 2.41, whereas the ones after the treatment showed 2.61 ± 2.18. The result of the fall <strong>risk</strong> measured by the Biodex balance device was 3.43 ± 3.11 before the treatment, whereas it came out as 2.46 ± 2.02 after the treatment. (p &lt; 0.05)</div></div><div><h3>Conclusion</h3><div>Static balance and fall risc play a significant role in the well-being of nursing home residents through exercise programs designed for plantar sensation. According to these outcomes, we believe that exercises intended for plantar sensation will be an effective treatment approach in terms of increasing the static balance and decreasing the fall risk with nursing home residents<strong>.</strong></div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"62 ","pages":"Article 102156"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Displaced, intra-articular fractures of the calcaneus: Review of non-operative management, open reduction internal fixation and novel minimally invasive techniques","authors":"Adrian J. Talia ,&nbsp;David W. Shepherd ,&nbsp;Sasha Roshan-Zamir","doi":"10.1016/j.foot.2025.102160","DOIUrl":"10.1016/j.foot.2025.102160","url":null,"abstract":"<div><div>Calcaneal fractures comprise 1–2 % of all fractures and typically occur in younger, working age male patients. These injuries result in a significant burden to the patient in terms of residual pain, inability to work or participate in sports, difficulty with shoe wear and secondary reconstructive surgery such as subtalar arthrodesis. They also result in a significant burden to the healthcare system. Calcaneal fractures can be sub-classified into extra-articular and intra-articular, two-thirds of calcaneal fractures involve the articular facets of the subtalar joint. The treatment of displaced intra-articular calcaneal fractures is controversial, with many authors recommending non-operative treatment. The concerns with this approach include painful malunion, articular surface disruption, heel varus and increased calcaneal width, with a significant rate of secondary reconstructive surgery. Traditional operative approaches for calcaneal fractures allowed the surgeon to restore anatomic parameters, but have been associated with high rates of soft tissue complications, up to 40 % in some series. Newer, less invasive techniques for fixation allow the surgeon to obtain a similar anatomic reduction with reduced tissue compromise. We performed a systematic literature search which identifed forty articles on which this review is based. In this review article we discuss the background of displaced, intra-articular calcaneal fractures and compare the current knowledge base of operative vs. non-operative management. We then compare and contrast the three common surgical approaches used for treatment of these injuries: the extensile lateral approach, the sinus tarsi approach and newer percutaneous/minimally invasive techniques. At the current time, the sinus tarsi approach is the mainstay for treating these fractures, with most authors favouring this over the extensile lateral approach. There is momentum for adoption of newer minimally invasive techniques which show promising results, with reduced soft tissue complications and satisfactory functional outcomes.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"62 ","pages":"Article 102160"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implants for proximal interphalangeal joint arthrodesis of the lesser toes: Where are we? A systematic review","authors":"Vinodh Arumugam ,&nbsp;Shreyas Sanjeev Chitnis ,&nbsp;Esha Singh ,&nbsp;Alba Morillo Paterson ,&nbsp;Matthew Welck","doi":"10.1016/j.foot.2025.102157","DOIUrl":"10.1016/j.foot.2025.102157","url":null,"abstract":"<div><h3>Introduction</h3><div>Proximal interphalangeal joint (PIPJ) arthrodesis is indicated for the treatment of lesser toe deformities. K-wires have traditionally been the standard of care for PIPJ arthrodesis, however intramedullary implants may be superior. This systematic review evaluates the union rate and outcomes of implants for PIPJ arthrodesis.</div></div><div><h3>Methods</h3><div>MEDLINE, CENTRAL, EMBASE and Google Scholar databases were reviewed for studies reporting on outcomes of intramedullary implants for PIPJ arthrodesis in hammer or claw toe. The primary outcome measure was union rate. Secondary outcome measures included pain scores, functional improvement, patient satisfaction, quality of life and complications.</div></div><div><h3>Results</h3><div>12 studies comparing 12 different implants in 797 patients with 1118 treated toes were reviewed. Fusion rates ranged from 22.2 % to 96 % with the highest fusion rates demonstrated with Ossiofiber (96 %, n = 24), Smart toe (43.6–93.8 %, n = 217) and Nextra (84.44 %, n = 47) respectively. 4 studies compared 3 implants to K-wire (Smart toe, Tenfuse and Nextra) with improved union rates demonstrated compared to K-wire (p &lt; 0.05). Function, pain relief, patient satisfaction and quality of life all improved following PIPJ arthrodesis with implants, however these outcomes were equivocal to K-wire. All studies were rated as high or critical risk of bias.</div></div><div><h3>Conclusion</h3><div>A definitive judgement on the best implant for PIPJ arthrodesis is currently unobtainable due to the high risk of bias in the reviewed studies. Given the high cost of intramedullary implants and equivocal functional outcomes to K-wire, further comparative study with randomised control trials is advised to establish the standard of care for PIPJ arthrodesis.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"62 ","pages":"Article 102157"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The position, orientation and morphology of the peroneus longus tubercle in hallux valgus – A weight-bearing CT assessment","authors":"Christopher J. Marusza ,&nbsp;Howard Stringer ,&nbsp;James Redfern ,&nbsp;Dhrumin Sangoi ,&nbsp;Matthew Welck ,&nbsp;Lyndon W. Mason ,&nbsp;Karan Malhotra","doi":"10.1016/j.foot.2025.102161","DOIUrl":"10.1016/j.foot.2025.102161","url":null,"abstract":"<div><h3>Background</h3><div>Hallux valgus (HV) may be associated with a dysfunctional peroneus longus, however there is very little research into the link between these pathologies. The peroneus longus tubercle (PLT) may serve as a surrogate marker for peroneus longus function. Our objective was to compare the position, orientation and morphology of the PLT in feet with and without HV.</div></div><div><h3>Methods</h3><div>In this single center series, we analyzed weight-bearing CT scans of 20 feet (12 patients) with HV and 20 feet (12 patients) without HV. Groups were age matched. We compared differences between groups for recently reported measurements assessing the PLT: tubercle-to-floor distance (T-F distance), bisecting angle of the PLT, tubercle-to-metatarsals angle (T-MT angle), and cross-sectional areas and roundness of the PLT.</div></div><div><h3>Results</h3><div>The T-F distance was significantly lower in the HV group (p = 0.001). The bisecting angle was lower (less vertical) in the HV group (p = 0.017). T-MT angle was lower in the HV group (p = 0.041). There was no difference in the cross-sectional area or roundness of the PLT between groups.</div></div><div><h3>Conclusion</h3><div>We found patients with HV had differences in orientation of the PLT (with a less vertical tubercle). This could indicate a relationship between direction of pull of the peroneus longus and HV. There were no differences in size of the PLT suggesting strength of the peroneus longus may not play a role in developing HV. Further research is needed to build upon this preliminary work and determine the link between the observed differences and the pathogenesis of HV.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"62 ","pages":"Article 102161"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do operative or weight-bearing delays lead to worse outcomes in ankle surgery?","authors":"Alexander Carver ,&nbsp;Marc Choong ,&nbsp;Robert Fawdry ,&nbsp;Conor T. Boylan ,&nbsp;Nikhil Nanavati","doi":"10.1016/j.foot.2025.102159","DOIUrl":"10.1016/j.foot.2025.102159","url":null,"abstract":"<div><h3>Background</h3><div>Ankle fractures comprise 10 % of fractures seen in ED. Despite this, debate remains regarding the optimal timing of surgery and weight bearing post-operatively. There is no clear consensus whether delaying ankle ORIF leads to better outcomes. There is also debate whether early post-operative weight bearing (WB) impacts post-operative outcomes.</div><div>The aim of this study was to investigate whether a delay in operation or a prolonged post-operative weight-bearing plan led to (1) increased complications and (2) poorer outcomes in patient-recorded outcome measures (PROMs).</div></div><div><h3>Methods</h3><div>In this retrospective study, 160 patients were analysed. Primary outcomes were post-operative complications. Secondary outcomes were PROMs, using EQ-5D and MOxFQ questionnaires.</div><div>Data was analysed using <em>SPSS26</em>. Analysis used independent two-tailed Mann-Whitney U tests for continuous data with nominal independent variables, and Kruskal-Wallace tests for ordinal independent variables. Fisher-exact tests were used for categorical variables.</div></div><div><h3>Results</h3><div>Delay in operation had no statistically significant impact on overall complication rate (<em>p</em> = 0.482). There was no statistically significant difference in EQ-5D (<em>p</em> = 0.433) and MOxFQ (<em>p</em> = 0.325) scores regardless of delay in operation.</div><div>Additionally, time spent until WB post-operatively had no statistically significant impact on overall complication rate (<em>p</em> = 0.634). There was no statistically significant difference in EQ-5D (<em>p</em> = 0.358) and MOxFQ (<em>p</em> = 0.089) scores regardless of post-operative WB plan.</div></div><div><h3>Conclusions/Findings</h3><div>Our results suggest that a delay in ankle ORIF operation does not lead to an increase in complications or poorer PROMs post-operatively, endorsing GIRFT principles. Early post-operative WB also had no impact on complication rate or PROMs, meaning early mobilisation may accelerate patient rehabilitation, facilitate independence, and reduce prolonged inpatient hospital stay.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"62 ","pages":"Article 102159"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors associated with subtalar fusion within 5 years following calcaneal ORIF","authors":"Elisabeth White ,&nbsp;Sylvester Okoro ,&nbsp;Ameer Tabbaa ,&nbsp;Ariel N. Rodriguez ,&nbsp;Bhavya Sheth ,&nbsp;Andrew Horn ,&nbsp;Afshin E. Razi ,&nbsp;Amr A. Abdelgawad","doi":"10.1016/j.foot.2024.102154","DOIUrl":"10.1016/j.foot.2024.102154","url":null,"abstract":"<div><h3>Background</h3><div>Although most calcaneal fractures are managed with open reduction internal fixation (ORIF), they can ultimately lead to subtalar arthritis and pain requiring subtalar fusion when conservative treatments prove ineffective. Understanding the risk factors associated with subtalar fusion (STF) after calcaneal ORIF is crucial for optimizing patient outcomes and treatment strategies. This study aimed to comprehensively evaluate these risk factors and their association with the incidence of STF, including patient demographics, medical comorbidities, same day and 90-day reimbursement data.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed using the PearlDiver Mariner 157 national claims database from January 1st, 2010 to October 31st, 2021. Patients who underwent calcaneal ORIF, identified using Current Procedural Terminology (CPT) and ICD Procedure Codes were queried for 5-year rates of STF and reimbursement data. Patient demographics and comorbidities were recorded, and multivariate logistic regression was employed to determine the association of risk factors with STF.</div></div><div><h3>Results</h3><div>Patients with STF had a higher proportion of alcohol abuse (21.3 % vs. 16.2 %), depression (58.1 % vs. 43.1 %), drug abuse (29.1 % vs. 19.7 %), obesity (40.3 % vs. 28 %) and tobacco use (62.2 % vs. 50.3 %), all exhibiting a p-value of less than 0.001. Those with depression (OR: 1.54; 99 % CI:1.29–1.84; P &lt; 0.001) and obesity (OR:1.58; 99 % CI: 1.32–1.88; P &lt; 0.001) as comorbidities had a higher odds ratio of association with STF following calcaneal ORIF.</div></div><div><h3>Conclusion</h3><div>Patients who ultimately require STF within 5 years of calcaneal ORIF had higher rates of alcohol abuse, tobacco use, drug use, obesity, and depression. There was no significant difference observed between those with and without STF in average same-day and 90-day reimbursements and demographics.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"62 ","pages":"Article 102154"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of calcaneal pitch angle with recurrence of postoperative hallux valgus in patients with rheumatoid arthritis","authors":"Wataru Uehara,&nbsp;Toshifumi Fujiwara,&nbsp;Ryosuke Yamaguchi,&nbsp;Hidetoshi Tsushima,&nbsp;Daisuke Hara,&nbsp;Yukio Akasaki,&nbsp;Yasuharu Nakashima","doi":"10.1016/j.foot.2024.102155","DOIUrl":"10.1016/j.foot.2024.102155","url":null,"abstract":"<div><div>Hallux valgus (HV) and flatfoot deformities are frequently seen in patients with rheumatoid arthritis (RA). This study aimed to determine whether flatfoot deformity contributes to the recurrence of HV in RA patients. This study examined 62 feet from 45 RA patients who were diagnosed with HV and underwent the first metatarsal joint-preserving surgery between November 2010 and October 2021. Recorded data included age at surgery, sex, disease duration, body mass index [BMI], RA disease duration, medical treatment of RA, Larsen grade, blood test, pre/postoperative Japanese Society for Surgery of the Foot, HV angle, M1M2 angle, M1M5 angle, calcal pitch angle, and Meary’s angle. HV recurrence on radiography was defined as an HV angle exceeding 20°. HV recurrence was observed in 17 feet. Significant differences were observed due to risk factors such as BMI, disease duration, Larsen grade 4–5, and preoperative calcaneal pitch angle. Multivariate logistic regression analysis identified that lower BMI, a higher M1M2 angle, and a lower calcaneal pitch angle are preoperative risk factors for the recurrence of postoperative HV in RA patients.</div></div><div><h3>Level of evidence</h3><div>3</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"62 ","pages":"Article 102155"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracture dislocation of the ankle joint in low energy trauma: Choosing between invasive damage control procedures and closed reduction in plaster","authors":"Emmanouil Theodorakis ,&nbsp;Georgios Touloupakis ,&nbsp;Fabrizio Ferrara ,&nbsp;Stefano Ghirardelli ,&nbsp;Venuti Angelo ,&nbsp;Guido Antonini","doi":"10.1016/j.foot.2024.102146","DOIUrl":"10.1016/j.foot.2024.102146","url":null,"abstract":"<div><h3>Introduction</h3><div>The purpose of this study is to identify significant differences in the clinical outcomes of patients who sustained a low energy trauma resulting into an ankle fracture-dislocation, treated with invasive (external fixation or skeletal traction) and conservative damage control procedures (closed reduction in plaster).</div></div><div><h3>Materials and methods</h3><div>This is a retrospective comparative study including 52 patients with low energy ankle fracture-dislocation, surgically treated between January 2015 and January 2017. Patients included in this study had a minimum 24 months follow-up (range 24–36 months). Patients were divided in 2 groups, group A (n = 21) initially treated with invasive damage control procedures to maintain reduction and group B (n = 31) treated with non-invasive damage control procedures. Patients were evaluated clinically and radiographically. Clinical assessment was performed by evaluating ankle range-of-motion and the Olerud - Molander ankle score at 6, 12 and 24 months as endpoints for both groups.</div></div><div><h3>Results</h3><div>Groups were assessed for homogeneity with a chi-squared test, and no statistical differences were found regarding Weber classification, type of dislocation, and Tscherne classification. A significant improvement in the Olerud-Molander score was noted between the 6- and 12-month follow-ups (p 0.01), but not between the 12- and 24-month follow-ups. This improvement was not observed between the 12 and 24 months follow-up. No statistically significant differences in the Olerud-Molander score were found between the two groups at both the 6- and 24-month follow-ups.</div></div><div><h3>Conclusions</h3><div>Closed reduction in plaster for fracture-dislocations of the ankle joint following low-energy trauma appears capable of maintaining reduction with outcomes comparable to more invasive damage control procedures.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"61 ","pages":"Article 102146"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinematic coordination in the rearfoot, midfoot, and forefoot differs depending on subgroups based on foot stiffness and kinetic parameters during walking","authors":"Daiki Yamagiwa ,&nbsp;Yoshitaka Iwamoto ,&nbsp;Rei Konishi ,&nbsp;Masahiro Kuniki ,&nbsp;Nobuhiro Kito","doi":"10.1016/j.foot.2024.102144","DOIUrl":"10.1016/j.foot.2024.102144","url":null,"abstract":"<div><div>This study aimed to classify subgroups of healthy young adults based on foot stiffness and related kinetic parameters during gait, as well as to analyze intra-foot sagittal kinematics within each subgroup. Data were collected from 25 males and 24 females using a 3D motion capture system, which measured the rearfoot, midfoot, and forefoot segments. Cluster analysis identified three subgroups based on the following variables: the truss coefficient, windlass coefficient, forward component of ground reaction force (F-GRF), and ankle plantar flexion power. Group 1 demonstrated the highest foot stiffness, as indicated by the largest truss coefficient, while Groups 2 and 3 exhibited lower stiffness, characterized by greater dorsiflexion of the midfoot and forefoot relative to the rearfoot during the stance phase. Additionally, the kinematic coordination patterns between the rearfoot-midfoot and midfoot-forefoot of Groups 2 and 3 during the early and late stance phases showed significant variation. Group 3, in particular, exhibited lower F-GRF and ankle plantar flexion power than Groups 1 and 2. These results suggest that midfoot movement during the late stance phase is critical in generating foot stiffness, with a midfoot-dominant kinematic pattern potentially serving as a key contributor. The study underscores the importance of understanding intersegmental coordination for managing foot stiffness, which could have implications for improving gait mechanics and preventing injuries. Further research is needed to explore how these findings can be applied to individuals with various foot conditions or pathologies.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"61 ","pages":"Article 102144"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flexible fixation versus open reduction internal fixation and primary arthrodesis for ligamentous Lisfranc injuries: A systematic review and meta-analysis","authors":"Kyle P. O’Connor ,&nbsp;Erica R. Olfson ,&nbsp;John T. Riehl","doi":"10.1016/j.foot.2024.102145","DOIUrl":"10.1016/j.foot.2024.102145","url":null,"abstract":"<div><h3>Introduction</h3><div>Flexible fixation (FF) has allowed treatment of isolated ligamentous Lisfranc injuries while preserving joint motion. We hypothesize that patient-reported outcome measures (PROMs), complications, and return-to-activity rates will be similar between patients undergoing FF versus those undergoing open reduction internal fixation (ORIF) or primary arthrodesis (PA).</div></div><div><h3>Methods</h3><div>Databases included PubMed, OVID Medline, Embase, SCOPUS, Cochrane Central Register of Clinical Trials, and clinicaltrials.gov from their inception to 5/13/2024. Search terms focused on treatment of Lisfranc injuries with FF, ORIF, or PA. Only English studies were included. Studies were included if the Lisfranc injury was purely ligamentous and had PROM scores. Quality, validity, and comparability were assessed using MINORS and GRADE criteria. Meta-analysis was conducted using pooled statistics. Cohen’s d and odds ratios (OR) determined effect sizes.</div></div><div><h3>Results</h3><div>Twenty-five studies were included. There were 184 patients undergoing FF, 236 patients undergoing ORIF, and 80 patients undergoing PA. Postoperatively, American Orthopaedic Foot and Ankle Society (AOFAS) scores were 89.7 ± 10.0, 78.7 ± 44.2, and 87.4 ± 31.8, VAS-pain scores were 1.5 ± 1.5, 1.6 ± 3.8, and 0.3 ± 2.6, and return to activity rates (RTA) were 100 %, 63.3 %, and 78.4 %, respectively. Rates of post-traumatic arthritis were 0 %, 13.0 %, and 0 %, hardware removal were 0 %, 86.0 %, and 22.5 %, and complications were 3.8 %, 17.7 %, and 23.5 %. Meta-analysis demonstrated that FF had superiority over ORIF regarding better AOFAS scores and RTA with lower rates of post-traumatic arthritis, hardware removal, and complications (p &lt; 0.05). Also, FF had superiority over PA with higher RTA and lower rates of hardware removal and complications. PA demonstrated better VAS-pain scores (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>FF had satisfactory outcomes after Lisfranc injury treatment. Low-quality evidence suggested that FF had better outcomes, however, this conclusion was drawn from single-arm studies which have significant limitations. Further prospective, comparative studies should investigate this relationship.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"61 ","pages":"Article 102145"},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}