Foot最新文献

{"title":"Incidence and associated factors of surgical site infection in patients undergoing foot and ankle surgery: a 7-year cohort study","authors":"João Murilo Magalhães ,&nbsp;Roberto Zambelli ,&nbsp;Otaviano Oliveira-Júnior ,&nbsp;Nubia Carelli Pereira Avelar ,&nbsp;Janaine Cunha Polese ,&nbsp;Amanda A.O. Leopoldino","doi":"10.1016/j.foot.2024.102092","DOIUrl":"10.1016/j.foot.2024.102092","url":null,"abstract":"<div><p>Surgical site infections (SSI) constitute 31% of all hospital-acquired conditions, with ankle and foot surgical procedures showing an incidence of SSI ranging from 0.5% to 6.5%. This study aimed to assess the incidence of both superficial and deep surgical site infections in foot and ankle surgery, along with associated factors. Conducted as a retrospective cohort study, it included 2180 patients undergoing foot and ankle surgery in a private hospital between 2014 and 2020, encompassing elective and trauma cases. Outcome variables comprised SSI, while predictor variables encompassed sex, age, diabetes mellitus, systemic arterial hypertension, smoking, American Society of Anesthesiologists (ASA) score, and body mass index. Logistic regression models were employed to identify associations between study variables. The incidence of surgical site infections stood at 4% (83/2180), comprising a rate of 2.8% (57/2180) for superficial infections and 1.2% (26/2180) for deep infections. Smoking (OR 2.9, 95%CI 1.4–5.3) and ASA score &gt;2 (OR 3.4, 95%CI 1.2–8.4) emerged as independent factors associated with surgical site infections. The group with deep infections exhibited higher proportions of smokers (p = 0.002), systemic arterial hypertension (p = 0.018), trauma surgery (p = 0.049), and an ASA score &gt;2 (p = 0.011). Overall infection incidence in this cohort reached 4%, with trauma cases, smoking, hypertension, and an ASA score &gt;2 independently linked to deep infections. Surgeons should be cognizant of these risk factors when managing prophylactic antibiotic regimens for patients.</p></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"59 ","pages":"Article 102092"},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140267963","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":"Flatfoot arch correction with generic 3D-printed orthoses at different body weight percentages","authors":"Tommy Lavoie-Turcotte ,&nbsp;Anne-Laure Ménard ,&nbsp;Mickael Begon ,&nbsp;Marie-Lyne Nault","doi":"10.1016/j.foot.2024.102093","DOIUrl":"https://doi.org/10.1016/j.foot.2024.102093","url":null,"abstract":"<div><h3>Background</h3><p>Flatfoot can be associated with foot pathologies and treated conservatively with foot orthoses to correct arch collapse and alleviate painful symptoms. Recently, 3D printing has become more popular and is widely used for medical device manufacturing, such as orthoses. This study aims at quantifying the effect of generic 3D-printed foot orthoses on flatfoot arch correction under different static loading conditions.</p></div><div><h3>Methods</h3><p>Participants with normal and flatfeet were recruited for this cross-sectional study. Clinical evaluation included arch height, foot posture index, and Beighton flexibility score. Surface imaging was performed in different loading conditions: 1) 0% when sitting, 2) 50% when standing on both feet, and 3) 125% when standing on one foot with a weighted vest. For flatfoot participants, three configurations were tested: without an orthosis, with a soft generic 3D printed orthosis, and with a rigid 3D printed orthosis. Arch heights and medial arch angles were calculated and compared for the different loading conditions and with or without orthoses. The differences between groups, with and without orthoses, were analyzed with Kruskal-Wallis tests, and a p &lt; 0.05 was considered significant.</p></div><div><h3>Results</h3><p>A total of 10 normal feet and 10 flatfeet were analyzed. The 3D printed orthosis significantly increased arch height in all loading conditions, compared to flatfeet without orthosis. Wearing an orthosis reduced the medial arch angle, although not significantly. Our technique was found to have good to excellent intra and interclass correlation coefficients.</p></div><div><h3>Conclusions</h3><p>Generic 3D printed orthoses corrected arch collapse in static loading conditions, including 125% body weight to simulate functional tasks like walking. Our protocol was found to be reliable and easier to implement in a clinical setting compared to previously reported methods.</p></div><div><h3>Level of evidence</h3><p>II</p></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"59 ","pages":"Article 102093"},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140187042","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":"Fatigue of the intrinsic foot core muscles had a greater effect on gait than extrinsic foot core muscles: A time-series based analyze","authors":"Hilal Keklicek ,&nbsp;Halit Selcuk ,&nbsp;Ali Yilmaz","doi":"10.1016/j.foot.2024.102088","DOIUrl":"https://doi.org/10.1016/j.foot.2024.102088","url":null,"abstract":"<div><h3>Background</h3><p>The Heel Rise endurance (HRE) which indicates the extrinsic foot core (ECO) muscle’s performance and the paper grip endurance (PGE) which indicates the intrinsic foot core (ICO) muscle's performance are essential components of a healthy foot function. However, the foot core muscles’ fatigue response on spatial and temporal gait parameters after the HRE and the PGE tests were not adequately investigated. The purpose of this study was to determine whether the fatigue of the ICO and the ECO muscles affect gait parameters.</p></div><div><h3>Material and methods</h3><p>A prospective, cross-sectional study was conducted on 22 sedentary individuals (44 feet). Gait was investigated pre and after the Heel Rise (HR) endurance test and the paper grip (PG) endurance test by inertial sensors. At least 500 consecutive steps were collected for each individual. Spatial-temporal gait parameters were used as outcome measures.</p></div><div><h3>Results</h3><p>ECO fatigue and ICO fatigue led to increases in the step length (p &lt; 0.05) and the stride lengths (p &lt; 0.05), the single support (p &lt; 0.05), and the terminal stance durations (p &lt; 0.05). It was also seen that ICO fatigue had a greater effect on gait than ECO fatigue. The ECO fatigue had a medium to large effect on the gait parameters (d=0.313–0.646). The ICO fatigue affected gait with a large effect (d=0.524–2.048).</p></div><div><h3>Conclusion</h3><p>The ECO fatigue and the ICO fatigue led to clinically important changes in long-range gait parameters and the ICO fatigue had a greater effect on gait than ECO fatigue. It was suggested that clinicians add ICO muscle endurance training to improve the physical performance of individuals.</p></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"59 ","pages":"Article 102088"},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140191741","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":"Medial arch instability/internal foot overload association with non-insertional Achilles tendinopathy and the ‘Zone of Conflict Theory’","authors":"C. Pasapula ,&nbsp;P. Tadikonda ,&nbsp;L. Valentini ,&nbsp;H. Youssef ,&nbsp;S. Chaudhri ,&nbsp;C. Howell ,&nbsp;A. Hardcastle ,&nbsp;S. Shariff","doi":"10.1016/j.foot.2024.102090","DOIUrl":"10.1016/j.foot.2024.102090","url":null,"abstract":"<div><h3>Background</h3><p>Non insertional Achilles tendinopathy [AT] is a degenerative condition that is prevalent in runners. 30% have no preceding history and many runners do not develop AT. Overuse, pronation, and compromised blood supply are hypothesised as causal. The exact precipitant is still unknown. The link between medial arch instability and AT has not been made. The purpose of this study was to investigate the association between spring ligament (SL) laxity and first ray (FRI) instability, and the presence of (AT).</p></div><div><h3>Methods</h3><p>Ethical approval was obtained. Patients were identified from hospital databases for unilateral AT, allowing the opposite unaffected foot to be used as an internal control. SL laxity was measured using the lateral translation score and FRI was measured using a modified digital Klauemeter. Ultrasound was used to assess the tendoachilles [TA] in affected vs unaffected legs.</p></div><div><h3>Results</h3><p>17 patients were recruited with a mean age of 55.6 and mean body mass index (BMI) of 33.3. The average symptom duration was 3.62 years. There were 12 left feet and 5 right feet. There was no statistical difference in dorsiflexion angles for the TA or the gastrocnemius. All Beighton scores &lt; 5. Lateral translation scores, FRI scores and TA thickness was significantly greater in AT feet [p &lt; 0.05]. More affected feet had Tibialis posterior tendon pain (TP) [p &lt; 0.05].</p></div><div><h3>Conclusions</h3><p>Feet with AT exhibit higher lateral translation scores and greater FRI compared to healthy feet, and combined with previous literature evidence, suggests alteration of the subtalar axis alters force moments that may lead to an intrinsic overload of the TA, when the foot enters a \"zone of conflict\". Medial arch instability, in particular SL laxity and FRI, may contribute to the development of non-insertional AT and treatment of this with early arch support may prevent progressive degeneration.</p></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"59 ","pages":"Article 102090"},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140281562","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 cadaveric research model for calcaneus fractures: A scoping review of biomechanical, anatomical, radiographic and fracture fixation studies","authors":"Joe Pang ,&nbsp;Ali Hussain ,&nbsp;Mathhew Yan ,&nbsp;Karan Kapur ,&nbsp;Georgios Solomou ,&nbsp;Cecilia Brassett ,&nbsp;Chandra Pasapula ,&nbsp;Alan R. Norrish","doi":"10.1016/j.foot.2024.102085","DOIUrl":"https://doi.org/10.1016/j.foot.2024.102085","url":null,"abstract":"<div><h3>BACKGROUND</h3><p>Calcaneal fractures remain a big challenge in orthopaedic surgery and lead to long lasting disabilities. Cadaveric research plays an important role in determining optimal fracture treatment. This scoping review aims to provide insight into cadaveric research that has been conducted on calcaneal fractures, including biomechanics, fixation, approaches and radiographic studies.</p></div><div><h3>METHODOLOGY</h3><p>A search strategy was created and implemented as per PRISMA guidance. 3 databases, Medline, Embase and Scopus, were used when conducting this review.</p></div><div><h3>Results</h3><p>484 individual studies were retrieved across the 3 databases, of which 186 duplicates were excluded. Study abstracts were individually reviewed, of which 208 studies were excluded in accordance with study criteria. 90 papers were sought for retrieval, of which 83 full text papers were successfully retrieved. Of the full papers retrieved, 22 did not meet our inclusion criteria, and 19 papers related only to talus fractures. In the end, 43 cadaveric studies pertaining to this scoping review were included and reviewed.</p></div><div><h3>Discussion</h3><p>Studies were grouped into biomechanical, anatomical, fixation and radiographic studies for review.</p></div><div><h3>Conclusion</h3><p>Evaluation of current cadaveric studies pertaining to calcaneal fractures has allowed greater insight into the myriad challenges in the management of these injuries. Effects of intra-articular fractures on calcaneal biomechanics assist in establishing surgical goals. Whilst fixation studies showing good stability of nail fixations could encourage further development in minimally invasive techniques. Avoiding pitfalls seen in the extensile lateral approach. Recommendations of areas for further research include use of external fixators, fixation in non-Sanders Type 2 fractures, and comparison of intraoperative CT/3D fluoroscopy with o conventional fluoroscopy.</p></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"59 ","pages":"Article 102085"},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S095825922400018X/pdfft?md5=94613d4d8c318bcf66523d9fc6274547&pid=1-s2.0-S095825922400018X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140139109","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":"Locking vs. non-locking plate fixation in comminuted talar neck fractures: a biomechanical study using cadaveric specimens","authors":"Luke Maxwell ,&nbsp;Tobia Nava ,&nbsp;Alan Norrish ,&nbsp;Tamas Kobezda ,&nbsp;Marc Pizzimenti ,&nbsp;Cecilia Brassett ,&nbsp;Chandra Pasapula","doi":"10.1016/j.foot.2024.102084","DOIUrl":"https://doi.org/10.1016/j.foot.2024.102084","url":null,"abstract":"<div><h3>Background</h3><p>Talar neck fractures are rare but potentially devastating injuries, with early reduction and rigid fixation essential to facilitate union and prevent avascular necrosis. Even small degrees of malunion will alter load transmission and subtalar joint kinematics. Changes in fixation techniques have led to dual plating strategies. While locked plating has perceived advantages in porotic bone and comminution, its biomechanical benefits in talar neck fractures have not been shown.</p></div><div><h3>Aim</h3><p>To compare the strength of locking <em>vs.</em> non-locking plate fixation in comminuted talar neck fractures.</p></div><div><h3>Method</h3><p>Seven pairs of cadaveric tali were randomised to locking or non-locking plate fixation. A standardised model of talar neck fracture with medial comminution was created, and fixation performed. The fixed specimens were mounted onto a motorised testing device, and an axial load applied.</p></div><div><h3>Results</h3><p>Peak load to failure, deformation at failure, work done to achieve failure, and stiffness of the constructs were measured. No statistically significant difference was found between locking and non-locking constructs for all parameters.</p></div><div><h3>Conclusions</h3><p>Both constructs provide similar strength to failure in talar neck fracture fixations. Mean peak load to failure did not exceed the theoretical maximum forces generated of 1.1 kN when weight-bearing. We would advocate caution with early mobilisation in both fixations.</p></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"59 ","pages":"Article 102084"},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0958259224000178/pdfft?md5=fadd706f1b3bed60104c31046be203c1&pid=1-s2.0-S0958259224000178-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140163858","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":"Ten year outcomes after non-fixation of the smaller posterior malleolar fragment: A retrospective cohort study","authors":"Leo Swee Liang Chong,&nbsp;MohammadAli Khademi,&nbsp;Kundam Murali Reddy,&nbsp;Geoffrey Hunter Anderson","doi":"10.1016/j.foot.2024.102091","DOIUrl":"https://doi.org/10.1016/j.foot.2024.102091","url":null,"abstract":"<div><h3>Introduction</h3><p>Treatment of posterior malleolar (PM) ankle fractures remains controversial. Despite increasing recommendation for small PM fragment fixation, high quality evidence demonstrating improved clinical outcomes over the unfixated PM is limited. We describe the long term clinical and radiographical outcomes in younger adult patients with PM ankle fractures managed without PM fragment fixation.</p></div><div><h3>Material and methods</h3><p>A retrospective cohort study was performed on PM ankle fracture patients aged 18–55 years old admitted under our orthopaedic unit between 1st of April 2009 and 31st of October 2013. Inclusion criteria were ASA 1 and 2, independent mobility pre-trauma, no pre-existing ankle pathologies, with satisfactory bimalleolar and syndesmotic stabilisation. Open fractures, talar fractures, calcaneal fractures, pilon fractures, subsequent re-injury and major complications were excluded. All PM fragments were unfixated. Clinical outcomes were evaluated using visual analogue scale (VAS) for pain, Foot and Ankle Ability Measure (FAAM) with activities of daily living (ADL) and sports subscale for function, and patient satisfaction ratings. Osteoarthritis was assessed using modified Kellgren-Lawrence scale on follow-up weightbearing ankle radiographs.</p></div><div><h3>Results</h3><p>Sixty-one participants were included. Mean follow-up was 10.26 years. Average PM size was 16.2 ± 7.39%. All participants were evaluated for clinical outcomes. Mean score of FAAM-ADL was 95.5 ± 7.13, FAAM-Sports 86.4 ± 15.5, patient satisfaction 86.2 ± 14.4% and pain score 1.13 ± 1.65. Radiographical outcomes were evaluated in 52 participants, showing no-to-minimal osteoarthritis in 36/52 (69%), mild osteoarthritis in 14/52 (27%) and moderate osteoarthritis in 2/52 (4%). Pain and functional scores were independent of PM fragment size, post-reduction step-off, dislocation, malleoli fractured or syndesmotic injury. PM step-off more than 1 mm and traumatic dislocation/subluxation were associated with worse radiographical osteoarthritis.</p></div><div><h3>Conclusion</h3><p>After controlling for confounders, the unfixated smaller posterior malleolus fragment at 10-year follow-up demonstrated largely satisfactory clinical outcomes with some radiographical progression of osteoarthritis.</p></div><div><h3>Level of evidence</h3><p>Level III – Retrospective cohort study</p></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"59 ","pages":"Article 102091"},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179638","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":"Whipping or tearing? The biomechanics of Achilles tendinopathy in rearfoot strike runners","authors":"Kevin G. Aubol,&nbsp;Clare E. Milner","doi":"10.1016/j.foot.2024.102082","DOIUrl":"10.1016/j.foot.2024.102082","url":null,"abstract":"<div><h3>Background</h3><p>Two biomechanical mechanisms for the development of Achilles tendinopathy in runners have been proposed: A whipping mechanism characterized by prolonged and excessive rearfoot eversion, and a tearing mechanism characterized by high eccentric plantar flexor forces. The purpose of this pilot study was to determine if runners with and without a history of Achilles tendinopathy exhibited gait biomechanics consistent with either of these mechanisms.</p></div><div><h3>Methods</h3><p>Seven male runners with previous or current Achilles tendinopathy and seven healthy male control runners were evaluated by three-dimensional gait analysis. Peak rearfoot eversion angle, rearfoot eversion excursion, duration of rearfoot eversion, and peak rearfoot inversion angle were compared between groups to evaluate the whipping mechanism of injury. Peak dorsiflexion angle, peak dorsiflexion velocity, and peak ankle power absorption were compared between groups to evaluate the tearing mechanism. Additionally, rearfoot eversion angle and sagittal plane ankle power waveforms were compared between groups using statistical parametric mapping.</p></div><div><h3>Findings</h3><p>There were no differences in any rearfoot eversion, inversion, or dorsiflexion variables or waveforms during running in the Achilles tendinopathy group compared to controls.</p></div><div><h3>Interpretation</h3><p>Rearfoot strike runners with Achilles tendinopathy do not exhibit running biomechanics consistent with either the whipping or tearing mechanisms of injury.</p></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"59 ","pages":"Article 102082"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0958259224000154/pdfft?md5=cd9a9d8248e2306add89d8cb0069f551&pid=1-s2.0-S0958259224000154-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279295","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":"A critical literature review highlighting the methodological differences within epidemiological studies: Pedal Amputations in England","authors":"","doi":"10.1016/j.foot.2024.102081","DOIUrl":"10.1016/j.foot.2024.102081","url":null,"abstract":"<div><h3>Introduction</h3><p>There is an absence in the application of standardised epidemiological principles when calculating and reporting on lower extremity amputation (LEA) rates [1]. The rates of minor LEAs in the diabetic population range from 1.2–362.9 per 100,000 and in the population without diabetes 0.9–109.4 per 100,000. The reported rates of major lower limb amputations vary from 5.6–600 per 100,000 in the diabetic population and 3.6–58.7 per 100,000 in the total population [1]. The variation in methodology does not facilitate comparison across populations and time. All studies published using the population from England, UK, describing minor amputations were systematically reviewed and rates and methodologies compared.</p></div><div><h3>Method</h3><p>A systematic search was carried out using (PRISMA) guidelines [2] to reveal primary data of minor lower extremity amputation rates in England between 1988–2018. This was carried out using electronic databases, grey literature and reference list searching. The search yielded eleven studies that were eligible for review.</p></div><div><h3>Results</h3><p>Significant variation in the reporting of minor lower extremity amputation rates across regional and gender groups in England was found. Rates in the diabetic and non-diabetic population varied from 1.2 to 362.9 per 100,000 and 0.9 to 109.4 per 100,000 respectively. This was predominately a result of poorly describing numerator and denominator populations and defining minor amputations differently. As a result, there was an inability to confidently establish regional, gender and time trends.</p></div><div><h3>Conclusion</h3><p>The inconsistent nature of reporting minor amputations makes drawing conclusions on temporal and population change difficult. Future studies should describe and present basic numerator and denominator population characteristics e.g. number, age and sex and use the standard definition of minor amputation as one that is at or below the ankle.</p></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"60 ","pages":"Article 102081"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140277938","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":"Diagnostic accuracy of clinical, radiological and device-driven tests for the detection of First Ray Instability: A systematic review","authors":"Georgios Solomou ,&nbsp;Andrey Bilyy ,&nbsp;Pranav Tadikonda ,&nbsp;Brian Gurdas ,&nbsp;Chandra Pasapula","doi":"10.1016/j.foot.2024.102080","DOIUrl":"10.1016/j.foot.2024.102080","url":null,"abstract":"<div><h3>Introduction</h3><p>First Ray Instability (FRI) and especially hypermobility leads to the collapse of the medial longitudinal arch's structural framework, which reduces the foot's ability to become a rigid lever for propulsion, resulting in progressive foot deformities. Early detection of FRI with prompt intervention helps prevent degenerative foot deformities. Various manual, device-based and radiographic diagnostic tests for FRI quantification have been described in the literature. We aim to conduct an up-to-date, comprehensive, systematic review of the literature reporting on diagnostic tests to evaluate FRI.</p></div><div><h3>Methodology</h3><p>Electronic databases (Medline, Embase and PubMed) and bibliography lists were searched until May 2021 for studies evaluating diagnostic tests for FRI. MeSH terms were used to conduct the literature search. The authors screened all produced abstracts. Selected articles were further assessed in full based on inclusion and exclusion criteria. The relevant studies were qualitatively assessed and grouped into tables based on tests.</p></div><div><h3>Results</h3><p>18,176 studies were identified. Thirty-two full-text articles were included for assessment. Ten articles were excluded based on evaluation criteria. 18 studies were included for qualitative assessment: two studies describing manual diagnostic tests, three evaluating device-driven tests, six image-guided studies and seven comparison studies assessing a new test versus an established one.</p></div><div><h3>Conclusion</h3><p>Gold standard tests in defining FRI need to be improved. Manual tests exhibit significant subjective variability. Radiographic tests, while accurate, are complex and cumbersome to perform and, therefore, are not widely applied. Dorsal rulers have demonstrated mixed results and shown variability when compared to instruments. The focus has been on assessing FRI in hallux valgus (HV). More studies are needed to investigate FRI in the absence of HV.</p></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"59 ","pages":"Article 102080"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0958259224000130/pdfft?md5=a7e756e63d025545bbb665c70a32656b&pid=1-s2.0-S0958259224000130-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133440","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}