Foot & Ankle Orthopaedics最新文献

{"title":"Weightbearing Computed Tomography Measurements in Progressive Collapsing Foot Deformity: A Contemporary Review.","authors":"Aly Maher Fayed, Matthew Jones, Kepler Alencar Mendes de Carvalho, Nacime Salomão Barbachan Mansur, Cesar de Cesar Netto","doi":"10.1177/24730114251316547","DOIUrl":"10.1177/24730114251316547","url":null,"abstract":"","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 1","pages":"24730114251316547"},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515161","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":"First Metatarsophalangeal Joint-Preserving Surgery Is Effective for Forefoot Deformity With Moderate to Severe Joint Destruction in Rheumatoid Arthritis.","authors":"Soichiro Sakai, Toshifumi Fujiwara, Ryosuke Yamaguchi, Nobuhiko Yokoyama, Daisuke Hara, Yukio Akasaki, Yasuharu Nakashima","doi":"10.1177/24730114251322790","DOIUrl":"10.1177/24730114251322790","url":null,"abstract":"<p><strong>Background: </strong>The study compares the clinical outcomes of first metatarsophalangeal (MTP) joint fusion vs joint-preserving surgery in rheumatoid arthritis (RA) patients with severe forefoot deformities.</p><p><strong>Methods: </strong>This single-center retrospective study at Kyushu University Hospital reviewed RA patients who underwent either first MTP joint arthrodesis or joint-preserving surgery for hallux valgus (HV) deformity between January 2008 and December 2022. A total of 103 feet (73 cases) were analyzed, with 75 feet (58 cases) showing radiographic bone destruction of Larsen grade 3 or higher. One foot underwent resection arthroplasty, so ultimately 74 feet in 57 cases were evaluated. Surgical procedures included joint-preserving biplane osteotomy or arthrodesis with crossed screws. Clinical outcomes were measured using the Japanese Society for Surgery of the Foot (JSSF) Hallux scale, whereas radiographic assessments included HV angle (HVA). Propensity score matching was used to minimize bias when comparing postoperative outcomes between the arthrodesis and joint-preserving surgery groups.</p><p><strong>Results: </strong>This study analyzed 74 feet undergoing either arthrodesis (27 feet) or joint-preserving surgery (47 feet) for HV. Patients in the 2 groups showed similar demographic and clinical characteristics except with respect to length of follow-up, which was greater in the arthrodesis group (5.1 ± 2.6 years vs 2.4 ± 2.0 years, <i>P</i> < .01) than the joint-preserving group. In the arthrodesis group, all patients underwent resection arthroplasty on the second to fifth toes. The joint-preserving group included first MTP joint surgery alone (n = 5) and first MTP joint and lesser MTP joint surgeries (resection arthroplasty, n = 29; joint-preserving surgery, n = 13). Functional scores significantly improved in both groups, with first metatarsophalangeal joint-preserving surgery yielding better postoperative outcomes. In cases of deformity recurrence, the recurrent cases exhibited greater immediate postsurgical HVA, but other foot function outcomes remained similar at the end of follow-up.</p><p><strong>Conclusion: </strong>Joint-preserving surgery for advanced rheumatoid forefoot deformity showed better functional improvement than arthrodesis using the propensity score matching and comparable clinical outcomes, highlighting it as a potential treatment option for severe joint destruction.</p><p><strong>Level of evidence: </strong>Level Ⅳ, retrospective study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 1","pages":"24730114251322790"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515158","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":"Weightbearing Protocols and Outcomes in Open Surgical Management of Haglund Syndrome: A Large Retrospective Analysis.","authors":"Zoe W Hinton, Katherine M Kutzer, Kali J Morrissette, Kevin A Wu, Alexandra N Krez, Albert T Anastasio, Andrew E Hanselman, Karl M Schweitzer, Samuel B Adams, Mark E Easley, James A Nunley, Annunziato Amendola","doi":"10.1177/24730114251316554","DOIUrl":"10.1177/24730114251316554","url":null,"abstract":"<p><strong>Background: </strong>Following insertional Achilles tendinopathy debridement and Haglund prominence resection for Haglund syndrome, patients undergo varying degrees of weightbearing limitation (weightbearing as tolerated [WBAT], partial weightbearing [PWB], touchdown weightbearing [TDWB], and nonweightbearing [NWB]). Given the scarcity of large-scale literature on the topic, the purpose of this study is to evaluate the impact of postoperative weightbearing protocols on outcomes after open surgical management of Haglund syndrome.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients who underwent open surgical management for Haglund syndrome between January 2015 and December 2023 at a single academic institution by fellowship-trained foot and ankle surgeons. Patients were excluded if they underwent concurrent operative management of additional foot pathologies. Patient demographics, comorbidities, surgical techniques, and postoperative weightbearing protocols were recorded. Complications (Achilles tendon rupture, wound breakdown/infection, persistent pain, plantarflexion weakness) and revision rates were compared across weightbearing protocols. Statistical analysis was conducted using R with significance set at <i>P</i> <.05.</p><p><strong>Results: </strong>Three-hundred eighty-seven patients were included (mean age 55.2 years, 66.1% female) with a mean follow-up of 10.1 (range: 0-86.3) months. The most common regimen was NWB (n = 268; 69.3%) followed by TDWB (n = 56; 14.5%), WBAT (n = 54; 14.0%), and PWB (n = 9; 2.3%). There were no significant differences in complications between the weightbearing protocols (<i>P</i> = .48354). Complications included persistent pain (n = 40; 10.3%), weakness (n = 6; 1.6%), wound breakdown/infection (n = 33; 8.5%), and rupture (n = 1; 0.3%)]. Revision surgery occurred in 1.8% (n = 7).</p><p><strong>Conclusion: </strong>This large cohort study found no significant association between postoperative weightbearing protocols and outcomes following open surgical treatment for Haglund syndrome at a mean follow-up of 10.1 months. This study provides evidence that surgeons can individualize appropriate weightbearing protocols based on patient needs and preferences when treating Haglund syndrome with Achilles debridement and Haglund resection.</p><p><strong>Level of evidence: </strong>Level III, comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 1","pages":"24730114251316554"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440446","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 Novel Indication for 3D-Printed Titanium Total Talus Replacements in Isolated Talar Tumors.","authors":"Martina Galea Wismayer, Harriet Branford-White, Mark B Davies, Rick Brown","doi":"10.1177/24730114251318732","DOIUrl":"10.1177/24730114251318732","url":null,"abstract":"<p><strong>Background: </strong>Intraosseous talar tumors are rare and usually require complex surgery such as tibiocalcaneal fusion with allograft, resulting in a poor functional outcome. Total talus replacement (TTR) has been primarily described predominantly after trauma for talar avascular necrosis in the absence of peri-talar arthrosis. We present our small initial case series of this novel indication for a TTR to treat a localized talus tumor with no associated osteoarthritis.</p><p><strong>Methods: </strong>Four patients underwent total talus replacement with a custom-made 3D-printed talar implant for an isolated intraosseous talar tumor between February 2021 and December 2022. The pathologies were fibrous dysplasia, a primary vascular tumor, and 2 cases each with an isolated metastatic endometrial carcinoma. All 4 cases were performed by the same surgical team. The Manchester-Oxford Foot Questionnaire (MOXFQ) and EuroQoL-5 Dimensions (EQ-5D) questionnaire were recorded pre- and postoperatively.</p><p><strong>Results: </strong>At a mean follow-up of 26 months (range, 14-37) all our patients showed an improvement in their MOXFQ and EQ-5D scores. Average MOXFQ scores decreased from 57.3 to 20.3. Three of the 4 patients showed an improvement in their function and ability to perform usual activities. One patient scored an improvement in their mobility. None had any intraoperative or postoperative complications.</p><p><strong>Conclusion: </strong>TTR is an alternative technique for the management of isolated talar tumors, which will maintain movement and provide better function than previous options.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 1","pages":"24730114251318732"},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413827","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":"Ankle Arthrodesis: Epidemiology, Etiology, and Complications in Diabetic vs Nondiabetic Patients Using US Nationwide Inpatient Sample Data.","authors":"Assil Mahamid, David Maman, Summer Sofer, Mykhail Pavlenko, Amr Mansour, Marah Hodruj, Yaron Berkovich, Eyal Behrbalk","doi":"10.1177/24730114251315122","DOIUrl":"10.1177/24730114251315122","url":null,"abstract":"<p><strong>Background: </strong>Ankle arthrodesis (AA), or ankle fusion, is a surgical procedure used to treat severe ankle pathologies, particularly in patients with chronic pain and reduced mobility due to conditions like osteoarthritis, posttraumatic arthritis, and Charcot arthropathy. Diabetic patients undergoing AA often face higher risks of complications due to comorbidities such as dyslipidemia and hypertension. This study aims to compare the outcomes of AA in diabetic vs nondiabetic patients, using data from the Nationwide Inpatient Sample (NIS) from 2016 to 2019.</p><p><strong>Methods: </strong>Using the Nationwide Inpatient Sample database, 12 325 patients who underwent ankle arthrodesis were identified from 2016 to 2019 based on <i>ICD-10</i> procedure codes. χ² tests and <i>t</i> tests were used for univariate analysis, followed by multivariate logistic regression to assess complications between diabetic and nondiabetic patients. Temporal trends in surgical volume were analyzed using linear regression models, and risk ratios were calculated for perioperative complications during the index hospital stay.</p><p><strong>Results: </strong>Primary osteoarthritis was the most common cause, accounting for 55.4% of AA procedures. Multivariate logistic regression revealed that diabetes mellitus (DM) was significantly associated with increased risks of blood loss (odds ratio [OR] 1.59, 95% CI 1.23-2.05, <i>P</i> = .004), infection (OR 3.12, 95% CI 2.55-3.82, <i>P</i> < .001), heart failure (OR 1.35, 95% CI 1.06-1.73, <i>P</i> = .01), and acute kidney injury (OR 2.42, 95% CI 1.57-3.75, <i>P</i> = .001). No significant association was observed between DM and pneumonia (OR 2.27, 95% CI 1.645-4.605, <i>P</i> = .20).</p><p><strong>Conclusion: </strong>Diabetic patients undergoing AA have higher rates of comorbidities and postoperative complications, leading to longer hospital stays. These findings highlight the need for comprehensive preoperative and postoperative care to improve outcomes in this population.</p><p><strong>Level of evidence: </strong>Level III, retrospective study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 1","pages":"24730114251315122"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390537","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":"Offloading Interventions for the Management of Charcot Neuroarthropathy in Diabetes.","authors":"Thomas Berhane, Kanakamani Jeyaraman, Mark Hamilton, Henrik Falhammar","doi":"10.1177/24730114251315670","DOIUrl":"10.1177/24730114251315670","url":null,"abstract":"<p><strong>Background: </strong>The use of a nonremovable patellar tendon bearing (PTB) cast in Charcot neuroarthropathy (CA) has not been well studied. We describe the offloading devices, including PTB cast used in our setting for the treatment of CA.</p><p><strong>Methods: </strong>We performed a retrospective observational study on patients with CA and diabetic foot ulcer (DFU) presenting to the multidisciplinary foot clinic at Royal Darwin Hospital, between January 2003 and June 2015. Various immobilization and offloading methods used in CA treatment and their outcomes were analyzed.</p><p><strong>Results: </strong>Ninety-three cases of CA were included. PTB cast (n = 76) and a variety of custom-made removable devices (n = 17) were used for initial offloading. Patients treated with PTB casts were allowed to fully weightbear on the affected limb, as tolerated. Initial offloading was continued until the joint stabilized and ulcer healed (6.5±1.9 months), and then patients were transitioned to various orthotic devices and then to accommodative footwear. At the end of the whole offloading treatment (median duration 13.1 months; range 10-24), patients treated with PTB initially had better outcomes compared with patients treated with removable devices.</p><p><strong>Conclusion: </strong>Immobilization using PTB casting was an effective offloading method for CA with DFU. With our offloading regimen, Indigenous and non-Indigenous patients had similar outcomes.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 1","pages":"24730114251315670"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390542","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":"Retaining Severely Damaged Talar Body and Medial Malleolar Cartilage for Diabetic Ankle/Hindfoot Charcot Arthrodesis Using Intramedullary Nail: A Short Report.","authors":"Kaissar Yammine, Camille Samaha, Chahine Assi","doi":"10.1177/24730114251315672","DOIUrl":"10.1177/24730114251315672","url":null,"abstract":"<p><strong>Background: </strong>The tibiotalocalcaneal (TTC) arthrodesis using an intramedullary nail (IMN) is a common method used to treat advanced diabetic ankle/hindfoot Charcot deformity. The talus is usually resected when severe loss of its body is present and the medial malleolar cartilage excised. We report our initial results with talar retention and absence of medial ankle gutter cartilage debridement.</p><p><strong>Methods: </strong>Four patients with type 2/3A Brodsky classification and stage 2/3 as Eichenholtz classification, presenting with a hindfoot varus deformity were treated with TTC using IMN. The talus was retained after excision of its proximal and distal cartilages while the medial malleolus cartilage was not touched. Bone union was the primary outcome. The minimum follow-up period was 12 months.</p><p><strong>Results: </strong>Bone union was achieved radiologically in all 4 cases within 6 months. No signs of postoperative infection was noted. The mean limb length difference between the pre- and postoperative values was 0.5 ± 0.2 cm. At the final follow-up, all patients were able to walk pain-free with full weightbearing. All 4 patients were very satisfied at 12 months with a mean American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score of 87 ± 3.1.</p><p><strong>Conclusion: </strong>When performing TTC arthrodesis for diabetic Charcot, preserving the talus even when the body is severely damaged could add to the stability of the construct resulting in bone healing and some leg length preservation. Including the medial malleolus in the fusion surgery might not be necessary.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 1","pages":"24730114251315672"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363825","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":"Thank You to <i>Foot & Ankle Orthopaedics</i> Reviewers.","authors":"","doi":"10.1177/24730114251318866","DOIUrl":"https://doi.org/10.1177/24730114251318866","url":null,"abstract":"","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 1","pages":"24730114251318866"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188935","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":"Secondary Subtalar Arthrodesis: Surgical Outcome and Predictors of Functional Outcome and Quality of Life After Bone Block Distraction vs In Situ Technique.","authors":"Robin Eelsing, Sally Al-Sheikh, Jens A Halm, Tim Schepers","doi":"10.1177/24730114241311895","DOIUrl":"10.1177/24730114241311895","url":null,"abstract":"<p><strong>Background: </strong>The outcome of a secondary subtalar arthrodesis after prior calcaneal fracture has been widely described. However, the surgical treatment has evolved significantly over the past decade, paralleling the shifts observed in primary repair strategies. Therefore, we describe the outcome following a secondary arthrodesis after an intra-articular calcaneal fracture, comparing the in situ (ISA) and bone block distraction arthrodesis (BBDA) techniques.</p><p><strong>Methods: </strong>In total, 339 patients who underwent a subtalar arthrodesis between January 1998 and November 2022 were screened for eligibility. Inclusion criteria were age ≥16 years, having undergone a subtalar arthrodesis following a calcaneal fracture, and a minimal follow-up of 1 year. Exclusion criteria were subtalar arthrodesis before January 2010 and a subtalar arthrodesis within 6 weeks of injury. A total of 259 patients did not meet the inclusion criteria, resulting in the inclusion of 80 patients with 82 fractured calcanei.</p><p><strong>Results: </strong>No significant differences between ISA and BBDA in surgical outcome were seen. Subtalar fusion was achieved in 78 of the patients (95.1%). Additionally, a deep surgical site infection occurred in 6 patients (7.8%). The American Orthopaedic Foot & Ankle Society ankle-hindfoot scale (AOFAS) and Foot Function Index (FFI) scores and the EuroQol-5 dimensions (EQ5D) index were similar between the 2 groups. However, a significantly higher EQ5D-VAS was reported by the subjects who received a BBDA (median [interquartile range], 70.0 [52.0-82.0] vs 81.0 [70.0-90.3], <i>P</i> = .021). Multiple regression revealed that a higher Böhler angle before the initial fracture reconstruction significantly improved the AOFAS score, whereas the FFI significantly improved by an initial conservative treatment and implant removal after arthrodesis. Finally, increasing age significantly improved the EQ5D index.</p><p><strong>Conclusion: </strong>Our study presents comparable surgical outcomes between ISA and BBDA for secondary subtalar arthrodesis following calcaneal fractures. Functional outcomes, as measured by the AOFAS and FFI scores, were also similar between the 2 techniques, although patients undergoing BBDA reported higher EQ5D visual analog scale scores.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 1","pages":"24730114241311895"},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046108","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":"Long-term Clinical Outcomes After Syndesmosis Fixation With K-wires in Ankle Fractures With Syndesmotic Instability.","authors":"Diogo Vieira Cardoso, Filippo Pierobon, Anne Lübbeke-Wolff, Victor Dubois-Ferrière","doi":"10.1177/24730114241310425","DOIUrl":"10.1177/24730114241310425","url":null,"abstract":"<p><strong>Background: </strong>Syndesmotic instability is a significant concern in the management of unstable ankle fractures, occurring in approximately 10% to 13% of these cases. Early recognition and stabilization of syndesmotic injuries are essential to ensure optimal long-term outcomes. Several techniques are currently in use, often involving complex procedure and/or costly devices. Our study presents a syndesmosis fixation technique using K-wires that is both simple and cost-effective.</p><p><strong>Methods: </strong>This is a retrospective single-center case series. Three hundred seventy-seven ankle fractures with intraoperative syndesmosis instability and subsequent syndesmosis fixation with a K-wire were treated between 2002 and 2012. Of the 377 patients, 51 died and we were able to obtain long-term questionnaire completions from 94 patients (29% of presumed living patients), with a mean follow-up of 10.6 ± 3.0 years.</p><p><strong>Results: </strong>The mean age was 46.6 ± 18.5 years; 42% were Danis-Weber type B and 58% type C fractures. Syndesmosis fixation failure was observed in 9 (2%) patients, and 5 (1%) patients had K-wire displacement without loss of syndesmosis reduction. The Manchester-Oxford Foot Questionnaire (MOXFQ) was obtained 10±3 years after surgery. The mean MOXFQ pain score was 25.9 ± 25.4, the mean functional score was 18 ± 24.8, and the mean social score was 13.7 ± 22.2.</p><p><strong>Conclusion: </strong>We report long-term (10.6 ± 3 years) functional outcomes using a validated patient-reported questionnaire in patients who underwent syndesmosis fixation with 2 K-wires for unstable ankle fractures. In the subset of patients we were able to find in follow-up, we found low rates of syndesmosis fixation failure, low pain scores, and excellent functional outcomes. The availability and low cost of these implants make this technique an accessible and cost-effective solution to consider for syndesmosis fixation.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"10 1","pages":"24730114241310425"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028170","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}