Foot & Ankle Orthopaedics最新文献

{"title":"Primary Tibiotalocalcaneal Nailing vs Open Reduction and Internal Fixation for Fragility Ankle Fractures in Older Adults: A Markov Model.","authors":"Andrew Bouras, Akin A Adio, Rahul Kumar, Rohan Phadke, Samuel W Rice, Kush Mody, Anthony Ndu","doi":"10.1177/24730114261450956","DOIUrl":"10.1177/24730114261450956","url":null,"abstract":"<p><strong>Background: </strong>Fragility ankle fractures are common in the elderly population. The cost-effectiveness of primary tibiotalocalcaneal (TTC) nailing compared with open reduction and internal fixation (ORIF) in this population remains unclear.</p><p><strong>Methods: </strong>We constructed a Markov cohort model with a 4-year time horizon to compare TTC nailing vs ORIF for fragility ankle fractures in patients aged 75 years and older. All complication rates were derived from the McDonald et al's (2025) systematic review and meta-analysis. Costs were in 2024 US dollars with 3% annual discounting for costs and outcomes. Probabilistic and deterministic sensitivity analyses were performed.</p><p><strong>Results: </strong>In the base case, ORIF yielded 3.210 quality-adjusted life years (QALYs) (95% credible interval [CrI] 2.785-3.584) at $30 091 (95% CrI $21 426-$40 852) compared with 3.207 QALYs (95% CrI 2.783-3.581) at $33 583 (95% CrI $23 741-$45 447) for TTC nailing. ORIF dominated incremental cost (+$3492, 95% CrI -$11 467 to +$18 273) and incremental QALYs (-0.003, 95% CrI -0.009 to +0.002). The cost differential was driven by the $3000 higher index procedure cost for TTC, partially offset by lower superficial infection (2.1% vs 10.2%). Probabilistic sensitivity analysis demonstrated 33% probability of cost-effectiveness at $100 000/QALY. All 4 scenario analyses confirmed that ORIF dominated.</p><p><strong>Conclusion: </strong>Under McDonald's pooled estimates, TTC nailing is dominated by ORIF for fragility ankle fractures in older adults. The lower superficial infection rate with TTC does not offset its higher procedure cost and higher rates of nonunion and hardware failure. These findings support ORIF as the preferred strategy from a cost-effectiveness standpoint, although the small incremental differences should be considered alongside clinical factors when selecting treatment.</p><p><strong>Level of evidence: </strong>Level IV, economic modeling.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261450956"},"PeriodicalIF":0.0,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155968","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":"Talar Center of Migration Ratio (TCM-R) as a Reliable Ratio-Based Method for Measuring Talar Translation on Noncalibrated Radiographs: A Short Report.","authors":"Kira Lu, Ricardo Ummen de Almeida Tenório Villar, Samantha Morton, Ranqing Lan, Constantine Demetracopoulos, Jensen Henry","doi":"10.1177/24730114261451259","DOIUrl":"10.1177/24730114261451259","url":null,"abstract":"<p><strong>Background: </strong>Coronal talar translation is an important marker of deformity in ankle arthritis, and its correction is vital in total ankle replacement (TAR). The current method for measuring this deformity is talar center of migration (TCM). We developed a novel method, TCM-Ratio (TCM-R), to measure talar translation accurately across all talus sizes using noncalibrated radiographs. Furthermore, we aimed to describe correlations between TCM-R and concomitant procedures during TAR.</p><p><strong>Methods: </strong>Patients were collected from a single-institution prospective TAR registry from June 2023 to May 2024. Inclusion criteria were preoperative calibrated weight-bearing radiographs. For each patient, 4 raters measured the TCM (distance from center of talus to mechanical axis of tibia) and the TCM-R (talar displacement divided by talar radius). Intraclass correlation coefficients (ICCs) were used to assess inter-rater agreement. Pearson correlations were used to assess agreement between TCM-R and TCM.</p><p><strong>Results: </strong>Fifty-eight patients were included, 60.3% male, with mean age 64.8 ± 9.4 years, and mean BMI 30.0 ± 4.7. Inter-rater agreement was excellent for TCM (ICC = 0.914) and TCM-R (ICC = 0.944). TCM-R was highly correlated with TCM (<i>R</i> = 0.95, CI 0.91-0.97, <i>P</i> < .001). The mean absolute value of TCM-R was 13.89% ± 11.29% (range, -34.57% to +47.53%).</p><p><strong>Conclusion: </strong>We described a new ratio-based method, TCM-R, to measure coronal talar translation, obviating the need for calibrated radiographs while accounting for variations in talar size. TCM-R had excellent inter-rater reliability and strongly correlated with TCM.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261451259"},"PeriodicalIF":0.0,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155905","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":"Nonoperative Treatment of Intra-articular Calcaneus Fractures Is Associated With Lower Rates of Certain Long-term Adverse Events Compared to Operative Management: A Retrospective Database Analysis.","authors":"Ava M McKane, N Reid Kiritsis, Karl V Mohr, Omkar S Anaspure, Conor N O'Neill, Albert T Anastasio","doi":"10.1177/24730114261450622","DOIUrl":"10.1177/24730114261450622","url":null,"abstract":"<p><strong>Background: </strong>Management of displaced intra-articular calcaneus fractures remains controversial. While operative techniques are well-described, few large-scale studies have compared long-term outcomes between operative vs nonoperative treatment. Conservative management may limit soft-tissue complications, while operative treatment may improve alignment and potentially reduce the risk of posttraumatic arthritis.</p><p><strong>Methods: </strong>The TriNetX Research Network, including 140 million patient records, was used to identify patients with displaced intra-articular calcaneus fractures using <i>ICD-10</i> codes S92.061, S92.062, S92.063 over a 20-year period. Patients were stratified into operative (<i>CPT</i>: 28415, 28420, 28406) and nonoperative (<i>CPT</i>: 28400, 28405) cohorts. Patients with polytrauma or incomplete records were excluded. Propensity score matching adjusted for demographics and comorbidities, yielding 1260 patients per group. Primary outcomes included any adverse event within 90 days and posttraumatic osteoarthritis, nonunion, malunion, and conversion to subtalar fusion at 2 and 5 years. Statistical analyses included <i>t</i> test, χ², and odds ratios with 95% CIs (<i>P</i> < .05).</p><p><strong>Results: </strong>Baseline demographics and comorbidities were balanced between groups. At 90 days, operative treatment was associated with significantly higher rates of overall adverse events (8.5% vs 3.6%, OR 2.51, <i>P</i> < .001) and lower emergency department utilization (11.5% vs 21.6%, OR 0.47, <i>P</i> < .001). At 5 years, operative patients experienced higher rates of posttraumatic osteoarthritis (6.1% vs 3.8%, OR 1.64, <i>P</i> = .008) and implant-related complications (3.6% vs 1.3%, OR 2.71, <i>P</i> < .001). Nonunion, malunion, and subtalar fusion rates were similar at all time points.</p><p><strong>Conclusion: </strong>Operative treatment was associated with higher rates of certain complications. Findings should be interpreted cautiously given limitations, including coding variations, lack of surgical specifics, and inability to stratify by fracture severity. The observed associations do not establish causality, as fracture severity is a critical determinant of outcomes and treatment selection, although the findings are important for informing future studies. Prospective studies incorporating fracture classification, cost-analysis, and patient-reported outcomes are needed.</p><p><strong>Level of evidence: </strong>Level III, retrospective analysis.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261450622"},"PeriodicalIF":0.0,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155915","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":"Examining Delays in Definitive Fixation: An Association of Patient Demographics in Orthopaedic Trauma Requiring External Fixation.","authors":"Alana O'Mara, Emily Teehan, Andrew W Fealy, Sean M Lee, Rongzhe Zhao, James DeBritz","doi":"10.1177/24730114261450079","DOIUrl":"10.1177/24730114261450079","url":null,"abstract":"<p><strong>Background: </strong>Disparities in health care continue to affect marginalized populations in the United States, contributing to increased morbidity, mortality, and health care costs. Although disparities have been extensively studied in arthroplasty and spine surgery, there is limited understanding of how they manifest in orthopaedic trauma, where treatment is often emergent. Therefore, to explore associations between patient demographics and orthopaedic trauma care beyond the emergent timeframe, this study investigated timing to care in patients that required acute external fixation followed by staged definitive fixation.</p><p><strong>Methods: </strong>A retrospective review of trauma patients who underwent lower extremity external fixation at a level 1 trauma center from January 2014 to March 2024 was conducted. Data collected included patient sex, race, age, insurance, comorbidities, fracture type (open vs closed), and substance use. Key outcomes were days from admission to external fixation and from external fixation to open reduction internal fixation (ORIF). Negative binomial post hoc testing was used, with significance set at <i>P</i> <.05.</p><p><strong>Results: </strong>A total of 129 patients met the inclusion criteria. There was a significant difference in timing to ORIF between genders (<i>P</i> = .034) but no significant difference in timing to ORIF between races (<i>P</i> = .093); no differences were seen in timing to external fixation. After post hoc analysis, only femur fractures showed a significant difference in timing spending 44% shorter time in external fixation (<i>P</i> = .03).</p><p><strong>Conclusion: </strong>These findings suggest that, following initial stabilization, gender may correlate with the timing of definitive fixation in orthopaedic trauma care. Identifying and addressing disparities is essential to reducing inequities in clinical outcomes and health care utilization. This study highlights the need for further research aimed at understanding and mitigating delays in treatment.</p><p><strong>Level of evidence: </strong>Level III, retrospective data from single institution.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261450079"},"PeriodicalIF":0.0,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155957","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":"Automated 3-Dimensional Measurements of First Metatarsal Dysplasia in Hallux Valgus.","authors":"Luc Meuric, Matthieu Lalevée, Nacime Salomao Barbachan Mansur, Scott Ellis, Albert DaCosta, François Lintz, Matthew S Conti, Cesar de Cesar Netto","doi":"10.1177/24730114261448850","DOIUrl":"10.1177/24730114261448850","url":null,"abstract":"<p><strong>Background: </strong>Pronation of first metatarsal (M1) in hallux valgus (HV) is currently the subject of a growing body of scientific research. Several methods of manual measurements have been developed, providing heterogeneous results. Our objective was to develop automatic 3D weightbearing computed tomography (WBCT) measurements in a retrospective case-control design to compare coronal rotation of M1 head relative to the ground, M1 intrinsic torsion, and valgus deviation of M1 distal articular surface (or distal metatarsal articular angle [DMAA]) in HV and controls.</p><p><strong>Methods: </strong>Forty-four symptomatic HV and 44 matched controls were retrospectively enrolled, all of whom had undergone WBCT acquisition. Bone segmentation was performed (Bonelogic 2.1 software). Two methods were developed to assess position of the M1 head. One was based on automatic geometric fitting of a cylinder on the head, and the other on automatic selection of the position of the sesamoid gutters. Similarly, 2 methods were developed to assess the position of the M1 base. One was defined using principal components analysis (PCA) of the proximal articular surface of M1, and the other using the longest diagonal of the M1 base.</p><p><strong>Results: </strong>First metatarsal head rotation relative to the ground was, respectively, 8.9° ± 8.4° (95% CI 6.1°-11.7°) and 2.1° ± 6.4° (95% CI 0.1°-4.1°) via the cylinder method (<i>P</i> < .001) and 9° ± 8.3° (95% CI 6.2°-11.8°) and 0.7° ± 6.8° (95% CI -1.4° to 2.8°) via the gutters method (<i>P</i> < .001) in the HV and control groups. Combining the different sets of head and base measurements, the increase in M1 intrinsic torsion in HV ranged from 2° to 5°. The DMAA was 11.4° ± 6.9° (95% CI 9.3°-13.5°) in the HV group and 5.6° ± 4.7° (95% CI 4.1°-7.0°) in the control group (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>Using automatic 3D WBCT measurements, we found that HV showed an increase in M1 head pronation relative to the ground of 7° to 8° greater than controls, with an increase in M1 intrinsic torsion in pronation of 2° to 5° and an increase in valgus deviation of the M1 distal articular surface of approximately 6°. Changing measurements reference points altered angular values in our study, particularly when moving from measurements based on the sesamoid gutters to gutter-independent measurements, highlighting that these methods may capture different anatomic constructs.</p><p><strong>Level of evidence: </strong>Level III, case control study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261448850"},"PeriodicalIF":0.0,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155924","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":"Flatfoot vs Pronation: Structural and Functional Dissociation Between Foot Posture and Foot Physiology.","authors":"Daniele Origo, Marco Tramontano, Gabriele Montini, Fulvio Dal Farra","doi":"10.1177/24730114261451239","DOIUrl":"10.1177/24730114261451239","url":null,"abstract":"<p><strong>Background: </strong>In clinical practice, static foot posture is frequently interpreted as a proxy for foot structure and function. The Foot Posture Index-6 (FPI-6) is a descriptive tool, often used to infer the presence of flatfoot and abnormal dynamic loading. However, the extent to which static pronation reflects structural arch collapse and functional plantar loading remains unclear.</p><p><strong>Methods: </strong>This secondary analysis examined the concordance between static foot posture (FPI-6), structural flatfoot assessed through the Arch Index (AI), and dynamic plantar loading during gait. Data were derived from a previously published cross-sectional data set including 100 healthy adults. Feet were classified as pronated when FPI-6 ≥ +6 and as flatfoot when AI ≥ 0.26. Dynamic plantar pressures were recorded during walking using a pressure platform, with regional peak pressures and vertical forces extracted for the hallux, metatarsals, midfoot, and heel. Associations between measures were explored using Spearman correlations and χ² tests.</p><p><strong>Results: </strong>Among 200 analyzed feet, 43.2% were classified as pronated by FPI-6, whereas only 19% met flatfoot criteria according to the AI. Overlap between classifications was limited, with only 16.3% of pronated feet also showing structural flatfoot. No statistically significant association could be detected between FPI-6 and AI (ρ = -0.05; <i>P</i> = .445).Distinct dynamic loading patterns emerged, with higher FPI-6 scores associated with increased hallux loading and reduced fifth metatarsal loading, whereas higher AI values correlated with greater central and lateral forefoot loading. These patterns suggest limited concordance between static posture, structural morphology, and dynamic loading characteristics.</p><p><strong>Conclusion: </strong>In this asymptomatic sample, within the present data set, static pronation assessed with the FPI-6 was not significantly associated with structural flatfoot (<i>P</i> = .445) and showed limited concordance with dynamic plantar loading patterns. These findings should be interpreted with caution given the cross-sectional design and the potential nonindependence of bilateral observations. A multidimensional assessment integrating static posture, structural measures, and dynamic analysis may provide a more comprehensive framework for clinical evaluation.</p><p><strong>Level of evidence: </strong>Level III, diagnostic, cross-sectional study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261451239"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143383","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":"Biomechanical Comparison of Sustained Dynamic Compression Screws vs Static Compression Screws in Subtalar Arthrodesis: A Cadaveric Study.","authors":"James Baker, Mariah Arave, James Johnson, David Safranski, Jeannie Huh","doi":"10.1177/24730114261449242","DOIUrl":"10.1177/24730114261449242","url":null,"abstract":"<p><strong>Background: </strong>Subtalar arthrodesis is a reliable procedure to address subtalar arthritis, though nonunion remains a challenge. Adequate compression is critical to optimizing fusion, but bone resorption and settling impair the ability of standard static compression (SC) screws to maintain compression. Sustained dynamic compression (SDC) screw constructs that use the pseudoelastic property of nitinol may enable more sustained compression than static compression screws.</p><p><strong>Methods: </strong>Ten fresh talo-calcaneal cadaveric specimens were instrumented with either 2 SC screws or 2 SDC nitinol screws. Using a custom mechanical fixture, the compression force generated during and after screw insertion was measured in each group. The fixture was allowed to relax over a controlled distance and time to simulate bone resorption. The force at each relaxation point was measured, and the resorption capacity was calculated for each construct.</p><p><strong>Results: </strong>Maximum compression at implantation was 430.2 ± 237.2 N for SC and 406.8 ± 117.7 N for SDC. After a 1-minute dwell period, compression was 299.6 ± 194.4 N for SC and 367.9 ± 108.0 N for SDC, corresponding to retention of 69.6% and 90.4% of initial compression, respectively. At 2 mm of simulated resorption, the SDC construct retained 111.1 ± 45.4 N compared with 8.3 ± 18.6 N for SC. The resorption capacity was 4.2 mm compared with 1.3 mm for the sustained dynamic compression and static constructs, respectively.</p><p><strong>Conclusion: </strong>We did not detect a difference in initial compressive force between the SC and SDC screws. However, under identical bench conditions, the SDC construct retained more of its initial compression during the first minute and maintained substantially greater compression during simulated bone resorption than the SC construct. These findings support further study of whether sustained compression may help preserve fixation-generated preload during subtalar arthrodesis.</p><p><strong>Clinical relevance: </strong>In a cadaveric subtalar arthrodesis model, novel sustained dynamic compression screws retained more interfragmentary compression than standard static compression screws during early relaxation and simulated bone resorption. This technology may aid surgeons in maintaining compression despite postoperative settling or resorption during subtalar arthrodesis, particularly in higher-risk patients.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261449242"},"PeriodicalIF":0.0,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148028862","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":"Evaluation of Large Language Models for Automated Simple <i>CPT</i> Coding in Foot and Ankle Surgery.","authors":"Eve R Glenn, Ariana Rowshan, Eric Mao, David Ryu, Yesha Parekh, Nigel N Hsu, John M Thompson, Amiethab A Aiyer","doi":"10.1177/24730114261448207","DOIUrl":"10.1177/24730114261448207","url":null,"abstract":"<p><strong>Background: </strong>Accurate <i>Current Procedural Terminology</i> (<i>CPT</i>) coding is crucial for appropriate billing and reimbursement in foot and ankle surgery but is often time-consuming and prone to error. Large language models (LLMs) offer an approach to automate coding and reduce administrative burden, yet their performance in orthopaedic subspecialties remains limited. This study sought to evaluate the accuracy of 5 publicly available LLMs-ChatGPT-5 Mini, Google Gemini 2.5 Flash, Claude 4.0 Sonnet, Deepseek V3, and Perplexity-in correctly generating <i>CPT</i> codes for single-code (simple) foot and ankle procedures.</p><p><strong>Methods: </strong>Twenty-one common procedures identified by a single <i>CPT</i> code were selected. Each LLM was queried 4 times with standardized prompts requesting <i>CPT</i> codes. Accuracy was assessed based on the correct identification of <i>CPT</i> codes, with statistical analyses comparing performance across models and trials.</p><p><strong>Results: </strong>Perplexity achieved the highest accuracy (92.9%, 95% CI = 87.4%-98.4%), whereas Deepseek V3 performed worst (48.2%, 95% CI = 37.5%-58.9%). Global χ² testing showed significant differences in coding accuracy among models (<i>P</i> < .001). Pairwise comparisons revealed Perplexity outperformed ChatGPT-5 Mini, Claude 4.0 Sonnet, and Deepseek V3; Google Gemini 2.5 Flash outperformed Deepseek V3 and ChatGPT-5 Mini; and Claude 4.0 Sonnet outperformed Deepseek V3.</p><p><strong>Conclusion: </strong>LLM performance in <i>CPT</i> coding for simple foot and ankle procedures was highly variable, with some models demonstrating acceptable accuracy whereas others performed poorly. These findings highlight that current LLMs are not sufficiently reliable for independent clinical use. Select models may serve as first-pass aids when combined with careful human verification.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261448207"},"PeriodicalIF":0.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987003","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":"Increased Intercuneiform and Naviculocuneiform Joint Spacing in Hallux Valgus: A 3-Dimensional Distance Mapping Pilot Study.","authors":"Brian F Closkey, Brett D Steineman, A Holly Johnson, Scott J Ellis, Matthew S Conti","doi":"10.1177/24730114261448837","DOIUrl":"10.1177/24730114261448837","url":null,"abstract":"<p><strong>Background: </strong>Hallux valgus (HV) is a complex 3-dimensional (3D) deformity of the first ray. Recurrence rates following surgical intervention for HV remain high, which may be due to unrecognized midfoot instability. Previous studies have suggested that instability at the first tarsometatarsal (TMT1) is the source of deformity, but separate work suggests that midfoot joints such as the intercuneiform (IC) and naviculocuneiform (NC) joints may also be involved. No studies have investigated whether joint space widening occurs in other joints along the medial column. The goal of this study was to compare spacing of midfoot joints between HV patients and controls.</p><p><strong>Methods: </strong>A retrospective pilot study of 20 HV patients with preoperative weightbearing CT scans were identified and matched with 20 selected control patients. Midfoot bones were segmented from scans, and 3D distance mapping was performed to evaluate regional differences in minimum joint spacing at the TMT1, IC, and NC joints. The segmented WBCT scans were uploaded to Geomagic Design X, and automated coordinate systems for each bone were calculated using a previously published open-source code in Matlab. The TMT1 joint was divided into dorsal and plantar regions, the IC joint was divided into distal and proximal regions, and the NC joint was divided into medial and lateral regions.</p><p><strong>Results: </strong>Joint spacing was greater in the proximal IC joint of HV patients (0.95 mm, IQR: 0.89-1.02 mm), compared with controls (0.61 mm, IQR: 0.48-0.76 mm, <i>P</i> = .006). Spacing was also greater in the medial NC joint of HV patients (1.23 mm, IQR: 1.14-1.36 mm) compared with controls (1.11 mm, IQR: 0.93-1.24 mm, <i>P</i> = .007). With the numbers available, no significant difference was observed at the TMT1 joint.</p><p><strong>Conclusion: </strong>HV patients demonstrated differences at the proximal IC and medial NC joints compared with controls, suggesting an association between proximal midfoot joint spacing and HV deformity. These findings highlight that structural changes in HV may extend beyond the TMT1 joint, and consideration of the broader midfoot in patients with HV may be relevant when evaluating the deformity.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study, case-control study, meta-analysis of Level III studies.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261448837"},"PeriodicalIF":0.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987021","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":"Corrigendum to \"Early and Mid-term Effects of Ankle and Hindfoot Arthrodesis on Quality of Life\".","authors":"","doi":"10.1177/24730114261455399","DOIUrl":"https://doi.org/10.1177/24730114261455399","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/24730114261446315.].</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261455399"},"PeriodicalIF":0.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987042","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}