Foot and Ankle Surgery最新文献

{"title":"EFAS Score validated in 16 languages to cover the majority of the world´s population.","authors":"Martinus Richter","doi":"10.1016/j.fas.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.fas.2025.03.005","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sural nerve injury risk during endoscopic gastrocnemius recession: Comparison of two approaches.","authors":"Wojciech Napiontek, Xavier Martin Oliva, Felipe Cárcamo-Aguilar, Diego A Belling, Milán F Zárate Leal, Tania Diaz Sanchez","doi":"10.1016/j.fas.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.fas.2025.03.003","url":null,"abstract":"<p><strong>Backgrounds: </strong>The gastrocnemius recession was originally introduced as a method of treating isolated gastrocnemius contractures among pediatric population, however currently this procedure allows to treat various foot pathologies. Different modifications of open technique has been developed over the years and recently endoscopic approach become a widespread technique among many surgeons. It provides smaller incision and shorter operative time, however might be associated with the higher risk of sural nerve damage as a result of poor visualization. The aim of this study was to evaluate two different endoscopic approaches, introduced by Stryer and Lui, in terms of sural nerve injury.</p><p><strong>Method: </strong>In 14 dissected legs the following measurements were assessed: 1) Distance between the sural nerve and cannula. 2) Distance to the sural nerve from the lateral portal and the medial portal when performing the Strayer technique. 3) Distance to the sural nerve from the lateral portal and the medial portal when performing the Lui technique.</p><p><strong>Result: </strong>In both techniques the sural nerve was located dorsally to the cannula and no nerve damage was observed. In Lui technique the distance between cannula and the nerve was noticeably deeper than in Strayer method.</p><p><strong>Conclusion: </strong>Both method of endoscopic gastrocnemius recession have similar risk of intraoperative sural nerve injury. Open method should always be considered as an alternative, especially for surgeons who lack experience in endoscopic procedures.</p><p><strong>Level of evidence: </strong>II.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of observer experience in clinical assessment of ankle and subtalar joint laxity: Validation of a multidirectional 3D opto-electronic motion analysis protocol.","authors":"Pierre-Henri Vermorel, Rodolphe Testa, Thomas Neri, Yann Lelonge, François Lintz, Margot Ronat, Yves Tourne, Rémi Philippot","doi":"10.1016/j.fas.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.fas.2025.03.002","url":null,"abstract":"<p><strong>Background: </strong>Role of ankle and subtalar ligaments remains poorly understood due to inconsistent literature. This study validates a protocol for analyzing multidirectional foot and ankle motions and assesses the impact of experience on clinical evaluations of ankle and subtalar instability.</p><p><strong>Methods: </strong>Five cadaveric feet were tested using a 3D opto-electronic system to measure talus, tibia, and calcaneus motions under varying ligament conditions. Anterior Drawer Test (ADT), varus talar tilt test in neutral flexion (VTTT), and in dorsiflexion (VTTTF) were tested by one experienced and one inexperienced observer. The system measured multidirectional angular rotations.</p><p><strong>Results: </strong>Intra-observer ICC exceeded 0.97. For ADT, flexion/extension and internal/external rotation correlated significantly with laxity scores for both observers (p < 0.05). For VTTT, varus/valgus correlations were stronger for the experienced observer, VTTTF correlations were significant only for the experienced observer.</p><p><strong>Conclusion: </strong>3D opto-electronic is reliable for foot and ankle multidirectional motion analysis. Experience improves subtalar instability assessment accuracy.</p><p><strong>Level of evidence: </strong>Level 5 (cadaveric study).</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Case report\" and \"Technical tip\" article types cancelled and \"Letter to the editor\" format maintained in Foot and Ankle Surgery.","authors":"Martinus Richter","doi":"10.1016/j.fas.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.fas.2025.03.001","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forefoot morphology change following subtalar arthroereisis for symptomatic flexible flatfoot in children.","authors":"Kuang-Yu Cheng, Chui-Jia Farn, Chia-Che Lee, Kevin Chun-Kai Chiu, Kuan-Wen Wu, Ken N Kuo, Ting-Ming Wang","doi":"10.1016/j.fas.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.fas.2025.02.007","url":null,"abstract":"<p><strong>Background: </strong>When symptomatic pediatric flexible flatfoot treated with subtalar arthroereisis to improve hindfoot alignment, the postoperative forefoot supinatus can be a concern.</p><p><strong>Methods: </strong>We retrospectively reviewed 110 patients (220 feet), ages 5-12, who underwent subtalar arthroereisis from January 2017 to December 2019, with at least two years of follow-up. Of these, 22 patients (44 feet) developed forefoot supinatus with metatarsus primus elevatus (MPE). Radiographic evaluations assessed postoperative forefoot supinatus, calcaneus and talus height. Functional outcomes were measured using the modified American Orthopaedic Foot & Ankle Society (AOFAS) Forefoot Score.</p><p><strong>Results: </strong>Improvements in forefoot supinatus were seen over time, with self-correction typically occurring around 6-7 months post-surgery. Bone growth positively influenced symptom relief, while demographic factors had minimal impact. The modified AOFAS score also improved.</p><p><strong>Conclusion: </strong>Forefoot supinatus and MPE following subtalar arthroereisis tend to self-correct over several months, aligning with pediatric foot bone growth.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open excision vs. percutaneous intermetatarsal ligament release for Morton's neuroma: A comparative analysis - Is width important?","authors":"Emanuel Cortesão Seiça, João Seixas, Alexei Buruian, Daniel Peixoto, Primoz Potocnik, João Vide","doi":"10.1016/j.fas.2025.02.016","DOIUrl":"https://doi.org/10.1016/j.fas.2025.02.016","url":null,"abstract":"<p><strong>Background: </strong>Morton's interdigital neuroma, caused by compression of the interdigital nerve, often requires surgery when conservative treatment fail. This study compared open neurectomy and percutaneous intermetatarsal ligament release (PILR), focusing on various predictive factors.</p><p><strong>Methods: </strong>A retrospective study, comprising 46 patients (58 feet) with Morton's neuroma who underwent either open excision (n = 24) or PILR (n = 22) from 2012 to 2022. Data included demographics, MRI-measured neuroma size, complications, and revision surgery. Outcomes were assessed using the Visual Analog Scale (VAS), Foot and Ankle Ability Measure (FAAM), and satisfaction scores.</p><p><strong>Results: </strong>Open excision yielded better outcomes than PILR for neuromas larger than 7.40 mm, with lower VAS scores (2.3 vs. 3.9), higher FAAM scores (87 vs. 72), and greater satisfaction (3.2 vs. 2.1). Neuroma width predicted outcomes in the PILR group.</p><p><strong>Conclusion: </strong>Open excision is superior for larger neuromas, while PILR may suit smaller ones (<7.40 mm).</p><p><strong>Level of evidence: </strong>Level III cohort study CLINICAL RELEVANCE: This study highlights the importance of neuroma width in determining the success of percutaneous intermetatarsal ligament release (PILR). Our findings suggest that PILR may be more appropriate for smaller neuromas (<7.40 mm), while open excision offers better outcomes for larger neuromas. This insight could guide surgeons in selecting the most suitable surgical approach, optimizing patient outcomes, and minimizing complications.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of weight-bearing strategies on functional recovery in acute Achilles tendon rupture: A network meta-analysis.","authors":"Shayan Ali Irfan, Shahrukh Ahmed, Anusha Ashkar, Gavin Heyes, Muhammad Waqas Khan, Syed M Ahsan Nawaz, Adeel Ahmed Siddiqui, Hussain Mustafa","doi":"10.1016/j.fas.2025.02.013","DOIUrl":"https://doi.org/10.1016/j.fas.2025.02.013","url":null,"abstract":"<p><strong>Objective: </strong>Evaluation of the impact of early weight-bearing on intervention to assess functional outcomes following acute Achilles tendon rupture.</p><p><strong>Methods: </strong>A systematic literature search was conducted following PRISMA guidelines including RCTs involving adult patients with AATR. Interventions were coded based on management approach and weight-bearing strategy: Open, Minimally Invasive, Percutaneous, and Conservative approach, with Early Weightbearing and Late Weightbearing. Outcomes included Achilles Tendon Rupture Score, re-rupture, total complications, return to work, and heel-raise functionality. A frequentist network meta-analysis using fixed-effects models was employed, with sensitivity analysis to assess robustness.</p><p><strong>Results: </strong>A total of 29 RCTs with 2549 patients were included. OR+LW showed significant improvement in early ATRS compared to OR+EW (MD -2.95 [95 % CI, -4.59; -1.31]). MI+EW was identified as the most suitable intervention for improving late ATRS (MD 4.21 [95 % CI, 0.94; 7.49]). MI+LW demonstrated the lowest incidence of re-rupture (OR 0.10 [95 % CI, 0.01; 0.80]). OR+LW was associated with better heel-raise (MD -7.97 [95 % CI, -9.72; -6.22]). Return to work was significantly quicker with MI+EW (SMD -2.53 [95 % CI, -3.34; -1.71]). No significant differences in total complications were found among the interventions.</p><p><strong>Conclusion: </strong>The study highlights the importance of weight-bearing timing in AATR rehabilitation. OR+LW was beneficial for early ATRS and heel-raise, while MI+EW was optimal for late ATRS and quicker return to work. MI+LW showed the lowest re-rupture rates. Despite variability in outcomes, no single intervention emerged as superior across all measures, emphasizing the need for individualized treatment approaches to achieve optimal functional outcomes.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-traumatic osteoarthritis after ankle fracture fixation: A minimum three-year follow-up.","authors":"Lin Wang, Chenni Ji, Xuesong Zhang, Lingchan Wang, Tianwei Liu, Huixian Sun, Yaming Zhang","doi":"10.1016/j.fas.2025.02.014","DOIUrl":"https://doi.org/10.1016/j.fas.2025.02.014","url":null,"abstract":"<p><strong>Purpose: </strong>Post-traumatic osteoarthritis (PTOA) is a prevalent and serious complication after ankle fracture surgery, and due to its delayed nature and nonspecific symptoms, identifying the risk factors is highly cost-effective. The aim of this study is to investigate the incidence and risk factors associated with PTOA following ankle fracture surgery.</p><p><strong>Methods: </strong>This study retrospectively analyzed patients who presented with ankle fractures and underwent open reduction and internal fixation (ORIF) at a university-affiliated tertiary care facility, between January 2018 and October 2021. Patients included must have complete data and a minimum 3-year follow-up assessments. Radiographic PTOA was diagnosed and classified in accordance with a validated and widely used criteria. Twenty-two potential risk factors selected based on literature, univariate statistical analysis and biologic plausibility were included for analysis. Univariate analysis and multivariable regression model were used to identify the independent risk factors.</p><p><strong>Results: </strong>A total of 477 eligible patients were included, comprising 279 males and 198 females, with a mean age of 49.0 ± 9.5 years, and the mean follow-up was 4.3 years. Radiographic PTOA was present in 163 patients (34.2 %), classified as grade Ⅰ in 96 (20.1), grade Ⅱ in 47 (9.9 %), and grade Ⅲ in 20 patients (4.2 %), respectively. Five risk factors were identified, including age (≥ 60 years) (OR, 1.416; 95 %CI, 1.122-2.161), physical labor intensity (> II) (OR, 2.997; 95 % CI, 1.791-5.015), BMI ≥ 28 kg/m² (OR, 2.186; 95 % CI, 1.067-4.112), posterior malleolus and involvement of the articular surface (≤ 25 %: OR, 2.024; 95 % CI, 1.167-3.511; > 25 %: OR, 3.533; 95 % CI, 1.630-67.658), and postoperative articular incongruency (OR, 2.011; 95 % CI, 1.138-4.058).</p><p><strong>Conclusions: </strong>These findings enhance the understanding of its risk profile, and may inform clinical decision-making and guide targeted interventions to mitigate the risk in vulnerable populations.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visualizing access in pilon fractures: A comparative study of eight approaches.","authors":"Tomas Urrutia, Jorge Faundez, Catalina Vidal, Joaquín Palma, Jorge Filippi","doi":"10.1016/j.fas.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.fas.2025.02.009","url":null,"abstract":"<p><strong>Background: </strong>Pilon fractures, constituting 3-10 % of all tibia fractures, present significant challenges due to their complex nature and frequent involvement of soft tissue damage. Effective management necessitates careful preoperative planning and strategic surgical approach selection. This study aims to provide a comprehensive cadaveric analysis comparing eight distinct surgical approaches to tibial pilon fractures, focusing on the consistently exposed segment and the extent of the exposed bone area for each approach.</p><p><strong>Methods: </strong>Sixteen foot and ankle specimens, obtained through our university's body donation program, were utilized for this study. Each specimen underwent two different approaches, resulting in four repetitions for each assessed method. The approaches analyzed included anteromedial, anterolateral, lateral, posterolateral, posteromedial, posterior modified posteromedial, anterior modified posteromedial, and medial approaches. Standardized incisions and retraction techniques were employed to measure the exposed bone area using ImageJ software, while the consistently exposed segment was determined through axial cuts and photographic analysis.</p><p><strong>Results: </strong>The anteromedial approach yielded the largest exposed area (18.36 cm²), whereas the anterolateral approach provided the greatest exposed segment (72°). The posteromedial approach proved most effective for exposing the Volkmann fragment, and the anterolateral approach was optimal for accessing the Chaput fragment and comminution areas. Combining the posteromedial and posterior modified posteromedial approaches could be suggested for extensive posterior malleolus fractures to maximize bone surface exposure while minimizing soft tissue damage.</p><p><strong>Conclusion: </strong>This study offers objective data on the exposed area and segment for various surgical approaches, providing a valuable resource for orthopedic surgeons in preoperative planning and decision-making. By enhancing the understanding of the capabilities and limitations of each approach, this research aims to improve surgical outcomes for patients with complex tibial pilon fractures.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining normative side-to-side differences in the distal tibiofibular joint of healthy individuals using weight-bearing CT 3D image analysis.","authors":"Lorena Bejarano-Pineda, Soheil Ashkani-Esfahani, Matthias Peiffer, Atta Taseh, Rohan Bhimani, Gregory Waryasz, Gino M M Kerkhoffs, Mario Maas, Daniel Guss, Christopher W DiGiovanni","doi":"10.1016/j.fas.2025.02.015","DOIUrl":"https://doi.org/10.1016/j.fas.2025.02.015","url":null,"abstract":"<p><strong>Background and purpose: </strong>Accurate quantification of bony malalignment within the ankle syndesmosis is crucial in diagnosing syndesmotic instability, especially when subtle. While three-dimensional (3D) measurement techniques using weight-bearing computed tomography (WBCT) have gained popularity, normative bilateral comparative data still need to be established. This study aimed to identify the side-to-side variations and gender differences in the syndesmotic area and volume among individuals without syndesmotic injury using WBCT.</p><p><strong>Methods: </strong>Retrospective analysis was conducted on bilateral ankle WBCT imaging of 88 individuals who underwent imaging for non-ankle-related injury or pathology. Two-dimensional area (at 1, 3, and 5 cm proximal to the tibial plafond) and three-dimensional volumetric (from 0.5 mm proximal to the tibial plafond and up to 3 and 5 cm proximally) measurements were obtained for bilateral ankles. Mean ( ± SD) values, percentage right-to-left differences, and gender differences were analyzed.</p><p><strong>Results: </strong>Although there were no significant differences between laterality in any of the measurements, the largest right-to-left difference was 8.9 at the syndesmotic area at 3 cm above the tibial plafond in general. Contrarily, significant gender differences were found in the areas and volumes, with the largest difference observed for the 0.5-5 cm volume (8.41 ± 0.87 vs 7.45 ± 1.47 in male vs female, respectively; P = 0.001).</p><p><strong>Conclusion: </strong>The mean side-to-site variation in the syndesmotic area and volume among individuals without syndesmotic injury is less than 9 %, and a side-to-side volume difference greater than 19 % might be indicative of abnormality. Additionally, gender-specific differences highlight the importance of considering gender norms in ankle syndesmosis evaluation and the need to use the contralateral side as a comparison.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}