Foot and Ankle Surgery最新文献

{"title":"High CT-scan confirmed union rates following subtalar and talonavicular arthrodesis through a single medial approach.","authors":"Daniel Saraiva, Markus Knupp, Jaeyoung Kim, José Tulha, Margalida Cadena, Xavier Martín Oliva","doi":"10.1016/j.fas.2026.05.016","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.016","url":null,"abstract":"<p><strong>Background: </strong>Subtalar (ST) and talonavicular (TN) arthrodesis through a single medial approach is an established technique when dealing with common hindfoot conditions, but evidence of arthrodesis union usually relies on plain radiographs evaluation. The aims of this study were to determine long-term clinical and radiographic outcomes, including computed tomography scan (CT-scan) confirmed union rates, of ST and TN arthrodesis through a single medial approach.</p><p><strong>Methods: </strong>A retrospective cohort study was performed on 36 patients who underwent ST and TN arthrodesis through a single medial approach. Patient satisfaction was assessed as \"very satisfied\", \"satisfied\" and \"unsatisfied\". Clinical evaluation was performed using the Visual Analog Scale (VAS-P) and the Foot and Ankle Outcome Score (FAOS). Radiographic assessment included postoperative CT-scan evaluation to confirm union rates.</p><p><strong>Results: </strong>The mean follow-up was 43 (range, 20-86) months. We registered 30 \"very satisfied\" patients (83.3%), 5 \"satisfied\" patients (13.9%) and 1 \"unsatisfied\" patient (2.8%), as well as statistically significant improvement on both clinical scores tested (p < .05). CT-scan evaluation confirmed fusion of both TN and ST joints on 32 cases (88.9%), TN joint non-union on 4 cases (11.1%) and ST arthrodesis on 36 cases (100%).</p><p><strong>Conclusion: </strong>ST and TN arthrodesis through a single medial approach provide statistically significant clinical and radiographic improvements, as well as CT-scan confirmed high union-rates.</p><p><strong>Level of clinical evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165368","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":"Endoscopic versus open flexor hallucis longus tendon transfer for reconstruction of chronic achilles tendon rupture: A prospective randomized pilot trial.","authors":"Abdelrahman Abdelsalam Afifi, Ayman Ibrahim Fathy Hewaidy, Ossama AbdelRaof El Shazly, Amr Farouk, Awab Ali Mousa Elaslaby, Mahmoud Ahmed Gamal, Mohamed Ahmed El Mowafi","doi":"10.1016/j.fas.2026.05.015","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.015","url":null,"abstract":"<p><strong>Background: </strong>Chronic Achilles tendon rupture often requires surgical reconstruction. Flexor hallucis longus (FHL) tendon transfer is widely used, and endoscopic techniques may reduce soft-tissue morbidity and facilitate early recovery.</p><p><strong>Methods: </strong>Thirty patients with chronic Achilles tendon rupture were randomized to undergo open or endoscopic FHL tendon transfer. Functional outcome was assessed using the Foot and Ankle Ability Measure (FAAM) over 18 months. Secondary outcomes included operative time and wound complications. Exploratory outcomes included postoperative pain assessed by visual analog scale (VAS), duration of analgesic use, and time to return to work.</p><p><strong>Results: </strong>FAAM scores improved significantly in both groups over time (P < .001), with no significant difference between techniques at final follow-up (P = .487). Operative time was significantly longer in the endoscopic group (P < .001). Wound complications occurred only in the open group, affecting 5 of 15 patients (33.3%). Endoscopic reconstruction was associated with shorter duration of analgesic use (P = .007) and earlier return to work (P = .013). VAS pain scores decreased significantly in both groups with no significant between-group differences.</p><p><strong>Conclusions: </strong>Both open and endoscopic FHL tendon transfer provided excellent functional outcomes in the management of chronic Achilles tendon rupture. The endoscopic technique was associated with fewer wound complications and improved early postoperative recovery, despite longer operative time.</p><p><strong>Level of evidence: </strong>Level II, randomized controlled trial (pilot).</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151925","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":"Multimodal diagnosis of periprosthetic joint infection after total ankle arthroplasty.","authors":"Kathrin Pfahl, Julia Eder, Veit Krenn, Leon Marcel Faust, Yunjie Zhang, Wolfgang Boecker, Boris M Holzapfel, Markus Walther","doi":"10.1016/j.fas.2026.05.013","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.013","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing periprosthetic joint infection (PJI) after total ankle arthroplasty (TAA) remains challenging. This study evaluated clinical, laboratory, imaging, microbiological and histopathological parameters in suspected PJI after TAA. We hypothesized that a multimodal approach improves diagnosis.</p><p><strong>Methods: </strong>This retrospective study included 57 patients with suspected PJI after TAA and applied European Bone and Joint Infection Society (EBJIS) criteria. Pre- and intraoperative parameters were analyzed using correlation, group comparison and L1-regularized logistic regression.</p><p><strong>Results: </strong>33 patients were classified as infection unlikely, 5 as likely, and 19 as confirmed. Strong associations with PJI were observed for 99mTc-SPECT/CT (rs = 0.88), synovial neutrophil percentage, blood culture positivity, microbiology, histology, and sonication (all p < .001).</p><p><strong>Conclusions: </strong>Clinical signs, synovial fluid analysis, microbiology, histology, sonication, and 99mTc-SPECT/CT showed substantial discriminatory value and support a multimodal diagnostic strategy in suspected ankle PJI.</p><p><strong>Levels of evidence: </strong>Level IV.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057540","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":"25-Year revision, reoperation, and complication risk following 150,000 hallux valgus bunion operations in England.","authors":"Jonathan Munro, Michael Atife, Conor Hennessy, Simon Abram, Rick Brown, Constantinos Loizou, Robert Sharp, Adrian Kendal","doi":"10.1016/j.fas.2026.05.014","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.014","url":null,"abstract":"<p><strong>Background: </strong>Hallux valgus surgery is common, with recurrence rates of 4%-78%. Further surgery is costly for individuals and healthcare systems. The study investigates revision surgery risk, further forefoot surgery and 90-day complications of hallux valgus surgery in England.</p><p><strong>Methods: </strong>An England population study of 152,061 operations was performed using the Hospital Episode Statistics database (1998-2023). The primary outcome was Kaplan-Meier analysis of revision surgery free survival. Secondary outcomes included 90-day complication rates, mortality and long-term risk of ipsilateral forefoot surgery. Cox proportional hazard modelling was used to identify those at highest risk of further surgery.</p><p><strong>Results: </strong>Revision-free survival was 93.0% at 25 years. Higher risk was seen in females (HR 1.12), white patients (HR 1.65), age 40-59 (HR 2.2), and the most deprived groups (HR 1.52). Overall, 4.6% had revision correction and 2.6% underwent fusion.</p><p><strong>Conclusion: </strong>Hallux valgus surgery is safe, with low revision risk and complication rates.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101941","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":"Is 1st tarsometatarsal joint instability important in the development or recurrence of hallux valgus in asymptomatic pes planus?","authors":"James Ritchie, Kristian Buedts, Sophie Ritchie, Xavier Martin Oliva","doi":"10.1016/j.fas.2026.05.012","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.012","url":null,"abstract":"<p><strong>Introduction: </strong>The association between hallux valgus and pes planus remains controversial with debate focussing largely on the postulated pivotal role of 1st tarsometatarsal joint. This is the first systematic review to evaluate the importance of 1st TMT joint instability in the development, or recurrence, of hallux valgus in asymptomatic pes planus.</p><p><strong>Methods: </strong>A systematic review of PubMed, Ovid EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) & Cochrane Database of Systematic Reviews (CDSR) and Wiley Online Library from inception to January 2026 was carried out. PRISMA guidelines were followed, the study registered with PROSPERO and the ROBINS-I criteria used to assess bias.</p><p><strong>Results: </strong>Thirty-six studies met the inclusion criteria. Numerous large studies demonstrated an association between pes planus and the prevalence and severity of hallux valgus. Biomechanical, radiological and cadaveric studies showed increased 1stTMT joint mobility in hallux valgus in planus feet, but several series suggest that this may be a result rather than cause of the deformity while others have identified alternative points of 1st ray instability. Studies of surgical outcome showed mixed results, but mild, asymptomatic pes planus was generally not associated with clinically significant recurrence following metatarsal osteotomy, while more severe deformity was associated with modest increases in radiographic recurrence that appeared non-progressive.</p><p><strong>Conclusions: </strong>1st TMT joint instability is common in hallux valgus with concomitant pes planus but is only one of many potential points of medial column failure and appears to be more often the result, rather than cause, of the deformity. The existing evidence does not justify routine 1st TMT joint fusion for hallux valgus in mild to moderate asymptomatic pes planus.</p><p><strong>Level of evidence: </strong>level III.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018277","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":"Response to the letter to the editor to comment on \"ChatGPT answers patient questions about hallux rigidus: Is it satisfactory?\"","authors":"Mahmut Kalem, Kamil Balaban, Merve Dursun Savran, Hakan Kocaoğlu, Ercan Şahin","doi":"10.1016/j.fas.2026.05.011","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.011","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983944","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":"Reliability, validity and responsiveness of the Portuguese Manchester-Oxford Foot Questionnaire (MOXFQ) in patients undergoing foot and ankle surgery.","authors":"Afonso Cardoso, Lucas Armada, José Mateus, António Serrano, Micael Belo, Isabel Rosa, João Vide, Daniel Sá da Costa, Daniel Mendes","doi":"10.1016/j.fas.2026.05.010","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.010","url":null,"abstract":"<p><strong>Background: </strong>The Manchester-Oxford Foot Questionnaire (MOXFQ) demonstrates strong psychometric properties among foot and ankle PROMs, but no validated European Portuguese version exists. This multi-center study aimed to translate and validate the MOXFQ for European Portuguese.</p><p><strong>Methods: </strong>The MOXFQ was translated following established guidelines. Patients undergoing elective foot and ankle surgery completed the Portuguese MOXFQ and FAOS preoperatively and postoperatively. Psychometric evaluation included test-retest reliability (intraclass correlation coefficient), internal consistency (Cronbach's α), construct validity (Spearman correlations), floor/ceiling effects, responsiveness, and minimal important change estimates.</p><p><strong>Results: </strong>Among 181 patients, test-retest reliability was excellent (ICC 0.836-0.914), internal consistency was good to excellent (α=0.804-0.941), and construct validity was supported by correlations with FAOS (ρ=-0.458 to -0.806). Large responsiveness was demonstrated (effect sizes 0.90-1.27). Completion rates were higher for MOXFQ than FAOS (91.3% vs 76.7%).</p><p><strong>Conclusion: </strong>The European Portuguese MOXFQ is a valid, reliable, and responsive instrument for foot and ankle surgery outcomes.</p><p><strong>Levels of evidence: </strong>Level II, prospective diagnostic study.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989782","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":"Letter to the editor to comment on ChatGPT answers patient questions about hallux rigidus: Is it satisfactory?","authors":"Ismail Sivri, Esra Babaoglu, Emre Kaygin, Tuncay Colak","doi":"10.1016/j.fas.2026.03.015","DOIUrl":"https://doi.org/10.1016/j.fas.2026.03.015","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989824","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":"Letter to the editor to comment on \"Total ankle replacement versus nonoperative management for end-stage ankle osteoarthritis: A comparative analysis\".","authors":"Ziliang Cheng","doi":"10.1016/j.fas.2026.04.010","DOIUrl":"https://doi.org/10.1016/j.fas.2026.04.010","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220334","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":"Fibular nailing is associated with fewer complications in high-risk ankle fractures: A propensity score-matched case-control study.","authors":"Iker Benegas-Lage, Ferran Blasco-Casado, María-Mercedes Reverté-Vinaixa, Oriol Pujol-Alarcón, Marta Altayó-Carulla, Sara Castellanos-Alonso, Jordi Teixidor-Serra, Jordi Tomàs-Hernández, Jordi Selga-Marsà, Carlos Alberto Piedra-Calle, Yaiza García-Sánchez, José-Vicente Andrés-Peiró","doi":"10.1016/j.fas.2026.05.006","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.006","url":null,"abstract":"<p><strong>Purpose: </strong>Ankle fractures are common, with higher complication rates in elderly, comorbid patients and those with complex injury patterns. Minimally invasive techniques such as intramedullary fibular fixation have gained interest for their potential to reduce morbidity. This study compared outcomes of fibular nailing versus plating in high-risk ankle fractures and aimed to identify the patient profile most likely to benefit from intramedullary fixation.</p><p><strong>Methods: </strong>A retrospective, propensity score-matched case-control study was conducted at a level I Trauma Center. Patients with low-energy rotational ankle fractures treated with either an intramedullary fibular nail (Fibula Rod System, Acumed) or a locking plate were included. Matching was based on age, ASA score, open fracture, fracture-dislocation, and soft tissue condition. Outcomes included postoperative complications, operative time, hospital stay, and time to full weight-bearing.</p><p><strong>Results: </strong>A total of 204 patients were analyzed (51 treated with fibular nailing and 153 with plate fixation). Nailing was performed in older patients (mean age 67.7 years) with relevant comorbidities (mean ASA score 2.2) and complex injuries, including open fractures (17.6%), fracture-dislocations (39.2%), and soft tissue compromise (58.8%). After matching, baseline characteristics were comparable between groups. The nailing group showed fewer major complications (3.9% vs. 18.3%, p = 0.01), no minor complications (vs. 19.0%, p < 0.01), shorter operative time (63.1 vs. 100.6 min, p < 0.01), and earlier full weight-bearing (36.0 vs. 51.1 days, p < 0.01).</p><p><strong>Conclusion: </strong>Intramedullary fibular nailing appears to be a safe and effective alternative to plating in high-risk, complex ankle fractures.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151930","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}