Foot and Ankle Surgery最新文献

{"title":"From anatomy to imaging: Towards a reliable MRI classification of the plantaris tendon.","authors":"Grégoire Rougereau, Cristian Cumpana, Eugénie Valentin, Agathe Yvinou, Alexandre Hardy","doi":"10.1016/j.fas.2026.05.002","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.002","url":null,"abstract":"<p><strong>Background: </strong>The plantaris tendon is common but anatomically variable, and some distal insertions may contribute to Achilles tendon disorders. No validated, reproducible MRI-based classification currently exists.</p><p><strong>Methods: </strong>We retrospectively reviewed 281 ankle MRI examinations performed between 2020 and 2023 using a standardized 3 T protocol. Tendon morphology was classified according to Olewnik's five-type cadaveric system. Inter- and intra-observer reproducibility were assessed with Cohen's kappa and positive agreement. Because reproducibility was limited, a simplified four-type MRI-based classification was developed and tested.</p><p><strong>Results: </strong>The original five-type classification showed only moderate reproducibility (inter-observer κ = 0.56; intra-observer κ = 0.60), mainly because type 5 was unreliable. The simplified four-type classification improved reproducibility substantially (inter-observer κ = 0.75; intra-observer κ = 0.78).</p><p><strong>Conclusion: </strong>Olewnik's classification is only moderately applicable to MRI. A simplified four-type MRI-based system appears more reproducible and may provide a reliable framework for clinical research.</p><p><strong>Level of evidence: </strong>III - Retrospective diagnostic study.</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":"147976593","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":"Retrospective study investigating the effect of isolated proximal medial gastrocnemius release for recalcitrant plantar fasciitis.","authors":"Romaan Akichjev, Delphine Hamers, Geoffroy Vandeputte, Sander Wuite, Stefan Clockaerts","doi":"10.1016/j.fas.2026.05.004","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.004","url":null,"abstract":"<p><strong>Background: </strong>Plantar fasciitis (PF) is a well-known cause of inferior heel pain. Gastrocnemius tightness plays an important role in the pathophysiology. PF is mainly treated conservatively, but in a limited number of patients further surgery is needed. We investigated whether proximal medial gastrocnemius release (PMGR) as an isolated procedure is a successful treatment with low complication rates.</p><p><strong>Methods: </strong>This retrospective follow up included patients who underwent PMGR between August 2020 and December 2024 for recalcitrant PF. Diagnosis of PF was confirmed clinically and radiologically. A minimum of 6 months conservative treatment together with a positive Silfverskiöld's test was indicative for surgery. Pain and functional assessment were measured preoperatively, at 2 weeks and 2 years postoperatively using the European Foot and Ankle Society (EFAS) questionnaire and the Visual Analog Scale (VAS).</p><p><strong>Results: </strong>A total of 24 patients (34 feet) were included. The mean preoperative EFAS score improved from 1.79 ± 3.362-12.46 ± 7.14 at 2 weeks (P < 0.001) and to 22.08 ± 4.31 at 2 years postoperative (P < 0.001). The mean preoperative VAS score declined from 8.17 ± 1.05-4.67 ± 2.48 2 weeks postoperatively (P < 0.001) to 1.17 ± 2.51 2 years postoperatively (P < 0.001). There was 1 case of deep venous thrombosis with associated pulmonary embolism, no other complications were noted.</p><p><strong>Conclusions: </strong>PMGR provides good results for patients with recalcitrant plantar fasciitis with a high satisfaction and low complication rate.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989241","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":"Establishing clinical thresholds for PROMs in foot and ankle surgery enhancing interpretability of SEFAS and EQ-5D: A national register study.","authors":"Marcus A Hallerström, Cyrus Brodén, Maria C Cöster","doi":"10.1016/j.fas.2026.05.008","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.008","url":null,"abstract":"<p><strong>Background: </strong>Interpreting patient-reported outcomes (PROMs) is enhanced by establishing clinical threshold values. This study determined the minimal important change (MIC), patient acceptable symptom state (PASS), treatment failure (TF) thresholds and responsiveness for the Self-reported Foot and Ankle Score (SEFAS) and the EuroQol 5 Dimensions (EQ-5D) in patients from the Swedish National Foot and Ankle Register (Swefoot).</p><p><strong>Methods: </strong>A cohort of 139 randomly selected patients (mean age 55, SD:13; 60% women) from Swefoot (2021-2024) was analyzed. MIC, PASS and TF thresholds were estimated using anchor-based adjusted predictive modelling with logistic regression. Responsiveness was evaluated using effect size (ES), calculated as the mean change divided by the preoperative standard deviation.</p><p><strong>Results: </strong>For forefoot disorders, SEFAS thresholds were: MIC 7.2, PASS 36.3 and TF 30.7. For ankle/hindfoot disorders, corresponding thresholds were: MIC 8.8, PASS 33.7 and TF 32.5. EQ-5D thresholds for forefoot disorders were: MIC 0.09, PASS 0.67 and TF 0.70; for ankle/hindfoot disorders: MIC 0.16, PASS 0.77 and TF 0.76. SEFAS responsiveness was 1.31 for forefoot and 1.64 for ankle/hindfoot; EQ-5D responsiveness was 0.69 and 0.97, respectively.</p><p><strong>Conclusion: </strong>The established thresholds enhance the interpretability and clinical utility of SEFAS and EQ-5D in patients undergoing foot and ankle surgery.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976557","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":"Complication and union rates of combined subtalar fusion and calcaneal osteotomy versus subtalar fusion alone in severe hindfoot deformity.","authors":"Jugert Bango, Callie Liu, Giselle Porter, Andy Tong, Edward T Haupt, Timothy Charlton","doi":"10.1016/j.fas.2026.05.005","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.005","url":null,"abstract":"<p><strong>Background: </strong>Subtalar arthrodesis (STA) is often used to correct arthritic hindfoot deformity, but calcaneal osteotomy (CO) may also be required. Few studies to date assess the outcomes of combined STA and CO compared to STA alone. This study aims to examine and compare union rates and complications between these groups.</p><p><strong>Methods: </strong>A retrospective review of patients aged 16 and older with stage 3-4 progressing collapsing foot deformity (PCFD) who underwent STA or STA and CO at the participating institutions was performed, with demographic matching between groups. Complications and radiographic union rates defined by greater than 50% osseus bridging on CT scans were compared using a two-tailed Fisher's exact test.</p><p><strong>Results: </strong>There were 21 patients in the STA and CO group, and 19 patients in our control group. There were no significant differences in complications between STA and the combined STA and CO group (p = 0.44). In both cohorts, only one case of delayed union was observed, with all other patients achieving union by the final follow up (p = 1.00).</p><p><strong>Conclusion: </strong>This study supports that performing CO with a STA may be utilized to prevent under correction of hindfoot deformity without additional wound complication risk.</p><p><strong>Level of evidence: </strong>Level III-Retrospective Comparative Study.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165414","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 - Defining failure in end-stage ankle osteoarthritis: How endpoint asymmetry and immortal time bias shape survival outcomes.","authors":"Junjun Zha, Hancheng Wang","doi":"10.1016/j.fas.2026.05.007","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.007","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007010","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":"Trephine-based in situ arthrodesis of the central tarsometatarsal joints: Clinical outcomes.","authors":"Rodrigo Díaz-Fernández, Nicolás Ruiz-Lozano, Javier Ortego-Sanz, Luis Cuesta-Saiz","doi":"10.1016/j.fas.2026.05.003","DOIUrl":"https://doi.org/10.1016/j.fas.2026.05.003","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis of the second and third tarsometatarsal (TMT) joints is a common cause of midfoot pain. Arthrodesis is a reliable treatment, although optimal joint preparation and fixation remain debated.</p><p><strong>Methods: </strong>A retrospective cohort study included 31 feet in 30 patients undergoing isolated or combined second and third TMT arthrodesis for idiopathic osteoarthritis (2016-2022). The technique used trephine-based joint preparation, calcaneal autograft, and nitinol staple fixation. Outcomes included MOXFQ, AOFAS scores, union, and complications.</p><p><strong>Results: </strong>Radiographic union was achieved in 95.5% of joints. MOXFQ improved from 33.3 to 9.9 and AOFAS from 37.6 to 77.3 (p < .001). No transfer metatarsalgia was observed. Implant removal occurred in 6.5% and staple breakage in 9.7%.</p><p><strong>Conclusion: </strong>This technique provides high union rates, significant functional improvement, and a low complication profile in selected patients.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934681","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 “Diagnosis, treatment, and prevention of ankle sprains: Comparing free chatbot recommendations with clinical guidelines”","authors":"Gongtao Jiang,&nbsp;Wei Fan,&nbsp;Qishui Xia","doi":"10.1016/j.fas.2025.09.001","DOIUrl":"10.1016/j.fas.2025.09.001","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"32 2","pages":"Page 193"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076383","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":"Return to sport after osteotomy in patients with hallux rigidus","authors":"P. Ceccarini,&nbsp;M. Donantoni ,&nbsp;G. Nuzzo,&nbsp;B. Carriero,&nbsp;G. Ancillai,&nbsp;G. Rinonapoli,&nbsp;A. Caraffa","doi":"10.1016/j.fas.2025.08.001","DOIUrl":"10.1016/j.fas.2025.08.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Hallux rigidus (HR) is a common degenerative condition of the first metatarsophalangeal joint (MTPJ), particularly limiting in active adults and athletes. While joint-sacrificing procedures such as arthrodesis are effective, joint-preserving techniques remain preferable in patients wishing to maintain function and mobility. The modified Youngswick osteotomy offers such an option by decompressing and realigning the joint.</div></div><div><h3>Methods</h3><div>This retrospective observational study included 55 physically active patients (mean age: 42.8 ± 8.5 anni years) with grade II HR who underwent modified Youngswick osteotomy between 2015 and 2022. Inclusion criteria included active engagement in sports, age under 60 years, and a minimum follow-up of 24 months. Clinical outcomes were assessed using the Visual Analog Scale (VAS), the European Foot and Ankle Society (EFAS) score, and return to sports (RTS) rates.</div></div><div><h3>Results</h3><div>At a mean follow-up of 79.3 months, 49 of 52 patients (94.2 %) resumed sports activities. Significant improvements were observed in VAS scores (from 5.04 to 0.9, <em>p</em> &lt; .001) and EFAS general (22.7 ± 6.1–37.1 ± 5.4, <em>p</em> &lt; .001) and sport-specific scores (9.3–14.3, <em>p</em> &lt; .001). Postoperative dorsiflexion improved from a mean of 24.5° to 52.5° (<em>p</em> &lt; .001). Complications were rare and mild, including two cases of transfer metatarsalgia and one hardware intolerance.</div></div><div><h3>Conclusion</h3><div>Modified Youngswick osteotomy is an effective joint-preserving surgical option for moderate HR in active adults. It provides excellent pain relief, improves function and range of motion, and allows for a high rate of return to sports. This technique represents a valid alternative to arthrodesis in patients wishing to maintain MTPJ mobility and an active lifestyle.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"32 2","pages":"Pages 145-151"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856723","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":"Percutaneous anterior to posterior screw fixation via lateral malleolus incision window for Bartoníček-Rammelt type 4 posterior malleolus fractures","authors":"Chunguang Sun ,&nbsp;Mu Han ,&nbsp;Hongjin Qi ,&nbsp;Wenshu Li ,&nbsp;Youhua Wang ,&nbsp;Cheng Li","doi":"10.1016/j.fas.2025.08.006","DOIUrl":"10.1016/j.fas.2025.08.006","url":null,"abstract":"<div><h3>Introduction</h3><div>The presence of a posterior malleolar (PM) fragment has a negative prognostic impact in ankle fractures. Percutaneous anterior to posterior screw fixation has been advocated for the treatment of ankle fractures involving the posterior malleolus and satisfactory results were demonstrated in several studies. The aim of this retrospective study was to evaluate the clinical effect of percutaneous anterior to posterior screw fixation via lateral malleolus incision window approach (APSF-LMA) for the treatment of posterior malleolus fracture (PMF) and present outcomes of patients with type 4 of Bartoníček-Rammelt classification in comparison to using the dorsiflexion ankle anterior posterior screw fixation (APSF-DA) and posterior plate fixation through posterolateral approach (PPF-PLA).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the clinical outcomes of 58 patients with ankle fractures involving Bartoníček-Rammelt type 4 PMF from January 2019 to December 2023. Comparisons were conducted between the groups regarding operative time, union time, the Olerud-Molander Ankle Score (OMAS), the EuroQol-5 Dimensions (EQ-5D), the American Orthopedic Foot and Ankle Society score (AOFAS), Kellgren-Lawrence (KL) osteoarthritis classification and clinical findings.</div></div><div><h3>Results</h3><div>The demographic characteristics were comparable between the groups. Fewer operative time was performed in the APSF-LMA (79(75–84.5) mins) and APSF-DA (78(70−85) mins) groups than in the PPF-PLA group (105(98−112) mins; <em>P</em> &lt; 0.0001). When compared with the other two approaches, the APSF-LMA approach was associated with higher AOFAS scores (<em>P</em> &lt; 0.05) and lower grade of KL (<em>P</em> &lt; 0.0001) at the last follow-up. No significant intergroup differences were detected in the incidence of complications (<em>P</em> &gt; 0.999), OMAS scores (<em>P</em> = 0.921) and EQ-5D (<em>P</em> = 0.806). Radiological and clinical findings demonstrated that fixation of the distal fibula (<em>P</em> = 0.727), the time of bony union and postoperative angulation (<em>P</em> = 0.846) were similar between the groups.</div></div><div><h3>Conclusions</h3><div>The APSF-LMA approach can serve as a safe and effective option for posterior malleolus fractures, as it offers favorable outcomes in ankle operation time and ankle functional recovery in the early postoperative period and is equivalent to the other two approaches in terms of the incidence of complications, fracture healing and postoperative angulation for patients with posterior malleolus fractures.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"32 2","pages":"Pages 176-182"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975189","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":"No difference in outcomes between golfers and non-golfers undergoing total ankle replacements","authors":"Jun Min Leow ,&nbsp;Nicholas Clement ,&nbsp;Andrew Murray ,&nbsp;Hisham Shalaby ,&nbsp;John Mckinley","doi":"10.1016/j.fas.2025.08.002","DOIUrl":"10.1016/j.fas.2025.08.002","url":null,"abstract":"<div><h3>Background</h3><div>The outcomes of total ankle replacements (TAR) in golfers are not known. The primary aim was to assess whether golfers experience similar improvements using the Manchester-Oxford Foot Questionnaire (MOXFQ) compared to the wider population. Secondary aims were to assess difference in demographics, health-related quality of life, and return to golf.</div></div><div><h3>Methods</h3><div>This was a retrospective review of prospectively collected data. Nineteen golfers and 144 non-golfers were included. Outcomes measured were MOXFQ, EQ5D3L and patient satisfaction.</div></div><div><h3>Results</h3><div>Golfers had significantly better MOXFQ scores preoperatively (p = 0.02) and postoperatively (p = 0.03), but there was no significant difference in mean change. Postoperative EQ5D3L scores were similar between groups. 52 % returned to golf within 6 months and 79 % within one year, similar to hip, knee and shoulder arthroplasty.</div></div><div><h3>Conclusion</h3><div>Golfers experience comparable improvements following TAR, with high rates of return to play. These findings may be used to counsel patients and manage expectations preoperatively.</div></div><div><h3>Level of evidence</h3><div>II</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"32 2","pages":"Pages 152-155"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876288","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}