Journal of Foot & Ankle Surgery最新文献

{"title":"Early Versus Delayed Rehabilitation Following First Metatarsophalangeal Joint Implant Arthroplasty: A Retrospective Comparison of 40 Cases.","authors":"Jagoda Głodkowska-Sutuła, Igor Świerkowski","doi":"10.1053/j.jfas.2026.10.015","DOIUrl":"https://doi.org/10.1053/j.jfas.2026.10.015","url":null,"abstract":"<p><strong>Background: </strong>First metatarsophalangeal (MTP) joint implant arthroplasty is used to preserve joint mobility and reduce pain in patients with advanced hallux rigidus. The optimal timing of postoperative rehabilitation remains unclear.</p><p><strong>Purpose: </strong>To compare clinical outcomes associated with early versus delayed rehabilitation following first MTP joint implant arthroplasty.</p><p><strong>Study design: </strong>Retrospective comparative study.</p><p><strong>Methods: </strong>Forty patients who underwent first MTP joint implant arthroplasty were analyzed. Twenty initiated rehabilitation immediately after suture removal (mean, 2.1 ± 0.4 weeks after surgery), whereas 20 initiated rehabilitation later (mean, 21.4 ± 3.0 weeks after surgery). Both groups followed the same standardized rehabilitation protocol. Outcomes assessed before and after rehabilitation included dorsiflexion, plantarflexion, pain intensity using the Visual Analog Scale (VAS), and the AOFAS Hallux Score. Group × Time interactions were evaluated using mixed-design ANOVA and linear mixed-effects models adjusted for age and sex.</p><p><strong>Results: </strong>Greater improvements were observed in the early rehabilitation group for dorsiflexion (+12.35° vs +6.75°), plantarflexion (+4.70° vs +1.70°), VAS (-3.35 vs -1.50), and AOFAS score (+26.90 vs +11.00). Significant Group × Time interactions were found for all outcomes (p ≤ 0.001), and the associations remained significant after adjustment for age and sex.</p><p><strong>Conclusions: </strong>Early rehabilitation was associated with greater improvements in joint mobility, pain, and functional outcomes than delayed rehabilitation. Given the retrospective, nonrandomized design and differences in postoperative assessment timing, these findings should be interpreted cautiously and confirmed in prospective studies.</p><p><strong>Level of evidence: </strong>III (Retrospective comparative study).</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149301746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Statistical Robustness of Literature on Extracorporeal Shockwave Therapy for the Treatment of Plantar Fasciitis.","authors":"Prabhjot Singh, Mark Kurapatti, Niklas Koehne, Ishandeep Singh, Jennifer Yu, Gray W Ricca, Nicholas Richardson, Robert L Parisien","doi":"10.1053/j.jfas.2026.10.014","DOIUrl":"https://doi.org/10.1053/j.jfas.2026.10.014","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal shockwave therapy (ESWT) is widely used in the treatment of plantar fasciitis; however, the statistical robustness of randomized controlled trials (RCTs) supporting its use remains unclear. This study evaluates the fragility of dichotomous outcomes in RCTs on ESWT for plantar fasciitis using fragility index (FI) and fragility quotient (FQ) metrics.</p><p><strong>Methods: </strong>A systematic search of PubMed and Scopus was conducted on March 1, 2025, to identify RCTs investigating ESWT for plantar fasciitis. Eligible studies included dichotomous outcomes in comparison to no treatment or alternative interventions. FI was calculated using two-tailed Fisher's exact tests. FQ was computed by dividing FI by the study's sample size. Subgroup analyses were conducted based on outcome type.</p><p><strong>Results: </strong>Nineteen RCTs met inclusion criteria, yielding 159 dichotomous outcomes. Of these, 20 outcomes were statistically significant (p < 0.05) and 139 were nonsignificant. The overall median FI was 5 (IQR:3-6) and FQ was 0.061 (IQR:0.040-0.108), indicating that reversal of 6.1% of patient outcomes could change statistical significance. Among significant outcomes, the median FI was 5 (IQR:2-11) and FQ was 0.029 (IQR:0.016-0.212). Pain outcomes were most frequently reported (n = 112). Subgroup analysis revealed that outcomes related to physical function were most fragile (FQ:0.036), while ultrasound-based outcomes were least fragile (FQ:0.081). In 20.75% of outcomes, the number of patients lost to follow-up exceeded the FI, suggesting that outcome significance could be altered by follow-up alone.</p><p><strong>Conclusions: </strong>Dichotomous outcomes in RCTs evaluating ESWT for plantar fasciitis demonstrate notable statistical fragility. Given that a small number of event reversals can shift the interpretation of many findings, clinicians should interpret statistically significant ESWT outcomes with caution. Future studies should incorporate fragility metrics to improve transparency and support more reliable clinical decision-making.</p><p><strong>Study type: </strong>Systematic Review.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screw Versus Kirschner Wire Fixation in Myerson Type B Lisfranc Injuries: A Retrospective Comparative Cohort Study With Plantar Pressure Assessment.","authors":"Gürkan Çalışkan, Yunus Elmas, Orhun Çelik, Avni Tan, Cemil Ertürk","doi":"10.1053/j.jfas.2026.10.016","DOIUrl":"https://doi.org/10.1053/j.jfas.2026.10.016","url":null,"abstract":"<p><strong>Background: </strong>Injury characteristics influence fixation choice and may also affect recovery after Lisfranc injury.</p><p><strong>Purpose: </strong>To compare clinical, radiographic, and plantar-pressure outcomes after screw or Kirschner wire (K-wire) fixation of Myerson type B injuries.</p><p><strong>Study design: </strong>Retrospective comparative cohort study.</p><p><strong>Methods: </strong>Thirty-six screw-treated and 20 K-wire-treated patients were assessed after at least 12 months. Outcomes included the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, Manchester-Oxford Foot Questionnaire (MOXFQ), visual analog scale (VAS) pain, Meary angle, and midfoot pressure asymmetry. Unadjusted comparisons, three regression models, and weighted sensitivity analyses were exploratory.</p><p><strong>Results: </strong>The screw group had more high-energy injuries (25/36 versus 8/20) and open reductions (24/36 versus 6/20). After adjustment for age, injury energy, subtype, comminution, and maximum diastasis, K-wire fixation was associated with shorter operative time (difference -16.1 minutes; 95% confidence interval -25.4 to -6.8; p < 0.001) and higher pain (+0.87 VAS points; 95% confidence interval 0.17-1.57; p = 0.015). Both associations persisted across analyses. Functional-score and pressure comparisons were inconclusive; Meary-angle estimates varied by model.</p><p><strong>Conclusions: </strong>K-wire fixation was associated with shorter operations and modestly higher pain. Clinical importance remains uncertain. Unmeasured injury severity, rehabilitation differences, and selective implant removal limit interpretation. These findings establish neither superiority nor equivalence and require prospective confirmation.</p><p><strong>Level of clinical evidence: </strong>Level III (Therapeutic).</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149276488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PEEK in Pediatric Calcaneal Lengthening: Alternative or Compromise? A Randomized Controlled Trial.","authors":"Moaaz Ali Hamoud, Mahmoud Elnemr","doi":"10.1053/j.jfas.2026.10.013","DOIUrl":"https://doi.org/10.1053/j.jfas.2026.10.013","url":null,"abstract":"<p><strong>Background: </strong>The optimal interposition material for lateral calcaneal lengthening osteotomy (LCLO) in pediatric flexible flatfoot remains uncertain. Iliac autogenous bone graft (AIBG) provides structural support but requires donor-site harvest; polyetheretherketone (PEEK) cages avoid a second incision.</p><p><strong>Methods: </strong>This randomized controlled trial included 60 unilateral feet in 60 patients allocated 1:1 to PEEK or AIBG. Weight-bearing radiographs were obtained preoperatively, immediately postoperatively, at 3 months, 6 months, 12 months, and final follow-up (minimum 24 months; mean 29 months). Six angles were assessed by two blinded observers. Longitudinal outcomes were analyzed using two-way repeated-measures ANOVA with Greenhouse-Geisser correction when required and Bonferroni-adjusted post-hoc comparisons.</p><p><strong>Results: </strong>Final American Orthopaedic Foot & Ankle Society (AOFAS) scores were 87.04±7.42 with PEEK and 88.31±6.56 with AIBG (p=0.489). All six angles showed their largest correction immediately postoperatively, followed by smaller changes in the same corrective direction. Time effects were significant, whereas treatment × time interactions were nonsignificant. Preoperative-to-immediate correction was significant for all angles; later changes were smaller. Union occurred in all feet. Composite complications were higher with PEEK (27% vs 3%; p=0.026).</p><p><strong>Conclusion: </strong>PEEK and AIBG produced similar functional and radiological trajectories, but the higher complication rate (27% vs 3%) with PEEK supports further comparative evaluation. The results illustrate how structural correction can be distinguished from later remodeling when repeated radiographic measures are analyzed.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admission C-Reactive Protein-to-Albumin Ratio Is Associated With Early Major Amputation After Minor Amputation in Patients With Infected Foot Wounds.","authors":"Han Bin Kim, Min Kyun Cho, Jung Shin Kim, Sung Yoon Jung, Myoung Jin Lee","doi":"10.1053/j.jfas.2026.10.011","DOIUrl":"https://doi.org/10.1053/j.jfas.2026.10.011","url":null,"abstract":"<p><strong>Background: </strong>Minor amputation is commonly performed as a limb-salvage procedure for infected foot wounds; however, some patients experience early limb-salvage failure and progress to major amputation. Reliable biomarkers predicting early failure remain limited.</p><p><strong>Purpose: </strong>To evaluate whether the admission C-reactive protein-to-albumin ratio (CAR) is associated with major amputation within 90 days after minor amputation in patients with infected foot wounds.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>Patients who underwent minor amputation for infected foot wounds between March 2005 and September 2025 were retrospectively reviewed. Of 358 screened patients, 257 met the inclusion criteria. Admission CAR was calculated from C-reactive protein and serum albumin levels. The primary outcome was major amputation within 90 days. Univariable logistic regression and multivariable Cox proportional hazards analyses were performed. Predictive performance was evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Among 257 patients, 60 (23.3%) progressed to major amputation within 90 days. Higher admission CAR values were significantly associated with major amputation. CAR remained an independent predictor in multivariable analysis (hazard ratio 1.17; 95% confidence interval 1.05-1.31; p value = .004). Adding CAR improved the predictive performance of the baseline model (area under the curve .883 vs .810).</p><p><strong>Conclusions: </strong>Admission CAR is a simple and independent factor associated with early major amputation after minor amputation and may help facilitate early risk stratification.</p><p><strong>Level of clinical evidence: </strong>Level III.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injury Patterns, In-Hospital Outcomes, and Resource Utilization of Acute Cuboid and Navicular Fractures.","authors":"Daniel Liu, Puranjay Gupta, Jamal Ahmad","doi":"10.1053/j.jfas.2026.10.012","DOIUrl":"https://doi.org/10.1053/j.jfas.2026.10.012","url":null,"abstract":"<p><strong>Background: </strong>Acute cuboid and navicular fractures can be serious injuries. However, multicenter data on their associated injuries and in-hospital course are limited.</p><p><strong>Purpose: </strong>To characterize the demographics, injury patterns, in-hospital outcomes, and resource utilization of trauma center patients with acute cuboid and/or navicular fractures.</p><p><strong>Study design: </strong>Retrospective cross-sectional database study.</p><p><strong>Methods: </strong>The American College of Surgeons National Trauma Data Bank (2017-2019) was queried for acute cuboid and/or navicular fractures. Multivariable regression identified factors associated with discharge to post-acute care, intensive care unit (ICU) admission, and hospital length of stay in adults.</p><p><strong>Results: </strong>Overall, 3,424 patients with 4,084 fractures were identified (2,327 with cuboid and 1,637 with navicular fractures, including 540 with both). Road-traffic mechanisms accounted for 64.5%, and 25.1% had polytrauma. Metatarsal, calcaneal, and talar fractures were the most common concomitant injuries. Combined fractures were more often ipsilateral than contralateral (457 vs 18 patients). Despite infrequent complications, 50.2% were discharged home without post-acute services (home health, inpatient rehabilitation, or skilled nursing care). In-hospital mortality was 1.1%. After adjustment, polytrauma (OR 3.75, 95% CI 3.04-4.61), bilateral involvement, and ankle, tibia, fibula, or metatarsal fractures were associated with discharge to post-acute care, whereas fracture pattern was not.</p><p><strong>Conclusions: </strong>Cuboid and navicular fractures are predominantly high-energy injuries that rarely occur in isolation. Post-acute care needs, ICU admission, and length of stay were associated with overall injury burden rather than the specific bone fractured.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of CT-based posterior malleolar fracture classifications on clinical outcomes in bimalleolar ankle fractures involving the posterior and lateral malleoli.","authors":"Sezai Çaltepe, Murathan Güler, Aykut Ceylan, Mehmet Bayram Çakır, Musa Berkay Alp, Abdulkadir Polat","doi":"10.1053/j.jfas.2026.10.010","DOIUrl":"10.1053/j.jfas.2026.10.010","url":null,"abstract":"<p><strong>Background: </strong>The prognostic value of computed tomography (CT)-based posterior malleolar fracture classifications in uniformly treated fractures remains uncertain.</p><p><strong>Purpose: </strong>To examine associations of the Haraguchi, Bartoníček/Rammelt, and Mason-Molloy classifications with 1-year functional and early radiographic outcomes.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>Fifty-eight patients with posterior malleolar and Weber B lateral malleolar fractures underwent fixation of both malleoli through a posterolateral approach. Outcomes were the 1-year American Orthopedic Foot & Ankle Society (AOFAS) score and Kellgren-Lawrence grade. Classification subgroups were compared using Kruskal-Wallis tests; fragment dimensions were assessed using Spearman correlations.</p><p><strong>Results: </strong>Mean AOFAS score was 92.97 ± 5.28 (95% confidence interval [CI], 91.58-94.35); 10 patients (17%) scored 100 and 24 (41%) scored ≥95. Subgroup mean scores were 91.0-93.3 for Haraguchi (p = 0.994), 84.0-96.5 for Bartoníček/Rammelt (p = 0.130), and 87.0-93.3 for Mason-Molloy (p = 0.836). Kellgren-Lawrence grades did not differ across Haraguchi, Bartoníček/Rammelt, or Mason-Molloy subgroups (p = 0.449, p = 0.277, and p = 0.608, respectively). AOFAS correlations with axial and sagittal fragment lengths were ρ = 0.001 (95% CI, -0.273 to 0.285; p = 0.992) and ρ = 0.049 (95% CI, -0.242 to 0.342; p = 0.717), respectively.</p><p><strong>Conclusions: </strong>No significant associations with 1-year outcomes were detected. Small, uneven subgroups and upper-end AOFAS clustering limited precision; potentially meaningful prognostic associations cannot be excluded.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Infection Rate in Open Anterior Talofibular Ligament Repair with Internal Brace Augmentation and Immediate Permissive Weight Bearing.","authors":"Jerry Poon, Bart Lambert, Astrid J de Vries, Tom M van Raaij","doi":"10.1053/j.jfas.2026.10.008","DOIUrl":"https://doi.org/10.1053/j.jfas.2026.10.008","url":null,"abstract":"<p><strong>Background: </strong>Modified Broström repair is the gold standard for chronic lateral ankle instability. Internal brace augmentation was introduced to increase ligament strength and allow earlier rehabilitation, but concerns exist regarding surgical site infection (SSI).</p><p><strong>Purpose: </strong>To compare the incidence of SSI following anterior talofibular ligament (ATFL) repair with internal brace augmentation and immediate permissive weight bearing versus ATFL repair without augmentation and restricted rehabilitation.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>Patients undergoing open ATFL repair with internal brace augmentation and immediate permissive weight bearing (ATFL-IB group) between January 2022 and February 2024 (n = 34) were compared with patients undergoing open ATFL repair without augmentation and restricted rehabilitation (ATFL group) between January 2016 and March 2019 (n = 31). The primary outcome was SSI, defined as infection within 90 days requiring antibiotic therapy or surgical intervention. Secondary outcomes included other complications. Baseline characteristics and SSI-related risk factors were assessed.</p><p><strong>Results: </strong>SSI occurred in 5 patients (15%) in the ATFL-IB group and none in the ATFL group (0%) (p = .034). Other complications included persistent ankle instability (3%) and malposition (3%) in the ATFL-IB group and knot pain (3%) in the ATFL group. Baseline characteristics and operative time were comparable, only smoking prevalence was higher in the ATFL group.</p><p><strong>Conclusions: </strong>ATFL repair with internal brace augmentation and immediate permissive weight bearing was associated with a higher SSI rate compared with ATFL repair without augmentation and restricted rehabilitation. Because augmentation and rehabilitation differed concurrently, their relative contributions could not be determined.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal Fixation Bone Mass Index (IFBM) and biomechanical performance of different fixation methods for Herscovici type B and type C medial malleolar fractures.","authors":"Ying Zhang, Zhenjun Zhang, Pan Hao, Bin Li, Zhaorui Liu","doi":"10.1053/j.jfas.2026.10.009","DOIUrl":"10.1053/j.jfas.2026.10.009","url":null,"abstract":"<p><strong>Background: </strong>Optimal fixation for Herscovici type B and type C medial malleolar fractures because of debated due to differences in fragment size and loading conditions.</p><p><strong>Purpose: </strong>This study introduces the theoretical concept of Internal Fixation Bone Mass Index (IFBM) and compares three fixation methods under multidirectional loading.</p><p><strong>Study design: </strong>Biomechanical study using Synbone® artificial tibia models.</p><p><strong>Methods: </strong>Synbone® tibia models simulated type B (small fragment, n = 27) and type C (large fragment, n = 27) fractures. Three fixation methods-cannulated screws (CS, 4.0 mm), fully threaded cancellous screws (FTCS, 4.0 mm), and Kirschner wires (KW, 1.5 mm)-were tested under axial, transverse, and traction loading using an Instron® 5969 machine. IFBM was defined as A_implant/A_bone.</p><p><strong>Results: </strong>For type B fractures, KW showed a higher 2 mm displacement load under traction than CS (65 ± 11 N vs. 31 ± 9 N; post-hoc p = 0.008) and FTCS (65 ± 11 N vs. 36 ± 12 N; post-hoc p = 0.012), with no statistically significant difference under axial and transverse loading (ANOVA p = 0.231 and p = 0.501). For type C fractures, CS and FTCS showed higher stability than KW under transverse and traction loading (ANOVA p = 0.004 and p = 0.003); no statistically significant difference was detected under axial loading (ANOVA p = 0.167).</p><p><strong>Conclusions: </strong>Fixation performance differed by fracture type. KW showed favorable performance for type B fractures, whereas screw fixation (CS or FTCS) demonstrated superior performance for type C fractures. IFBM is a theoretical metric that requires clinical validation.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of osteoporosis on ankle and hindfoot arthrodesis outcomes: a matched database analysis.","authors":"Nicholas R Kiritsis, Zodina Beiene, Samantha Morales, Conor O'Neill, Albert T Anastasio","doi":"10.1053/j.jfas.2026.10.007","DOIUrl":"10.1053/j.jfas.2026.10.007","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis increases fracture risk and impairs bone healing. Ankle, subtalar, and triple arthrodeses are often performed to repair complex osteoporotic ankle fractures. However, in osteoporotic patients, postoperative outcomes following these procedures remain uncharacterized.</p><p><strong>Purpose: </strong>To determine the impact of osteoporosis and disorders of bone mineral density (BMD) on outcomes following ankle, subtalar, and triple arthrodesis, and evaluate whether pharmacologic treatment influences outcomes in osteoporotic patients.</p><p><strong>Study design: </strong>This was a retrospective cohort study utilizing the TriNetX™ Research Network to identify patients who underwent ankle, subtalar, or triple arthrodesis between January 2010 and September 2024.</p><p><strong>Methods: </strong>Patients were stratified into three cohorts: osteoporosis, low BMD, and controls. One-to-one propensity-score matching balanced demographics and comorbidities. Primary outcomes were 90-day hospital utilization and 1-year pseudarthrosis rates. A secondary analysis compared outcomes among osteoporotic patients with pharmacologic treatment versus without.</p><p><strong>Results: </strong>Within 90 days of surgery, osteoporotic patients demonstrated higher overall adverse event, hospital readmission, and ED visit rates. At 1 year, the low BMD cohort showed increased incidence of mechanical loosening or displacement, and below-knee amputation when compared to controls, and lower pseudarthrosis rates. No significant differences were observed in 90-day or 1-year outcomes between osteoporotic patients with pharmacologic treatment versus without.</p><p><strong>Conclusions: </strong>Osteoporosis and low BMD are associated with increased morbidity following ankle, subtalar, and triple arthrodesis, particularly postoperative complications and mechanical failure. Osteoporotic patients demonstrated higher rates of adverse events, hospital readmission, and ED visits. This underscores the need for standardized preoperative bone health screening and targeted preoperative optimization strategies.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}