Journal of Foot & Ankle Surgery最新文献

The Association of Anterior Soft Tissue Depth (ASTD) with Wound Dehiscence Following Total Ankle Arthroplasty. 前软组织深度 (ASTD) 与全踝关节置换术后伤口开裂的关系。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-26 DOI: 10.1053/j.jfas.2025.03.015

Lauren M Christie, Avery Thomson, Charles Korba, Andreas C Kaikis, William M Wolfe, D Scot Malay

{"title":"The Association of Anterior Soft Tissue Depth (ASTD) with Wound Dehiscence Following Total Ankle Arthroplasty.","authors":"Lauren M Christie, Avery Thomson, Charles Korba, Andreas C Kaikis, William M Wolfe, D Scot Malay","doi":"10.1053/j.jfas.2025.03.015","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.03.015","url":null,"abstract":"Total ankle arthroplasty (TAA) is a common intervention for the treatment of end-stage ankle arthritis. Unfortunately, use of a longitudinal anterior incision to gain access to the ankle is commonly associated with postoperative wound dehiscence. In this retrospective cohort study the incidence of postoperative anterior wound dehiscence following TAA in 100 consecutive patients was 21%, and 7 (33.33%) of the dehiscence cases were serious enough to require additional operative treatment. The anterior soft tissue depth (ASTD) at the level of the tibiotalar joint was measured from the anterior margin of the skin to the anterior margin of the ankle as viewed on the standard lateral radiograph. The overall median ASTD for the entire cohort was 21.79 (range 5.7 to 37.3) mm, whereas that in the non-dehiscence group was 22.06 (5.7, 37.3) mm and that in the dehiscence group was 18.6 (12.78, 35.9) mm, and this difference was statistically significant (p = 0.0240). Receiver operating characteristic (ROC) curve analyses showed that a preoperative ASTD ≤ 16 mm maximized diagnostic sensitivity and specificity and predicted dehiscence.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744163","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}

引用次数: 0

Prospective Multicenter Study Assessing Radiographic and Patient Outcomes Following an Instrumented Mini-Open Triplanar Tarsometatarsal Arthrodesis with Early Weightbearing. 前瞻性多中心研究：评估早期负重的微型开放式三平面跖跗关节置换术后的影像学和患者疗效。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-26 DOI: 10.1053/j.jfas.2025.03.018

Jody Peter McAleer, Amber M Shane, Marque A Allen, Avneesh Chhabra, Justin Daigre, Daniel C Farber, Deidre Kile, Jeffrey E McAlister, Abdi Raissi, Paul Steinke, Robert P Taylor, Robert D Santrock

{"title":"Prospective Multicenter Study Assessing Radiographic and Patient Outcomes Following an Instrumented Mini-Open Triplanar Tarsometatarsal Arthrodesis with Early Weightbearing.","authors":"Jody Peter McAleer, Amber M Shane, Marque A Allen, Avneesh Chhabra, Justin Daigre, Daniel C Farber, Deidre Kile, Jeffrey E McAlister, Abdi Raissi, Paul Steinke, Robert P Taylor, Robert D Santrock","doi":"10.1053/j.jfas.2025.03.018","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.03.018","url":null,"abstract":"This prospective, multicenter study assessed the radiographic, clinical, and patient-reported outcomes for hallux valgus (HV) correction performed with an instrumented 1st tarsometatarsal (TMT) system through a mini-open incision (≤4cm) with a biplanar plating construct and early return to weightbearing. One hundred and five patients were treated, with 75 and 11 patients completing their 12- and 24-month visits, respectively. The median (min, max) length of the primary dorsal incision was 3.5 cm (3.0, 4.0). Patients underwent an early weightbearing protocol with mean (95% CI) of 7.9 (6.7, 9.1) days to weightbearing in a CAM boot. Significant improvements from baseline in mean radiographic measurements for Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), Tibial Sesamoid Position (TSP), and osseous foot width (OFW) were maintained through 12 months. Using recurrence definitions of greater than 15° and 20° postoperative HVA, recurrence rates were 5.5% (95% CI: 1.5%, 13.4%) and 0.0% at 12 months and 0.0% for both thresholds at 24 months, respectively. Significant improvements in patient-reported outcomes [Visual Analog Scale (VAS), Manchester-Oxford Foot Questionnaire (MOxFQ) and Patient-Reported Outcomes Measurement Information System (PROMIS)] were maintained through 12 and 24 months. A clinically meaningful assessment of the scar appearance was observed in the POSAS scores. One (1.0%) patient in the overall treated cohort of 105 required reoperation for removal of hardware due to pain. The results of this prospective, multicenter study on a mini-open 1st TMT system demonstrated improvements in radiographic correction, low recurrence, early return to activity with low complication rates, and improvements in patient-reported outcomes.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744162","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}

引用次数: 0

Nationwide Surgical Trends for Bunionectomies in Medicare Beneficiaries: An Increase in Lapidus Bunionectomy Procedure. 医疗保险受益人拇趾外翻切除术的全国手术趋势：Lapidus 拇趾外翻切除术的增加。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-26 DOI: 10.1053/j.jfas.2025.03.019

Ahad A Kesaria, Sterling J DeShazo, Oluwatofe Alimi, Vinod K Panchbhavi

{"title":"Nationwide Surgical Trends for Bunionectomies in Medicare Beneficiaries: An Increase in Lapidus Bunionectomy Procedure.","authors":"Ahad A Kesaria, Sterling J DeShazo, Oluwatofe Alimi, Vinod K Panchbhavi","doi":"10.1053/j.jfas.2025.03.019","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.03.019","url":null,"abstract":"Both orthopedic surgeons and podiatric surgeons perform the Hallux Valgus (HV) Bunionectomy, yet limited information exists on which procedures are being performed more often and which specialty is performing them.. This study aims to analyze specialty-specific trends in treatment for HV within the Medicare population. In a retrospective analysis, data for bunionectomies from 2013 to 2022 were obtained from the Centers for Medicare & Medicaid Services. Bunionectomies were identified using Current procedural terminology [CPT] codes (28292, 28296, 28297, 28298, 28299 from 2013-2022 and 28295 from 2017-2022). The results were further categorized based on operator type (orthopedist, podiatrist) and place of service (inpatient, outpatient, other). Work Relative Value Units (wRVU) were calculated for osteotomy and Lapidus procedures. 217,750 bunionectomies were identified. From 2013 to 2022, the number of bunionectomies declined from 81.48 to 42.18 per 100,000 patients, a decrease of 48.23%. Orthopedic surgeons had a 9.8% increase in relative procedure share of bunionectomies performed and a 12.95% decrease in bunionectomies performed per 100,000 patients compared to a 9.8% decrease and 54.12% decrease, respectively, for podiatrists. There was a 67.32% increase in Lapidus procedures (CPT Code: 28297) performed per 100,000 patients from 2013 to 2022. Outpatient services increased by 0.1%, inpatient increased by 0.1%, and other places decreased by 0.2%.There was a substantial decline in bunionectomies performed in the Medicare population between 2013 to 2022 with an increase in the number of Lapidus procedures. Trends show an increase in utilization of orthopedic surgeons for bunionectomies and minimal change in place of service.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744160","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}

引用次数: 0

Are immediate postoperative X-rays of value in foot surgery patients?

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-25 DOI: 10.1053/j.jfas.2025.03.016

Rahul Mishra, John M Giurini

{"title":"Are immediate postoperative X-rays of value in foot surgery patients?","authors":"Rahul Mishra, John M Giurini","doi":"10.1053/j.jfas.2025.03.016","DOIUrl":"10.1053/j.jfas.2025.03.016","url":null,"abstract":"A prospective nonrandomized study was conducted on consecutive patients undergoing foot surgery at a single academic medical center from April 1, 2022 through June 30, 2022. All patients underwent elective bone surgery, e.g. hallux abductovalgus surgery, lesser metatarsal osteotomy, midfoot procedures, hindfoot procedures. All patients obtained immediate x-rays in the post-anesthesia care unit per postoperative protocol at the medical center. A total of 56 patients were enrolled. The study was approved by the Institutional Review Board (IRB) of the medical center. The primary aim of the study was to determine if immediate postoperative x-rays altered the course of patient care in terms of unplanned return to the operating room, change in immobilization or a change in weightbearing recommendations. Eighteen (32 %) patients underwent hallux abductovalgus surgery, 10 (18 %) patients underwent lesser metatarsal surgery, 3 (5 %) underwent midfoot procedures, 10 (18 %) underwent hindfoot procedures and 15 (27 %) underwent other bone procedures. No patient required an early or unplanned return to the operating room based on the results of the immediate postop x-rays and 0 patients experienced a change in postoperative immobilization or weightbearing instructions. This relatively small prospective study suggests there is little value in obtaining immediate postoperative x-rays in the postanesthesia care unit as none resulted in immediate changes in postoperative management of patients. While immediate postoperative radiographs can be advantageous in specific clinical scenarios, the routine adoption of this practice should be carefully evaluated, considering added costs resulting in limited clinical benefits.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732242","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}

引用次数: 0

Evaluating the role of fluoroscopy in calcaneal pin placement.

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-25 DOI: 10.1053/j.jfas.2025.03.017

Fatih Barça, Ekin Barış Demir, Mustafa Fatih Sarı, Mutlu Akdoğan, Yalım Ateş, Halis Atıl Atilla

{"title":"Evaluating the role of fluoroscopy in calcaneal pin placement.","authors":"Fatih Barça, Ekin Barış Demir, Mustafa Fatih Sarı, Mutlu Akdoğan, Yalım Ateş, Halis Atıl Atilla","doi":"10.1053/j.jfas.2025.03.017","DOIUrl":"10.1053/j.jfas.2025.03.017","url":null,"abstract":"Although fluoroscopy-assisted calcaneal pin placement for ankle-spanning external fixation or skeletal traction was advocated in the literature, evidence for necessity of fluoroscopy for this application is lacking. This study aimed to compare the calcaneal pin locations and complications of patients who underwent pin placement with and without fluoroscopy guidance. In this retrospective cohort study, adult patients that underwent external fixation for ankle fractures between October 2022 and May 2024 were included. The primary outcome was the rate of the pins that were inside the safe zone. Secondary outcomes were the distance of pins to the tip of medial malleolus and the posteriormost point of calcaneus and complications such as neurovascular deficit and calcaneal fracture. Eighty-two patients (mean age 47±16.4 - min. 18 - max. 89, 54.9 % male) were involved in the study. Forty-five patients (group 1) had their pins placed without fluoroscopy assistance and thirty-seven patients (group 2) with fluoroscopy assistance. Five patients (11.1 %) in group 1 and seven patients (18.9 %) in group 2 had their pins placed outside the safe zone (P = 0.320). Distance of the hole from medial malleolus was mean 38.8 ± 7.9 mm for group 1 and 51.3 ± 8.32 mm for group 2 (P < 0.001), and distance from posteriormost point of calcaneus was mean 25.2 ± 6.3 mm for group 1 and 21.4 ± 7.9 mm for group 2 (P = 0.019). No neurovascular complications or calcaneal fracture were seen during follow-up. In conclusion, fluoroscopy guidance does not provide any additional benefit for placing calcaneal pins.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732542","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}

引用次数: 0

Comparison outcomes of cheilectomy, hemi-implant arthroplasty and decompression osteotomy for the treatment of hallux rigidus: A retrospective study of 153 patients.

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-22 DOI: 10.1053/j.jfas.2025.03.009

Ashley A Mariano, Lawrence M Fallat

{"title":"Comparison outcomes of cheilectomy, hemi-implant arthroplasty and decompression osteotomy for the treatment of hallux rigidus: A retrospective study of 153 patients.","authors":"Ashley A Mariano, Lawrence M Fallat","doi":"10.1053/j.jfas.2025.03.009","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.03.009","url":null,"abstract":"This retrospective case series investigated the treatment outcomes for hallux rigidus. A total of 153 patients (130 females, 49 males) were included. Of the 153 patients, 26 were bilateral and 179 procedures met the inclusion criteria. The patients had undergone 1 of the following procedures: cheilectomy (Group 1), hemi-implant arthroplasty (Group 2), decompression metatarsal osteotomy (DMO) (Group 3), and DMO with hemi-implant (Group 4). Mean patient age was 57 years (range 18-82), and the mean follow-up period was 26 months (range 12-72). All patients regardless of procedure had improvement in pain score with Group 4 demonstrating the greatest reduction in pain at 99 %. The majority of patients in the study had Stage II hallux limitus/rigidus (HL/HR) (67 patients), followed by 62 patients with Stage III and 49 patients with Stage IV. Preoperatively, the majority of patients lacked dorsiflexion at the first metatarsophalangeal joint. Group 1 gained 16° in dorsiflexion from preoperative to postoperative, Group 2 gained 20°, Group 3 gained 30° and Group 4 gained 24° by the 12 month followup. The results revealed that adhesions were the most common complication for all 4 surgical groups. These four surgical procedures for the treatment of Stage II, III and IV hallux rigidus are viable options and lead to satisfactory long-term outcomes that restore function, relieve pain and improve joint range of motion. Each procedure has demonstrated satisfactory long-term outcomes and high patient satisfaction.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677399","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}

引用次数: 0

Effects of kinesio taping versus extracorporeal shock wave therapy on pain in the treatment of plantar heel pain secondary to plantar fasciitis and a calcaneal spur: A retrospective clinical trial.

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-21 DOI: 10.1053/j.jfas.2025.03.011

Selda Çiftci İnceoğlu, Aylin Ayyıldız, Banu Kuran

{"title":"Effects of kinesio taping versus extracorporeal shock wave therapy on pain in the treatment of plantar heel pain secondary to plantar fasciitis and a calcaneal spur: A retrospective clinical trial.","authors":"Selda Çiftci İnceoğlu, Aylin Ayyıldız, Banu Kuran","doi":"10.1053/j.jfas.2025.03.011","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.03.011","url":null,"abstract":"Plantar heel pain is a common musculoskeletal problem in adults that causes limitation and disability in daily life activities. This study aimed to compare the effects of extracorporeal shock wave therapy(ESWT) and kinesio taping(KT) treatments on pain, functionality and quality of life in the treatment of plantar heel pain secondary to plantar fasciitis and a calcaneal spur. Patients who received ESWT or KT treatment for plantar heel pain between September 2023 and February 2024 were retrospectively screened. Before treatment and at the third month after treatment, pain levels were evaluated with Visual Analog Scale (VAS), sensitivity with Heel Tenderness Index (HTI), functional status with Foot Function Index (FFI) and quality of life with the 12-item short form health survey(SF-12).A total of 60 patients were included in the study,32 patients in the ESWT group and 28 patients in the KT group. There was no significant difference between the groups in terms of age, gender, VAS value, HTI level, FFI value and SF-12 physical component score (PCS) before treatment. There was a significant improvement in VAS, HTI, FFI, and SF-12 PCS evaluations after treatment in both groups compared to the baseline. Furthermore, while both treatment methods resulted in a regression in VAS levels and improvement in FFI scores, the KT group demonstrated significantly better outcomes than the ESWT group. There was no significant difference in improvement in SF-12 PCS scores between the two groups. Our study indicates KT may be more effective than ESWT for treating plantar heel pain in terms of pain and functionality, but both treatment modalities have similar effects on quality of life. LEVEL OF EVIDENCE: Level III.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694298","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}

引用次数: 0

Satisfactory Patient Reported Outcomes at Five Years Following Primary Repair with Suture Tape Augmentation for Anterior Talofibular Ligament Injury.

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-21 DOI: 10.1053/j.jfas.2025.03.010

Paul McMillan, William T Wilson, Graeme P Hopper, Gordon MacKay

{"title":"Satisfactory Patient Reported Outcomes at Five Years Following Primary Repair with Suture Tape Augmentation for Anterior Talofibular Ligament Injury.","authors":"Paul McMillan, William T Wilson, Graeme P Hopper, Gordon MacKay","doi":"10.1053/j.jfas.2025.03.010","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.03.010","url":null,"abstract":"The Brostrom technique is widely accepted as the gold standard surgical intervention for the treatment of chronic lateral ankle instability. Concerns with persistent postoperative instability, incomplete restoration of preinjury biomechanical strength, and variable return-to-sport rates have, however, led to growing interest in novel augmentation procedures. Suture tape augmentation, which reinforces the anterior talofibular ligament and acts as a secondary stabilizer, is one such method. This study assesses 5-year patient-reported outcomes of primary repair with suture tape augmentation for anterior talofibular ligament injuries. Seventy-seven patients undergoing anterior talofibular ligament repair with suture tape augmentation were prospectively followed for at least 5-years. The visual analogue scale for pain (VAS), veteran rands 12 (VR-12) score, functional foot index (FFI), and the foot and ankle ability measure sports subscale (FAAM-S) were assessed at baseline, 2-year follow-up and 5-year follow-up. Of the seventy-seven patients initially included, sixty-eight (88.3%) completed follow-up. The median VAS, VR-12, FFI, and FAAM-S scores all demonstrated significant improvement at both 2-year and 5-year follow-up, compared to preoperative baseline. Only the FFI demonstrated improvement between the 2-year and 5-year follow-up timepoints. In conclusion, primary repair with suture tape augmentation for anterior talofibular ligament injury demonstrates satisfactory patient-reported outcomes at a minimum of 5-year follow-up. These results suggest that this technique should be considered as an alternative to conventional Brostrom repair for treatment of lateral ankle instability. LEVEL OF EVIDENCE: Level IV.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694299","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}

引用次数: 0

Direct or indirect reduction internal fixation for posterior ankle fractures: A systematic review and meta-analysis.

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-19 DOI: 10.1053/j.jfas.2025.03.014

GuiSong Yu, YuPeng Dong, YuBo Cui, ZhiJun Yang, Xing Fu, Dian Li, WenLong Yang, FengYun Yang

{"title":"Direct or indirect reduction internal fixation for posterior ankle fractures: A systematic review and meta-analysis.","authors":"GuiSong Yu, YuPeng Dong, YuBo Cui, ZhiJun Yang, Xing Fu, Dian Li, WenLong Yang, FengYun Yang","doi":"10.1053/j.jfas.2025.03.014","DOIUrl":"10.1053/j.jfas.2025.03.014","url":null,"abstract":"Direct or indirect internal fixation for posterior ankle fractures remains a controversial topic. While direct plate or screw internal fixation is believed to provide better reduction, it may also cause more severe soft tissue damage, while indirect screw internal fixation is thought to result in less damage but may carry the risk of poor reduction. We conducted this meta-analysis to investigate the clinical efficacy and safety of direct versus indirect reduction internal fixation for posterior ankle fractures. The Preferred Reporting Items for Systematic Evaluation and Meta-Analysis (PRISMA) guidelines were used to search the China Knowledge Network database (CNKI), PubMed, Web of Science, Embase, and other databases from the year of establishment- February 2025, and relevant journals were manually searched to collect the relevant literature, and articles that met the requirements were screened and analyzed. Meta-analysis was conducted using RevMan 5.4 software, and a systematic evaluation was carried out when the data from the included studies could not be synthesized. A total of 17 articles involving 1538 study subjects were included, and the results showed that there were no statistical differences in postoperative AOFAS scores, complications, and Dorsiflexion restriction between ankle fractures after direct plate or screw reduction and fixation and those after indirect screw reduction and fixation; however, the Radiological evaluation>2 mm and Osteoarthritis (P < 0.05) were statistically different. Direct reduction and fixation of posterior ankle fractures has better imaging performance and reduces the incidence of postoperative arthritic events.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674638","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}

引用次数: 0

The role of local flap reconstruction for limb salvage in patients with moderate to severe medial arterial calcification.

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-18 DOI: 10.1053/j.jfas.2025.03.013

Rachel N Rohrich, Karen R Li, Ryan P Lin, Sami Ferdousian, Isabel A Snee, Roumina Adab, Jayson N Atves, John S Steinberg, Richard C Youn, Karen K Evans, Cameron M Akbari, Christopher E Attinger

{"title":"The role of local flap reconstruction for limb salvage in patients with moderate to severe medial arterial calcification.","authors":"Rachel N Rohrich, Karen R Li, Ryan P Lin, Sami Ferdousian, Isabel A Snee, Roumina Adab, Jayson N Atves, John S Steinberg, Richard C Youn, Karen K Evans, Cameron M Akbari, Christopher E Attinger","doi":"10.1053/j.jfas.2025.03.013","DOIUrl":"10.1053/j.jfas.2025.03.013","url":null,"abstract":"The medial arterial calcification (MAC) scoring system (Figure 1) predicts adverse limb events. This study applies MAC scoring to patients undergoing local flap reconstruction. To do so, we reviewed patients that underwent foot and ankle local flaps from January 2010 to November 2022. Radiographs were used to assign MAC scores: absent (MAC=0-1), moderate (MAC=2-3), or severe (MAC≥4). 182 patients underwent local flap reconstruction: 104 (57.1 %) absent MAC, 32 (17.6 %) moderate MAC, and 46 (25.3 %) severe MAC. Patients with severe MAC demonstrated significantly higher rates of diabetes mellitus (p = 0.001), end-stage renal disease (p < 0.001), and peripheral neuropathy (p < 0.001), and more often required a vascular intervention before reconstruction (p = 0.001). Flap-related outcomes and major limb amputation rates were statistically comparable among MAC groups. By a median of 16.5 (IQR: 36.6) months, limb salvage was 84.1 % and not independently associated with MAC on multivariable analysis. Postoperative vascular intervention (absent: 10.7 % vs. moderate: 28.1 % vs. severe: 17.4 %; p = 0.054), podiatric reoperation (absent: 35.6 % vs. moderate: 40.6 % vs. severe: 56.5 %; p = 0.056), and mortality (absent: 19.4 % vs. moderate: 34.4 % vs. 32.6 %; p = 0.102) were not independently associated with MAC on multivariable analysis. Given these results, local flaps are a viable option in patients with MAC. If utilizing a vasculo-plastic approach, severe MAC should not prevent limb salvage efforts via local flap reconstruction.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671671","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}

引用次数: 0