Journal of Foot & Ankle Surgery最新文献

{"title":"Functional Outcomes Comparing Open Reduction and Internal Fixation With and Without Bone Graft Substitute for Sanders Type III Calcaneus Fractures.","authors":"K C Athish, Raju Karuppal, Khayas Omer Kunheen, Karthik Raj","doi":"10.1053/j.jfas.2025.08.017","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.08.017","url":null,"abstract":"<p><strong>Background: </strong>Sanders Type III fractures of the calcaneus present a challenging injury often treated with open reduction and internal fixation (ORIF). The benefit of adding bone graft substitutes to enhance healing and outcomes remains uncertain.</p><p><strong>Purpose: </strong>To compare the clinical and radiological results of ORIF performed with versus without the use of bone graft substitutes in patients with Sanders Type III calcaneal fractures.</p><p><strong>Study design: </strong>A prospective cohort study.</p><p><strong>Methods: </strong>Fifty adult patients diagnosed with Sanders Type III calcaneal fractures were prospectively divided into two groups. Group 1 received ORIF combined with bone graft substitute implantation, while Group 2 underwent ORIF alone. Radiographic evaluation involved measuring Bohler's and Gissane's angles preoperatively and at intervals immediately post-surgery, 3 months, and 6 months afterward. Functional outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score.</p><p><strong>Results: </strong>Both groups showed marked improvement in Bohler's and Gissane's angles postoperatively (p < 0.05). Functional scores improved over time with no significant difference in AOFAS hindfoot scores between groups at 6 months (p > 0.05). Patients treated with bone graft substitutes reported more early postoperative discomfort and serous wound discharge.</p><p><strong>Conclusion: </strong>Although bone graft substitutes may assist in filling bone voids and provide initial mechanical support, their routine use may not be required for satisfactory outcomes when stable fixation is achieved in Sanders Type III calcaneal fractures.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202024","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":"Early Weight-bearing Following Modified Lapidus Arthrodesis: A Retrospective Review of 104 Cases & Postoperative Protocol.","authors":"Mr Akram Uddin, Mr John W Bramall, Dr Keng LeongNG, Dr Kajetan Klos, Dr Edgar Roth, Prof Derek Santos","doi":"10.1053/j.jfas.2025.09.001","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.09.001","url":null,"abstract":"<p><strong>Background: </strong>Lapidus arthrodesis is indicated for the treatment of first ray dysfunction or hypermobility, hallux valgus (HV) and functional hallux limitus (FHL). Postoperative weightbearing protocols vary amongst surgeons.</p><p><strong>Purpose: </strong>To report radiographic osseous healing and patient-reported outcome measures (PROMS) following a single early weightbearing protocol.</p><p><strong>Study design: </strong>Retrospective review of 104 adults (≥18 years) (104 feet) who underwent open modified Lapidus arthrodesis (without bone graft) by single compression screw and medial locking plate by two surgeons at one centre (between January 2019 to May 2023).</p><p><strong>Methods: </strong>Pre- and postoperative radiographs and electronic records were reviewed for evidence of osseous healing and return to full weightbearing. Secondary measures included deformity reduction and PROMS.</p><p><strong>Results: </strong>At 6-weeks follow-up 98 patients (94%) were confirmed of osseous healing and returned to full weightbearing. Six patients (6%) had delayed osseous healing at 6-weeks but showed signs of osseous healing by 3-months follow-up. Postoperative HV and intermetatarsal angle (IMA) showed significant reduction (mean difference: -12 (SD=8) and -5 (SD=4) degrees respectively; p<0.001 for both). Ten patients (10%) had postoperative complications: hardware irritation 5 (5%), sesamoiditis 2 (2%), hypertrophic scar 2 (2%) and joint stiffness 1 (1%). Eight patients (8%) required further surgery (5 required fixation removal due to hardware irritation. Three underwent either; 1^st MTPJ open-mobilization, excision of scar or distal metatarsal osteotomy with tibial sesamoid planning). Manchester-Oxford Foot Questionnaire (MOXFQ) showed significant improvement across all domains (mean difference (SD): -51 (SD=22); walking/standing -49 (SD=24); pain -52 (SD=22); and social interaction -51 (SD=28); (p<0.001 for all) with clinically significant effect size (Cohen's d: 2.37; 2.01; 2.37; and 1.84 respectively). Patient satisfaction questionnaire (PSQ-10) score was high mean of 91 (SD=8). 5 patients (5%) were lost by 6-months follow-up.</p><p><strong>Conclusion: </strong>Early weightbearing achieved consistent osseous healing and high PROMS. Larger controlled studies are required to validate these results.</p><p><strong>Level of evidence: </strong>Retrospective study.</p><p><strong>Level iii: </strong></p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193779","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":"Central Sensitization and Pain Phenotypes in Symptomatic Pes Planus: A Multicenter Cross-Sectional Study.","authors":"Gülseren Demir Karakılıç, Melek Aykut Selçuk, Esra Mert","doi":"10.1053/j.jfas.2025.09.008","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.09.008","url":null,"abstract":"<p><strong>Background: </strong>Pes planus (PP) is a common foot disorder often associated with persistent pain despite treatment. Central sensitization (CS) and nociplastic pain (NcP) are potential contributors but remain underexplored in PP.</p><p><strong>Purpose: </strong>To investigate the prevalence of CS and nociplastic-like features in patients with symptomatic PP and examine their associations with pain, disability, psychological distress, and quality of life.</p><p><strong>Study design: </strong>Multicenter cross-sectional study.</p><p><strong>Methods: </strong>A total of 107 patients with diagnosed PP and 107 age- and sex-matched healthy controls were enrolled. Participants completed Turkish versions of Visual Analog Scale (VAS), Foot Function Index (FFI), Pain-DETECT, Central Sensitization Inventory (CSI), Hospital Anxiety and Depression Scale (HADS), and Short Form-12 (SF-12). Group comparisons, correlation analyses, and regression models were performed to identify predictors of nociplastic-like features and CS.</p><p><strong>Results: </strong>Compared with controls, PP patients reported greater pain (VAS mean difference 3.9, 95% CI 3.1-4.7) and disability (FFI mean difference 45.8, 95% CI 41.2-50.4). Probable nociplastic-like features were identified in 48.6% of PP versus 3.7% of controls, and CSI ≥40 in 61.7% versus 43.9%. Anxiety and depression scores were higher in PP, while SF-12 physical and mental scores were lower. In regression models, pain duration, intensity, disability, and CS predicted nociplastic-like features, while CS was predicted by pain severity, disability, nociplastic-like features, and psychological distress.</p><p><strong>Conclusion: </strong>Symptomatic PP is not solely a structural condition but involves central and psychosocial mechanisms. Recognition of CS and nociplastic processes supports multidisciplinary management strategies that address biomechanical, central, and psychological contributors to persistent pain.</p><p><strong>Level of evidence: </strong>Level III, Cross-sectional study.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193690","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":"Comparison of elastic fixation and rigid fixation in the treatment of distal tibiofibular syndesmosis injury.","authors":"Ke Chen, Qiang Zhu, Wenping Huo, Jian Zhang, Shitao Wang","doi":"10.1053/j.jfas.2025.09.003","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.09.003","url":null,"abstract":"<p><strong>Objective: </strong>Compare clinical outcomes of elastic (Rigidloop) vs. rigid (screw) fixation for distal tibiofibular syndesmosis injury.</p><p><strong>Methods: </strong>Eighty-eight patients were divided into an elastic fixation group (n=43) and a rigid fixation group (n=45) groups, with the elastic fixation group undergoing Rigidloop fixation and the rigid fixation group undergoing screw fixation. Clinical data (operation time, blood loss, weight-bearing/fracture healing time), radiographic parameters (talocalcaneal fusion site [TFCS], tibiofibular overlap [TFO], medial clear space [MCS]), American Orthopaedic Foot and Ankle Society (AOFAS) scores, plantar flexion range, and complications were analyzed.</p><p><strong>Results: </strong>Preoperative and 12-month TFCS, TFO, and MCS were comparable (P >0.05). The elastic fixation group had shorter operation time (60.23±11.67 vs. 66.32 ± 12.28 min), reduced blood loss (151.05 ± 21.04 vs. 159.47 ± 22.11 mL), earlier weight-bearing (6.12 ± 1.06 vs. 7.75 ± 1.36 weeks), and faster wound/fracture healing compared with the rigid fixation group(P <0.05). At 3 months, the elastic fixation group showed superior plantar flexion (42.68 ± 4.00 vs. 40.18 ± 4.08°) and AOFAS scores (81.30 ± 5.23 vs. 77.98 ± 5.70 points, P <0.05), but both groups tended to be consistent by 12 months (P >0.05). Complications of the elastic fixation group (loosening, infection, re-separation) were lower (9.3% vs. 24.4%, P <0.05); satisfaction rates were similar (P >0.05).</p><p><strong>Conclusion: </strong>Rigidloop fixation is as effective as screw fixation in stabilizing syndesmosis injuries, and the Rigidloop system has the advantages of faster recovery, fewer complications, and early functional benefits, making it superior to screw fixation.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193773","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":"Can an Isolated Modified Lapidus Procedure Alter Hindfoot Alignment? A Retrospective Radiographic Study.","authors":"Ramy Samargandi, Aimery Sabelle, Jean Brilhault, Julien Berhouet, Rayane Benhenneda","doi":"10.1053/j.jfas.2025.09.002","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.09.002","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to evaluate the effect of first tarsometatarsal joint (TMT-1) arthrodesis using the modified Lapidus procedure on coronal hindfoot alignment, given the potential influence of medial column stabilization on talar positioning.</p><p><strong>Study design: </strong>A retrospective radiographic analysis was performed.</p><p><strong>Methods: </strong>We reviewed 54 feet in 40 patients (mean age 60.6 ± 9.78 years) who underwent an isolated modified Lapidus procedure with an average follow-up of 29.6 ± 13.9 months. Fixation was achieved using a compression screw and plantar plate. Preoperative and 12-month postoperative weight-bearing dorsoplantar, lateral, and Méary views were analyzed. Radiographic measurements were independently performed by two senior surgeons and assessed for inter-observer reliability. Importantly, only radiographic outcomes were evaluated.</p><p><strong>Results: </strong>On Méary view, hindfoot valgus decreased significantly using the Méary's circle angle method (-2.0 ± 2.0° for observer 1 and -2.44 ± 1.84° for observer 2; p < 0.001 for both). Djian's hindfoot valgus angle also decreased significantly (-1.44 ± 0.98°, p < 0.001 for observer 1; -1.67 ± 4.09°, p = 0.004 for observer 2). Inter-observer reliability was good (ICC = 0.87 and 0.80, respectively).</p><p><strong>Conclusion: </strong>The modified Lapidus procedure resulted in a significant radiographic reduction in hindfoot valgus, suggesting a stabilizing effect on the medial column and hindfoot. These radiographic findings may inform surgical planning in patients with hallux valgus and concomitant flatfoot, although further clinical validation is required.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193686","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":"Histopathological Analysis from Proximal Bone Samples During Minor Amputations for Diabetes-related Foot Infections: A Single-center, Retrospective Study.","authors":"Henco Nel, Lucy Stopher, Joseph Hanna, Laurens Manning, Shirley Jansen, Thomas Gliddon","doi":"10.1053/j.jfas.2025.08.014","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.08.014","url":null,"abstract":"<p><strong>Background: </strong>Minor amputations, defined as resection of bone below the ankle, are important procedures for managing diabetes-related foot infections (DFI). The optimal method to determine the presence of residual bone infection is unclear and unplanned reoperation rates are common. Although international guidelines endorse the use of histopathology, this approach has not been universally adopted.</p><p><strong>Purpose: </strong>We evaluated the utility of histopathological analysis from samples collected from 'proximal' or 'marginal' bone during minor amputations.</p><p><strong>Study design: </strong>A retrospective, single-center study was conducted at Sir Charles Gairdner Hospital, in Perth, Western Australia.</p><p><strong>Methods: </strong>The primary outcome of interest was treatment success at six months, defined as being alive and no unplanned reoperation at the original operation site.</p><p><strong>Results: </strong>Of 67 cases, 22 (33%) had positive histopathology. Patients with positive margins were less likely to have treatment success compared to those with negative margins (50% versus 82%; P=0.006). Antibiotic duration was significantly shorter in patients with negative histopathological margins compared to patients with positive histopathological margins (median 14 vs 42 days; P=0.0003). The concordance between histopathology and microbiology was 51%.</p><p><strong>Conclusion: </strong>Positive histopathology was associated with lower rates of treatment success, despite receiving longer antibiotic durations. Positive culture from the same samples were not predictive of outcome. Larger, prospective studies are needed to define optimal sampling methods and antibiotic therapy following minor amputation.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187335","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":"Evaluation of K-Wires Splinting of First and Second Metatarsals Following Proximal Open Wedge Osteotomy for Hallux Valgus Correction.","authors":"Abou Bakr Zein Mohammed, Ahmed Mahmoud Kholif, Ali Mohammed Reda, Hosam El-Din Amin, Sayed Naser Abdallah Naser","doi":"10.1053/j.jfas.2025.09.009","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.09.009","url":null,"abstract":"<p><strong>Background: </strong>Hallux valgus is a prevalent foot deformity affecting a significant portion of the population and often managed through various surgical techniques. Proximal opening wedge osteotomy of the first metatarsal bone is a popular and effective management modality, yet there remains no consensus on the optimal fixation method PURPOSE: Evaluating the outcomes of K-wires fixation versus plate and screws fixation following proximal opening wedge osteotomy of the first metatarsal bone for managing moderate to severe hallux valgus STUDY DESIGN: Retrospective multicenter cohort study.</p><p><strong>Methods: </strong>Forty patients were evenly divided into two groups; Group A (K-wires fixation to the second metatarsal) and Group B (plate and screws fixation). Patients were followed up for at least 1 year.</p><p><strong>Results: </strong>Both groups showed significant improvements in hallux valgus angle, inter-metatarsal angle, and American Orthopedic Foot and Ankle Society scores, with no significant differences between them. However, K-wires fixation was associated with lower implant costs (P = 0.01), and fewer subsequent surgeries (P = 0.01). Complications such as complex regional pain syndrome and wound issues were more frequent in the plate group, with six cases requiring plate removal due to prominence CONCLUSION: K-wire fixation is a cost-effective and reliable alternative to plate and screws fixation, offering similar clinical outcomes while reducing secondary surgical intervention rates.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187359","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":"Comparison of Popliteal Nerve Block and Combined Spinal-Local Infiltration Anesthesia in Hallux Valgus Surgery: A Randomized Clinical Trial.","authors":"Leonieke N Palmen, Myrthe P F van de Ven, Elcke Karthaus, Martin Hagenaars, Sander Koëter, Justus H W Jansen","doi":"10.1053/j.jfas.2025.08.016","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.08.016","url":null,"abstract":"<p><strong>Background: </strong>Early mobilization and adequate pain relief are important in hallux valgus surgery. The effect of anesthesia technique on post-operative mobility has not been well studied.</p><p><strong>Purpose: </strong>In search for the anesthesia technique that allows best for early mobility, a prospective clinical trial was conducted to compare popliteal nerve block anesthesia with combined local infiltration anesthesia (LIA) and spinal anesthesia.</p><p><strong>Study design: </strong>Randomized clinical trial METHODS: Thirty-three patients eligible for hallux valgus surgery were prospectively randomized to receive either LIA/spinal anesthesia (n=14) or popliteal nerve block anesthesia (n=17). Hallux valgus surgery was performed in a short stay clinical setting, facilitating data collection during an overnight stay. Patients were postoperatively mobilized both on the day of surgery, and the next day. The primary outcome was early postoperative mobility. Intra- and postoperative pain relief, and patient satisfaction were secondary outcomes.</p><p><strong>Results: </strong>On the day of surgery, independent mobilization and weight-bearing ability of patients who received LIA/spinal anesthesia were significantly better (p=0.022, p=0.010), compared to patients receiving the popliteal nerve block. The next day, independent mobilization did not differ between the 2 groups, although the weight bearing ability was better in patients who received LIA/spinal anesthesia. No significant between-group differences were observed in intra- and postoperative pain. High satisfaction with the anesthetic technique was achieved in both groups.</p><p><strong>Conclusion: </strong>LIA/spinal anesthesia was associated with earlier independent ambulation and weight-bearing, suggesting potential benefits for outpatient hallux valgus surgery. However, both popliteal nerve block anesthesia and LIA/spinal anesthesia are suitable for hallux valgus surgery, with adequate pain relief and high patient satisfaction.</p><p><strong>Level of clinical evidence: </strong>Level 2.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187345","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":"Comparative Study of Concurrent Arthroscopic Anterior Talofibular Ligament Repair and Posterior Ankle Debridement: Novel Adjustable Lateral Floating Position versus Traditional Repositioning with Re-preparation.","authors":"Fan Ding, Kuankuan Yu, Jie Zhang, Sha Li, Yan Chen, Shijun Wei","doi":"10.1053/j.jfas.2025.08.015","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.08.015","url":null,"abstract":"<p><strong>Purpose: </strong>The goal of this study was to compare our novel adjustable lateral floating position with traditional repositioning and re-prepping for concurrent arthroscopic anterior talofibular ligament (ATFL) repair and posterior ankle debridement.</p><p><strong>Study design: </strong>Retrospective control study.</p><p><strong>Methods: </strong>From 2019 to 2022, fifty-four cases underwent concurrent arthroscopic ATFL repair and posterior ankle debridement were retrospectively analyzed. According to the intraoperative position, 26 cases were assigned to group A (novel adjustable lateral floating position) and 28 to group B (traditional repositioning). The Foot and Ankle Ability Measure scales [FAAM, including activities of daily living (FAAM-ADL) and sports subscales (FAAM-SS)] and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores were compared. The surgical time and complications were also evaluated.</p><p><strong>Results: </strong>The average follow-up time was 26.2 ± 2.5 months (range, 24-28 months) without significant differences between the groups. There was no significant difference between FAAM-ADL, FAAM-SS, and AOFAS scores at the final follow-ups. No significant difference in complication rates was found. However, there is a significant difference in median and interquartile range (IQR) of the surgical time between both groups [58.0 (50.0, 74.0) vs. 78.0 (68.5, 88.5)], with a large effects size (Cohen's d = -0.75). It is notable that the surgical times of patients with postoperative deep vein thrombosis exceeded 110 minutes in both groups.</p><p><strong>Conclusion: </strong>For the concurrent arthroscopic ATFL repair and posterior ankle debridement, the novel adjustable lateral floating position is time-saving and reliable. This novel surgical positioning is also suitable for a younger or more junior surgeon.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187407","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":"Postoperative Complications After Hammertoe Correction: The Influence of Tobacco and Non-Tobacco Nicotine.","authors":"Joshua Wang, Apurvakumar Patel, Philong Nguyen, Megna Panchbhavi, Vinod K Panchbhavi","doi":"10.1053/j.jfas.2025.09.007","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.09.007","url":null,"abstract":"<p><strong>Background: </strong>Nicotine use is associated with impaired wound healing and heightened perioperative risks. However, non-tobacco sources such as e-cigarettes and its impact on postoperative complications following hammertoe correction surgery remains underexplored.</p><p><strong>Purpose: </strong>To evaluate the association between nicotine use and postoperative complications after hammertoe correction, comparing outcomes among tobacco-derived nicotine users, non-tobacco nicotine users, and non-nicotine users.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>A multi-institutional database (TriNetX) was queried to identify adult patients undergoing hammertoe correction. Patients were stratified into three cohorts: (1) nicotine users, (2) non-tobacco nicotine users (e.g., e-cigarette users), and (3) non-nicotine users. Propensity score matching was performed to control for confounders such as age, sex,race, and comorbities. Postoperative complications within 30 days were assessed, including wound disruption, infection, sepsis, deep vein thrombosis (DVT), and pulmonary embolism (PE).</p><p><strong>Results: </strong>Compared to non-nicotine users, both nicotine-exposed cohorts exhibited higher postoperative complication rates. Among tobacco nicotine users, complication rates were: wound disruption (2.7%), infection (1.7%), sepsis (0.4%), DVT (1.1%), and PE (0.5%). Non-tobacco nicotine users also demonstrated increased complications: wound disruption (2.3%), infection (1.7%), sepsis (0.4%), DVT (1.2%), and PE (0.5%).</p><p><strong>Conclusion: </strong>Nicotine exposure, whether from tobacco or alternative sources, is associated with significantly increased postoperative risks following hammertoe surgery. These findings highlight the importance of preoperative nicotine cessation strategies to reduce surgical complications and improve patient outcomes.</p><p><strong>Level of clinical evidence: </strong>Level 3, Retrospective Comparative Study.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186483","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}