Journal of Foot & Ankle Surgery最新文献_第2页

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

Distal tibial osteophytes are more accurate than medial malleolar anatomy when using patient specific instrumentation in total ankle replacement.

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-17 DOI: 10.1053/j.jfas.2025.03.012

Jason George DeVries, Andrew Regal, Tisileli S Tuifua, Brandon M Scharer

{"title":"Distal tibial osteophytes are more accurate than medial malleolar anatomy when using patient specific instrumentation in total ankle replacement.","authors":"Jason George DeVries, Andrew Regal, Tisileli S Tuifua, Brandon M Scharer","doi":"10.1053/j.jfas.2025.03.012","DOIUrl":"10.1053/j.jfas.2025.03.012","url":null,"abstract":"Total ankle replacement (TAR) is a treatment for end stage ankle arthritis. Patient specific instrumentation (PSI) has been used and shown to allow for accurate placement and alignment in TAR in the coronal and sagittal plane. PSI systems are available and use different anatomic landmarks for the cutting guides. This is a retrospective matched case control study comparing accuracy in alignment using 2 different PSI systems. The case series uses a medial malleolar landmark (MM Group), and each case patient was matched based on preoperative coronal plane alignment with 2 ankles in the control series using the distal tibial osteophytes as landmarks (DT Group), as this system has been in use and studied more. A total of 48 ankles were studied, 16 in the MM Group and 32 in the DT Group matched by coronal plane alignment. There was a difference in accuracy of postoperative coronal plane alignment, with the MM Group deviated from expected by 1.6° ± 1.3° compared to the DT Group at 1.1° ± 0.6°, p = 0.04. This corresponded to 68.8 % of MM Group ankles being within 2° of expected compared to 93.4 % of DT Group ankles. There was no statistically significant difference in sagittal plane alignment between the groups, p = 0.57. Procedure time was the only other statistically significant difference with the MM Group taking longer than the DT Group, 97.4 min and 80.6 min, respectively, p = 0.04. While both groups show good accuracy, alignment based on the distal tibial osteophytes is more accurate than using the medial malleolus.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665263","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

Defining the patient acceptable symptom state (PASS) for PROMIS after Hallux Rigidus correction surgery.

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-09 DOI: 10.1053/j.jfas.2025.03.008

Allison L Boden, Stone R Streeter, Seif El Masry, Grace M DiGiovanni, Matthew S Conti, Scott J Ellis

{"title":"Defining the patient acceptable symptom state (PASS) for PROMIS after Hallux Rigidus correction surgery.","authors":"Allison L Boden, Stone R Streeter, Seif El Masry, Grace M DiGiovanni, Matthew S Conti, Scott J Ellis","doi":"10.1053/j.jfas.2025.03.008","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.03.008","url":null,"abstract":"It is unclear which patient reported outcome metric correlates best with clinical improvement. The patient acceptable symptom state (PASS) incorporates the patient's subjective outcome experience into the outcome measurement. This study aims to establish PASS thresholds using Patient-Reported Outcome Measurement Information System (PROMIS) scores in patients undergoing hallux rigidus (HR) correction. A retrospective review of prospectively collected data identified 144 patients who were treated surgically for HR between February 2019 and March 2021, had preoperative and 2-year postoperative PROMIS scores, and had responses to two distinct PASS anchor questions. PASS thresholds were determined using the maximum Youden Index. Differences in demographic and surgical characteristics between patients who met or did not meet the PASS thresholds were compared using independent samples T-tests and Pearson Chi-Square tests. Overall, 70 % of patients met the PASS thresholds. Patients with better baseline PROMIS scores were more likely to meet the postoperative PASS thresholds for every PROMIS domain (p < 0.05). Patients who did not undergo first metatarsophalangeal (MTP) fusion were more likely to reach the PASS threshold for the Physical Function domain (p = 0.045). For the Pain Intensity domain, younger patients were more likely to meet the thresholds (p = 0.005). Patient sex, BMI, and use of either cheilectomy or Akin/Moberg osteotomy during surgery did not impact a patient's likelihood of meeting the PASS thresholds. After surgical intervention for HR, it may not be necessary for patients to reach normal physical function or pain levels in order to reach an acceptable postoperative symptom state. Level of Evidence: Level III, Retrospective Review.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607061","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

What is the best: Functional rehabilitation or traditional immobilization after double-row suture anchor repair for insertional Achilles tendinopathy?

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-08 DOI: 10.1053/j.jfas.2025.03.006

Daniel Soares Baumfeld, Gabriel Moraes de Oliveira, Otávio Vitório Alvarenga Pereira, Thiago Barreto Mafra Oliveira, Tiago Soares Baumfeld, Caio Nery

{"title":"What is the best: Functional rehabilitation or traditional immobilization after double-row suture anchor repair for insertional Achilles tendinopathy?","authors":"Daniel Soares Baumfeld, Gabriel Moraes de Oliveira, Otávio Vitório Alvarenga Pereira, Thiago Barreto Mafra Oliveira, Tiago Soares Baumfeld, Caio Nery","doi":"10.1053/j.jfas.2025.03.006","DOIUrl":"10.1053/j.jfas.2025.03.006","url":null,"abstract":"This retrospective study compared two rehabilitation methods for patients who underwent a double-row surgical technique for Insertional Achilles Tendinopathy (IAT). Group 1 (G1) received traditional immobilization with casting and no weightbearing for six weeks, while Group 2 (G2) followed a modern functional rehabilitation program with early weightbearing in a walking boot. Data were analyzed from 63 patients (68 feet), with 48 patients (51 feet) in G1 and 17 patients (17 feet) in G2. The minimum follow-up was two years (mean of 32 months, ranging from two to nine years). Pre- and postoperative data, including VAS (Visual Analog Scale) pain scores and functional scores, were collected at six months and at the final follow-up. Additionally, return-to-work, driving, and sports data were evaluated. Pre- and post-VAS scores for G1 were 7.49/1.39 and for G2 were 7.8/2.2, showing no significant difference (p = 0.89). The overall mean VAS improved from 7.56 to 1.58 postoperatively. The FAAM-ADL score was 81.68 points (88.28 %), with men experiencing statistically greater improvements than women. Patients in G2 returned to work, driving, and sports faster within the first six months. Although G2 initially had slightly higher functional scores, no significant differences were observed between the two groups after six months. Early functional rehabilitation facilitated a quicker return to daily activities without increasing pain but did not provide better long-term functional outcomes compared to traditional immobilization. Thus, early weightbearing aids short-term recovery but does not enhance functional scores beyond six months.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598237","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

Rate of bony union after Jones fracture fixation in the general population. 普通人群琼斯骨折固定术后的骨结合率

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-07 DOI: 10.1053/j.jfas.2025.03.004

Amber M Kavanagh, Brian J Burgess, David Garras, Aaron D Therien, Anand Vora

{"title":"Rate of bony union after Jones fracture fixation in the general population.","authors":"Amber M Kavanagh, Brian J Burgess, David Garras, Aaron D Therien, Anand Vora","doi":"10.1053/j.jfas.2025.03.004","DOIUrl":"10.1053/j.jfas.2025.03.004","url":null,"abstract":"Nonunion rates in the conservative treatment of Jones fractures can be high, therefore surgical intervention is often recommended. Most current studies in the literature look at a younger athletic population to assess bony union rates. Little has been published on healing rates in the general population. A retrospective chart review was performed of all patients undergoing surgical fixation of Jones fractures by three surgeons from 2015 to 2022. A total of 195 patients were collected. Radiographs were evaluated to determine time to fracture union, type of fixation construct, and risk factors for development of the fracture such as pes cavus and forefoot adduction. The bony union rate was 92.8 % with a nonunion rate of 7.2 % (14/195), a delayed union rate of 10.3 % (20/195), and a refracture rate of 4.1 % (8/195). The overall time to union was 14 weeks, with a median of 11 weeks in patients less than 30 years of age and 14 weeks in those greater than 30 years of age. Pes cavus was present in 42.1 % of patients and forefoot adduction in 32.8 %. Patients with increased age (p < 0.001) and type II diabetes (p = 0.04) were found to have statistically significant longer times to union. Metatarsus adductus was a significant predictor of nonunion status (p = 0.015). The primary aim of this study was to evaluate the healing rates of Jones fractures after fixation in the general population.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587781","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

Rejection rate, modifications, and turnaround time for patient specific instrumentation plans in total ankle replacement.

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-07 DOI: 10.1053/j.jfas.2025.03.007

Jason George DeVries, Brandon M Scharer

{"title":"Rejection rate, modifications, and turnaround time for patient specific instrumentation plans in total ankle replacement.","authors":"Jason George DeVries, Brandon M Scharer","doi":"10.1053/j.jfas.2025.03.007","DOIUrl":"10.1053/j.jfas.2025.03.007","url":null,"abstract":"Patient specific instrumentation (PSI) in total ankle replacement (TAR) has been reported to be accurate and time saving. However, there has been criticism regarding accuracy and an overreliance on the preoperative plan. This is a retrospective review of a single surgeon's PSI plans from 2016-2024. We report rejection rates, modifications, and turnaround time. A total of 101 plans were reviewed and found an overall rejection rate of 17.8 %, with 18 reports rejected. Average turnaround time was 29:07 hours. When comparing the 1st half of the study period to the second half, a statistically significant increase in rejection rate was found, 0 % to 45 %, p < 0.0001. In addition, there was a higher rate of rejection on more complicated stemmed implants or revision implants compared to low profile implants. This report shows there is not a blind trust of the engineer's plan, and with experience with PSI rejection rate increases. Also, the engineer's understanding of complicated cases is addressed with higher rates of rejection in complicated cases. This report refutes charges that surgeons that use PSI for TAR are overly reliant on CT-derived engineer produced plans. Further studies with national data or multiple surgeons should be undertaken to explore this further.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587786","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

Instrumented correction of metatarsus adductus with hallux valgus - A multicenter radiographic assessment.

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-07 DOI: 10.1053/j.jfas.2025.03.001

Jody Peter McAleer, Paul Dayton, Mindi Dayton, William T DeCarbo, Deidre Kile, Daniel J Hatch

{"title":"Instrumented correction of metatarsus adductus with hallux valgus - A multicenter radiographic assessment.","authors":"Jody Peter McAleer, Paul Dayton, Mindi Dayton, William T DeCarbo, Deidre Kile, Daniel J Hatch","doi":"10.1053/j.jfas.2025.03.001","DOIUrl":"10.1053/j.jfas.2025.03.001","url":null,"abstract":"Failure to address metatarsus adductus (MTA) with coexisting hallux valgus (HV) has resulted in mixed outcomes and increased deformity recurrence. The purpose of this study was to investigate early radiographic and clinical outcomes of a novel instrumented 2nd and 3rd TMT corrective arthrodesis combined with instrumented triplanar 1st TMT arthrodesis with early weightbearing. Radiographs and medical records from subjects undergoing this surgical approach were retrospectively reviewed. Forty-three subjects (N = 43 feet) with a mean ± SD age of 41.6 ± 14.2 (range 15 to 62) years were treated at four institutions with a mean ± SD follow-up time of 17.7 ± 10.6 (range 11.5 to 51.0) months. Radiographic parameters demonstrated improvements in the mean ± SD Sgarlato's angle (26.3 ± 5.7 to 10.2 ± 3.8 degrees), baseline 'True Intermetatarsal Angle' (23.2 ± 6.6 degrees) to measured Intermetatarsal Angle at final follow-up (3.7 ± 2.4 degrees), Hallux Valgus Angle (32.3 ± 8.4 to 7.2 ± 6.6 degrees), Tibial Sesamoid Position (5.0 ± 1.5 to 1.3 ± 1.1) and Osseous Foot Width (97.8 ± 7.0 to 86.8 ± 7.5 mm). The novel baseline Plumbline measurement was 93.0 % positive in the study cohort and converted to a negative reading following MTA correction in 90.7 % of subjects. All (N = 43) feet studied achieved stable arthrodesis at the time of final clinical and radiographic assessment. One patient required hardware removal. Radiographic outcomes of an instrumented triplanar correction and multi-planar locking plate fixation were promising with correction of the MTA and HV deformities and favorable healing noted. Level of evidence: Level 4, case series.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586897","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

Longitudinal changes in lower limb muscle activity during walking and stair climbing with full weight bearing in postoperative Trimalleolar fracture patients. 三肢骨折术后患者在完全负重情况下行走和爬楼梯时下肢肌肉活动的纵向变化。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-07 DOI: 10.1053/j.jfas.2025.03.003

Masanobu Yokochi, Masatoshi Nakamura, Ayaka Iwata, Ryota Kaneko, Naoyuki Oi, Kazuo Ouchi, Tetsuo Hayashi

{"title":"Longitudinal changes in lower limb muscle activity during walking and stair climbing with full weight bearing in postoperative Trimalleolar fracture patients.","authors":"Masanobu Yokochi, Masatoshi Nakamura, Ayaka Iwata, Ryota Kaneko, Naoyuki Oi, Kazuo Ouchi, Tetsuo Hayashi","doi":"10.1053/j.jfas.2025.03.003","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.03.003","url":null,"abstract":"Patients after ankle fracture are instructed to avoid weight bearing for several weeks. This study aimed to determine changes in lower limb muscle activity during both walking and stair climbing at 1 and 2 months after resuming weight bearing. The study population consisted of 10 patients who had undergone open osteosynthesis for unilateral trimalleolar fracture. Lower limb muscle activity was measured using surface electromyography. When it became possible to walk without the aid of assistive devices, we measured the lower limb muscle activity during walking and stair climbing. As a result of multiple comparisons, lower limb muscle activity during walking was significantly reduced when comparing the baseline and the measurement taken 2 months later. Both lower limb muscle activity when ascending and descending stairs was significantly reduced when comparing the 1 and 2 months later. The study compared lower limb muscle activity during walking and stair climbing in postoperative patients with trimalleolar fractures, immediately after resumption of full weight bearing and at 1 and 2 months' follow-up. The results showed that the degree of recovery varied between muscles when comparing baseline and 1 month later for both walking and stair climbing, but all muscle activities were reduced when compared to 2 months later. LEVEL OF CLINICAL EVIDENCE: 3.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587765","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

Open reduction and internal fixation compared to intramedullary nail fixation in distal fibula fractures: a meta-analysis.

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-06 DOI: 10.1053/j.jfas.2025.02.004

Filippo Migliorini, Luise Schäfer, Federico Cocconi, Daniel Kämmer, Jörg Eschweiler, Nicola Maffulli

{"title":"Open reduction and internal fixation compared to intramedullary nail fixation in distal fibula fractures: a meta-analysis.","authors":"Filippo Migliorini, Luise Schäfer, Federico Cocconi, Daniel Kämmer, Jörg Eschweiler, Nicola Maffulli","doi":"10.1053/j.jfas.2025.02.004","DOIUrl":"10.1053/j.jfas.2025.02.004","url":null,"abstract":"The operative treatment of distal fibula fractures is debated. This study compared intramedullary nailing (IMN) versus open reduction and internal fixation (ORIF) in patients with distal fibula fractures. The outcomes of interest were patient-reported outcome measures (PROMs) and the rate of anatomic reduction, bony union, complication, and nerve injury. This study was conducted according to the 2020 PRISMA statement. In October 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase, with no time constraint. All the clinical studies comparing IMN versus ORIF in patients with distal fibula fractures were accessed. Data from 11 studies (1040 patients) were retrieved. The mean length of follow-up was 25.1 ± 16.4 months. The mean age of the patients was 56.6 ± 14.8 years, and the mean BMI was 27.3 ± 1.3 kg/m2. A lower rate of nerve injury was evident in favour of the IMN group (P = 0.01). No further differences were found in the Olerud-Molander functional score (P = 0.07), the rate of anatomic reduction (P = 0.4), union (P = 0.9), and complications (P = 0.1). Concluding, osteosynthesis using ORIF might be associated with a greater nerve injury rate than IMN fixation in patients with distal fibula fractures; however, additional studies are required to establish the rate and type of nerve lesion. No difference was found in PROMs, rate of anatomic reduction, bony union, and other complications.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587774","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

Fluoroscopic visualization in ankle surgery: Evaluating the effects of lateral malleolus fixation order.

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-03-05 DOI: 10.1053/j.jfas.2025.03.002

Rong-Zhen Xie, Xu-Song Li, Wei-Qiang Zhao, Yu-Feng Liang, Jie-Feng Huang

{"title":"Fluoroscopic visualization in ankle surgery: Evaluating the effects of lateral malleolus fixation order.","authors":"Rong-Zhen Xie, Xu-Song Li, Wei-Qiang Zhao, Yu-Feng Liang, Jie-Feng Huang","doi":"10.1053/j.jfas.2025.03.002","DOIUrl":"10.1053/j.jfas.2025.03.002","url":null,"abstract":"Ankle fractures, particularly those involving the lateral and posterior malleolus, are complex injuries requiring careful surgical management. This study investigates how the sequence of lateral malleolus fixation affects the intraoperative visualization of the posterior malleolus fracture during fluoroscopy. A retrospective and prospective approach was used, comparing outcomes in patients who underwent surgery for combined lateral and posterior malleolar fractures. In the retrospective group, lateral malleolus fixation with a plate often obstructed fluoroscopic visualization of the posterior malleolus, complicating fracture reduction. The prospective group was adjusted to prioritize posterior malleolar fracture visualization before lateral malleolus fixation, using temporary Kirschner wires if necessary. The study aimed to determine if the initial fixation strategy influenced surgical outcomes, including fracture healing and functional recovery. Results showed that for fractures involving the visible posterior malleolar area, no significant differences in outcomes were observed between the two groups. However, for fractures extending into the obstructed region, the prospective approach provided clearer visualization, potentially leading to more accurate reduction and fixation. This study concludes that the appropriate fixation strategy should be based on the extent of the posterior malleolar fracture. For fractures involving the visible area, traditional fixation of the lateral malleolus can be used. For those involving the obstructed area, a more cautious approach with temporary fixation or prior reduction of the posterior malleolus is recommended. This study emphasizes the importance of preoperative assessment to guide surgical planning and optimize patient outcomes. Level of evidence: III.","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587978","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