Journal of Foot & Ankle Surgery最新文献

{"title":"Concomitant osteochondral lesion of the talus in ankle instability: Utilizing clinical presentation to guide imaging decision","authors":"Dhivakaran Gengatharan M.D. ,&nbsp;Walter Soon Yaw Wong MBChB, MRCS ,&nbsp;Wenxian PNG MBBS, MMed (Ortho), FRCSEd (Ortho) ,&nbsp;Inderjeet Singh Rikhraj MBBS, MMed (Ortho), FRCSEd (Orth) ,&nbsp;Eric Wei Liang Cher MBBS, MMed (Ortho), FRCSEd (Ortho)","doi":"10.1053/j.jfas.2024.10.011","DOIUrl":"10.1053/j.jfas.2024.10.011","url":null,"abstract":"<div><div>Low ankle sprains are a prevalent issue, often involving the anterior talofibular ligament. While there is increased attention placed on ligamentous injuries in ankle sprains, concomitant cartilaginous injuries are frequently overlooked. This article aims to (Park et al., 2021) evaluate the significance of magnetic resonance imaging in anterior talofibular ligament injuries to detect concurrent osteochondral lesions of the talus as well as other associated ligamentous injuries; (Hølmer et al., 1994) determine the importance of clinical presentation and its association with the risk of concomitant osteochondral lesions in anterior talofibular ligament injuries. We conducted a retrospective analysis of 129 patients who underwent anterior talofibular ligament reconstruction, reviewing patient data to assess the incidence of osteochondral lesions of the talus and associated ligamentous injuries. Clinical presentations were then reviewed to identify signs and symptoms associated with the occurrence of osteochondral lesions of the talus. The results indicated that calcaneofibular ligament was most injured in association with anterior talofibular ligament injuries (69.52 %; <em>n =</em> 73). Furthermore. 31.78 % (<em>n =</em> 41) of patients with anterior talofibular ligament injuries had concurrent osteochondral lesion of the talus. Analysis on clinical presentation revealed statistical significance (<em>p &lt;</em> .001) between patients that had ankle joint line tenderness lasting for more than 6 weeks and the occurrence of osteochondral lesions of the talus. This study concludes that magnetic resonance imaging could be beneficial in anterior talofibular ligament injuries with patients exhibiting persistent joint line tenderness to evaluate for osteochondral lesions to ensure a comprehensive pre-operative assessment.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 3","pages":"Pages 233-237"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565017","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 shock wave therapy and Low-dye tape method in patients with plantar fasciitis: A randomized controlled study","authors":"Fatih Enzin ,&nbsp;Ümit Ugurlu","doi":"10.1053/j.jfas.2024.12.003","DOIUrl":"10.1053/j.jfas.2024.12.003","url":null,"abstract":"<div><div>Plantar fasciitis is a common musculoskeletal issue that can cause severe pain and limit functionality. This study aimed to compare the effectiveness of Extracorporeal shock-wave therapy and Low-dye taping in relieving pain and improving functionality in plantar fasciitis. The study included cases with a confirmed diagnosis of plantar fasciitis, which were randomly divided into two groups: Extracorporeal shock-wave therapy and Low-dye taping. The subjects in the Extracorporeal shock-wave therapy group were treated with Extracorporeal shock-wave therapy, while the subjects in the Low-dye taping group were treated with Low-dye taping and sham Extracorporeal shock-wave therapy. Both treatments were administered in three sessions, once a week. Pain and functionality levels were evaluated using the Visual analog scala and Foot&amp;Ankle Outcome Score. Evaluations were conducted pre- and post-treatment, and at the six-week follow-up. Seventy-two subjects completed the study, and at the end of the treatment and follow-up periods, both groups showed a significant decrease in pain levels (p≤0.001) and an increase in functionality levels (p≤0.001) compared to the beginning. However, there was no significant difference between the groups regarding pain and functionality levels at the end of the treatment and follow-up period (<em>p</em> &gt; 0.05). Therefore, both Extracorporeal shock-wave therapy and Low-dye taping treatments were found to have similar effects in treating plantar fasciitis. These findings can guide clinicians in choosing the most effective conservative treatment for plantar fasciitis patients.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 3","pages":"Pages 291-295"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822835","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":"Modified Lapidus procedure with a nitinol staple and two screw construct technique","authors":"Chad A. Smith DPM, AACFAS ,&nbsp;Lauren M. Christie DPM, AACFAS ,&nbsp;Steven R. Cooperman DPM, MBA, AACFAS ,&nbsp;Christopher F. Hyer DPM, MS, FACFAS","doi":"10.1053/j.jfas.2024.12.001","DOIUrl":"10.1053/j.jfas.2024.12.001","url":null,"abstract":"<div><div>Many fixation options exist for correction of a hallux valgus deformity with a first tarsometatarsal joint arthrodesis with pros and cons to each. Few have looked at utilizing a shape memory alloy staple made from nitinol for fixation. This study evaluates the effectiveness of a modified Lapidus technique using a nitinol (shape memory alloy) staple combined with a two-screw construct for first tarsometatarsal joint arthrodesis in correcting hallux valgus deformity. The non-union rate, time to weightbearing in both a boot and a shoe, hardware removal of the staples, and the need for revision surgeries were all evaluated. A retrospective review of 42 patients meeting the inclusion criteria was conducted, with an average follow-up time of 12.3 months (SD 4.5). Bony union was achieved in 47 of 48 (97.92 %) cases for a non-union rate of 2.08 %. The average time to weightbearing in a boot was 27.35 days (SD 3.47), while in a shoe, it was 55.58 days (SD 10.03). There was a total of 3 procedures requiring staple removal (3/48) (6.25 %), and no revision surgeries were needed due to loss of correction or non-union. These outcomes suggest that the nitinol staple and two-screw construct is a reliable option for first tarsometatarsal joint arthrodesis in hallux valgus deformity, showing similar results compared to other fixation methods.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 3","pages":"Pages 279-284"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830744","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":"Studies directly comparing Lisfranc injuries treated with primary arthrodesis or open reduction and internal fixation show no significant difference in return to sport and complications: A systematic review and meta-analysis","authors":"Matthew W. Feldman BS ,&nbsp;Stephen Fucaloro BS ,&nbsp;Laura Krivicich MD ,&nbsp;Suzanne Kent MD ,&nbsp;Matthew J. Salzler MD","doi":"10.1053/j.jfas.2025.02.005","DOIUrl":"10.1053/j.jfas.2025.02.005","url":null,"abstract":"<div><div>Lisfranc injuries are common and can cause sport-ending morbidity. Management through primary arthrodesis (PA) or open reduction and internal fixation (ORIF) is a subject of debate.</div><div>PubMed, EMBASE, and the Web of Science databases were queried for studies assessing return to sport (RTS) outcomes following treatment of Lisfranc injuries with PA or ORIF. RTS rates, time to RTS, and complication rates were assessed. Maximum likelihood random-effects models were created based on comparative studies to evaluate differences in RTS and complication rates with odds ratios representing pooled estimates. Heterogeneity of return to sport outcomes was explored with sub-analysis of athlete level (non-elite vs. elite) and type of fixation.</div><div>Across 23 studies, 603 Lisfranc injuries were identified; 498 underwent ORIF and 105 received PA. Return to sport ranged from 65 to 100 % in ORIF subjects and 67-100 % of PA subjects. Meta-analysis of comparative studies reveals no significant difference in likelihood of RTS or complications (<em>p</em> = 0.44 <em>I²</em>=26 %; <em>p</em> = 0.93 <em>I²</em>=0 %, respectively). RTS times range from 8 to 30 weeks for ORIF and 19.7-28.5 weeks for PA.</div><div>Studies assessing RTS following ORIF and PA for Lisfranc injuries are heterogeneous, yet pooled data from comparative evidence suggests no significant difference in likelihood of RTS or complications. PA and ORIF have the potential for successful RTS though further prospective randomized studies are needed to better counsel athletes regarding the ideal surgical management for patient goals.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 3","pages":"Pages 318-327"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531843","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":"Radiographic outcomes of flexible and rigid fixation techniques of syndesmotic injuries across various body mass indices: A retrospective analysis","authors":"Alexandra T. Black DPM, FACFAS ,&nbsp;Son Tran DPM, AACFAS ,&nbsp;Zoë K. Haffner BS ,&nbsp;Daisy L. Spoer MS ,&nbsp;Ali Rahnama-Vaghef DPM, FACFAS ,&nbsp;Jered M. Stowers DPM, FACFAS","doi":"10.1053/j.jfas.2024.11.002","DOIUrl":"10.1053/j.jfas.2024.11.002","url":null,"abstract":"<div><div>In the setting of ankle trauma, surgical management of syndesmosis injury involves screw fixation and suture button technique. The efficacy of flexible (suture button) versus rigid (screw) fixation in the management of syndesmotic injury has been investigated extensively in current literature. There is sparse data comparing these two techniques across different body mass indices (BMI). In this study, two fellowship-trained foot and ankle surgeons at urban level-1 trauma centers reviewed blinded post-operative ankle radiographs of BMI-stratified patients undergoing syndesmotic fixation. A total of 79 patients were included for analysis based on inclusion and exclusion criteria. There were 42 patients in the screw fixation group and 37 patients in the suture button group. The average follow-up period was 5.5 months. No significant difference was found in the average radiographic measurements when comparing the two fixation types, regardless of BMI parameters. This was consistent when analyzing individual fixation types stratified by BMI, as well as when comparing BMI groups stratified by fixation type. Additionally, the distribution of body mass index was even across both fixation types. Our study demonstrates that both fixation groups achieved comparable anatomic ankle reduction regardless of body mass index. The authors suggest expanding the indication of suture button fixation to include the higher body mass index patients.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 3","pages":"Pages 248-252"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631791","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":"Tarsal coalition resection in children: Is it effective?","authors":"Mitzi L Williams DPM, FACFAS ,&nbsp;Jeffrey Sanker DPM ,&nbsp;Miranda L. Ritterman Weintraub PhD MPH ,&nbsp;Thomas Dobbs ,&nbsp;Kyleigh Pierson DPM AACFAS ,&nbsp;Matthew B Dobbs MD, FACS","doi":"10.1053/j.jfas.2024.10.008","DOIUrl":"10.1053/j.jfas.2024.10.008","url":null,"abstract":"<div><div>Tarsal coalitions in children are a group of disorders that typically present as a rigid flatfoot deformity. Operative treatment generally consists of resecting the coalition alone or resection plus flatfoot reconstructive procedures. The purpose of this study was to evaluate the rate and risk factors for complications, including infection, recurrence, and reoperation, following the surgical management of tarsal coalitions in children.</div><div>This is a retrospective cohort study on the surgical outcomes of pediatric tarsal coalitions alone or in combination with adjunctive procedures. This study was conducted between 01/01/2008 and 12/31/2019 and utilized electronic health records and chart review was performed to describe patient demographic, clinical, perioperative characteristics, and whether patients have subsequent foot and ankle procedures after the index resection surgery.</div><div>The study cohort included 165 feet belonging to 144 patients. The age range at time of surgery was 12 years of age (11-14). Of the 165 feet, 18 (10.9%) experienced a postoperative complication, including six infections of which two required reoperation, six recurrences all requiring reoperation, and six reoperations not due to recurrence. Patients with a postoperative complication demonstrated increased age (13.9 years vs 12.4 years, p=0.007), obesity (33.3% vs 13.6%, p=0.026), and/ or preoperative hindfoot valgus deformity (33.3% vs 7.5%, p=0.004).</div><div>The overall postoperative complication rate was 10.9%. Results of this study provided important information for providers as they discuss different treatment approaches and anticipated outcomes with patients and their families.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 3","pages":"Pages 220-223"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640169","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":"Iatrogenic Medial Malleolar Fracture and Stress Fracture Considerations in Total Ankle Joint Replacement: A Multicenter Retrospective Study.","authors":"Dr James M Cottom, Dr Jay S Badell, Dr Karl W Dunn, Dr Josh Ekladios","doi":"10.1053/j.jfas.2025.04.008","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.04.008","url":null,"abstract":"<p><p>Total ankle replacement (TAR) is a challenging but rewarding treatment option for primary or post-traumatic tibiotalar osteoarthritis. Acute and latent postoperative stress fractures of the medial malleolus, however, pose a common potential complication that may arise during joint resection, especially during implantation of the tibial component. This is a multicenter retrospective study highlighting considerations for iatrogenic medial malleolar fractures during and after TAR surgery by assessing relationships between fractures and medial malleolus width (MMW). 159 patients undergoing primary TARs without prophylactic tibial fixation from 2016-2022 were selected from multiple institutions. MMW (mm) was measured as the distance between the tibial tray component placement and the medial malleolus' outer cortex using standard AP ankle radiographs intraoperatively and postoperatively. Demographics included BMI, gender, age, and implant type. Average MMW of the 148 patients without fracture was 11.12 mm. Average MMW was 9.43 mm in the 11 patients who suffered intraoperative medial malleolus fracture (n = 7) or developed postoperative stress fracture (n = 4). Tibial fixation was performed only in the fracture group. The difference in MMW between the two groups was statistically significant (p < 0.05). There were no statistically significant differences among all the demographics. Mean follow-up, age, and BMI were 20.9 months, 64.4 years, and 30.4, respectively, and there were no statistically significant differences among demographics. This data demonstrates how shorter MMW, specifically a threshold of 9.43 mm or shorter, may be associated with higher probability of intraoperative or postoperative stress fracture of the medial malleolus.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990491","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 100 most impactful articles in foot and ankle surgery: An altmetric analysis","authors":"Marc Bernstein MS (Research Fellow) ,&nbsp;Emilio Feijoo BS (Research Fellow) ,&nbsp;Hudson Tate BS (Medical Student) ,&nbsp;Faheem Pottayil BS (Medical Student) ,&nbsp;Ashish Shah MD (Professor)","doi":"10.1053/j.jfas.2024.11.005","DOIUrl":"10.1053/j.jfas.2024.11.005","url":null,"abstract":"<div><div>Citation count and impact factor of the publishing journal are two historically utilized metrics to determine an article's impact in its research field. However, these metrics are limited given the rise in research dissemination through social media. Across other orthopedic specialties, the Altmetric Attention Score (AAS) has been used to determine which articles are most impactful. This study utilizes the AAS to highlight the 100 most impactful articles in foot and ankle surgery and determine if bibliometric factors and article characteristics are predictive of AAS. The AAS website was queried on a single day in September 2024 and 4,262 articles were retrieved. The top 100 relevant foot and ankle articles published after 2010 were ranked by AAS and analyzed for bibliometric factors, study design, and study subject. The median (IQR) AAS was 18 (14, 42.5). A majority of the top 100 impactful articles were published in the <em>Journal of Foot and Ankle Surgery</em> and <em>Foot and Ankle Surgery</em>. Most articles were original clinical research articles (54 %). Facebook and news mentions were positively correlated with AAS (p = 0.019, p &lt; 0.0001, respectively) while other social media mentions had no significant relationship (p &gt; 0.05). Study design and study subject were not significant predictors of AAS (p &gt; 0.05). In conclusion, our study finds that, while citation count indicates an article's longitudinal impact, it does not correlate with AAS in foot and ankle surgery, which provides an immediate, dynamic metric to directly compare articles’ impacts.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 3","pages":"Pages 215-219"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792281","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":"Assessment of peroneal tendon lesions using 2-dimensional and 3-dimensional isotropic magnetic resonance imaging with surgical correlation","authors":"Flavio Duarte Silva ,&nbsp;Rubeel Akram ,&nbsp;Atul Kumar Taneja ,&nbsp;Dhilip Andrew ,&nbsp;Angela He ,&nbsp;Anuj Gupta ,&nbsp;Naveen Rajamohan ,&nbsp;George Liu DPM, MPH, FACFAS ,&nbsp;Michael VanPelt DPM, FACFAS ,&nbsp;Yin Xi ,&nbsp;Avneesh Chhabra MD","doi":"10.1053/j.jfas.2024.12.002","DOIUrl":"10.1053/j.jfas.2024.12.002","url":null,"abstract":"<div><div>Accurate diagnoses of peroneal pathologies remains a challenge due to limitations of conventional 2D (dimensional) imaging, which can impact long-term patient outcomes. This study evaluates MRI accuracy and inter-reader reliability of peroneal compartment pathology for 2D and 3D MRI. A consecutive series of patients who underwent peroneal compartment surgery with preoperative 1.5- or 3.0-Tesla ankle MRIs from 2009 to 2024 included 32 scans (22 with 2D, 10 with 2D+3D) from 31 patients (ages 17–74 years, all genders). Three musculoskeletal readers blinded to surgical findings independently analyzed MRI scans for common peroneal tenosynovitis, peroneus brevis and peroneus longus tenosynovitis, tendinopathy, and tears. Inter-reader reliability and diagnostic performance measures were calculated. Using majority vote, overall accuracy, sensitivity, and specificity for peroneal tendons using 2D MRI were 80%, 81%, and 79%, respectively. Using 3D MRI sequences, whether in isolation or combination with 2D MRI, accuracy, sensitivity, and specificity increased to 85%, 88%, and 83%, respectively. The inter-reader reliability for peroneus brevis lesions was 0.45-0.75 for 2D, 0.25-0.35 for 3D, and 0.31-0.54 for combined 2D+3D, while for peroneus longus lesions, it was 0.45-0.90 for 2D, 0.20-0.71 for 3D, and 0.64-0.81 for combined 2D+3D scans. The inter-reader reliability for tenosynovitis ranged from 0.62-0.64 for 2D, 0.25-0.37 for 3D, and 0.57-0.66 for combined 2D+3D scans. The addition of 3D MRI to 2D high-resolution ankle MRI protocol or 3D MRI alone increases accuracy of peroneal compartment lesion detection with minor decrease in inter-reader reliability for peroneal brevis tendon assessment. Larger studies may help validate our findings.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 3","pages":"Pages 285-290"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822797","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 influence of pre-operative reduction quality on post-operative wound complications in ankle fractures: A review of 247 cases.","authors":"Rye Yern Yap, Peter Logan, Mohammad Iqbal, Vishwajeet Kumar, Zaid Al-Wattar","doi":"10.1053/j.jfas.2025.04.010","DOIUrl":"10.1053/j.jfas.2025.04.010","url":null,"abstract":"<p><p>Opinions vary on the definition of an adequate pre-operative reduction for unstable ankle fractures that require surgical fixation. We hypothesized that residual tibiotalar subluxation may impair post-operative wound healing. This study aimed to evaluate the influence of pre-operative reduction quality on the rate of wound complications following ankle fracture fixation. A retrospective cohort study of consecutive ankle fractures in adults treated with surgical fixation at a district general hospital from January 2020 until July 2023 was conducted. Pre-operative reduction was categorized as inadequate if there was residual tibiotalar joint subluxation of > 2mm on post-manipulation radiographs. Wound complication was defined as any wound problem requiring additional dressing care, antibiotics, or a return to the operating room. Two hundred and forty-seven patients were included in this study, with a median age of 56.9 (range 18.3 - 88.7). One hundred and sixty-six (67.2 %) patients were female. The median follow-up duration was 12.3 (range 2 - 148). Ninety-eight (39.7 %) patients had an inadequate pre-operative reduction. There were 29 (11.7 %) cases of post-operative wound complications. The rate of wound complications was higher in patients with an inadequate pre-operative reduction compared to those in whom adequate reduction was achieved (17.3 % versus 8.1 % respectively, p = 0.03). Persistent pre-operative tibiotalar joint subluxation was associated with an increased rate of wound complications following ankle fracture fixation. Initial closed reduction should aim to restore the tibiotalar alignment for soft tissue resuscitation. Urgent intervention is warranted in cases with persistent subluxation despite initial attempts at closed reduction.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025184","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}