Journal of Foot & Ankle Surgery最新文献

{"title":"Prospective multicenter study assessing radiographic and patient outcomes following an instrumented mini-open triplanar tarsometatarsal arthrodesis with early weightbearing","authors":"Jody Peter McAleer DPM, FACFAS ,&nbsp;Amber M. Shane DPM, FACFAS ,&nbsp;Marque A. Allen DPM, FACFAS ,&nbsp;Avneesh Chhabra MD ,&nbsp;Justin Daigre MD ,&nbsp;Daniel C. Farber MD ,&nbsp;Deidre Kile MS ,&nbsp;Jeffrey E. McAlister DPM, FACFAS ,&nbsp;Abdi Raissi MD ,&nbsp;Paul Steinke DPM, FACFAS ,&nbsp;Robert P. Taylor DPM, FACFAS ,&nbsp;Robert D. Santrock MD","doi":"10.1053/j.jfas.2025.03.018","DOIUrl":"10.1053/j.jfas.2025.03.018","url":null,"abstract":"<div><div>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<strong>.</strong> 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.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 574-580"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","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}

{"title":"The association of anterior soft tissue depth (ASTD) with wound dehiscence following total ankle arthroplasty","authors":"Lauren M. Christie DPM, AACFAS ,&nbsp;Avery Thomson DPM, MS ,&nbsp;Charles Korba DPM ,&nbsp;Andreas C. Kaikis DPM, FACFAS ,&nbsp;William M. Wolfe DPM, MPH ,&nbsp;D. Scot Malay DPM, MSCE, FACFAS","doi":"10.1053/j.jfas.2025.03.015","DOIUrl":"10.1053/j.jfas.2025.03.015","url":null,"abstract":"<div><div><span><span><span>Total ankle arthroplasty (TAA) is a common intervention for the treatment of end-stage ankle arthritis. Unfortunately, use of a longitudinal anterior </span>incision to gain access to the ankle is commonly associated with postoperative </span>wound dehiscence<span>. 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 (</span></span><em>p</em> = 0.0240). Receiver operating characteristic (ROC) curve analyses showed that a preoperative ASTD ≤ 16 mm maximized diagnostic sensitivity and specificity and predicted dehiscence.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 559-565"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","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}

{"title":"Morphological analysis of the retrotalar pulley and its role in flexor hallucis longus impingement: Insights from a CT-based study","authors":"Lolita Micicoi MD ,&nbsp;Barbara Piclet-Legré MD ,&nbsp;Tristan Fauchille MD ,&nbsp;Alexandre Rudel MD ,&nbsp;Nicolas Bronsard MD-Ph.D ,&nbsp;Jean-François Gonzalez MD-Ph.D ,&nbsp;Matthieu Ollivier MD-Ph.D","doi":"10.1053/j.jfas.2025.01.002","DOIUrl":"10.1053/j.jfas.2025.01.002","url":null,"abstract":"<div><div>The Flexor Hallucis Longus (FHL) is a muscle that can be subject to multiple conflicts. The most common conflict is due to inflammation of the tendon at the retrotalar pulley. The constraints exerted on the FHL are responsible for a pathology called functional Hallux Limitus.</div><div>The purpose of this anatomical study is to describe morphologic finding about retrotalar pulley, which may account the impingement between FHL and the hindfoot. Using a retrospective approach at a single center, a detailed analysis was conducted on a cohort of 350 patients. Precise measurements were taken to document the angles, areas, and distances that define the relationship between the Flexor Hallucis Longus (FHL) tendon and its surrounding anatomical structures.</div><div>The angle between the retrotalar pulley and the sustentaculum tali exhibited a range of 124 to 170 degrees in profile and 113.3 to 178 degrees in frontal view. The dimensions of the retrotalar pulley varied from 1.1 to 54 mm², while the posterolateral and posteromedial tubercles displayed dimensions ranging from 3.4 to 77.9 mm² and 2.6 to 35.2 mm², respectively. Distances between posterior tubercles further underscored the anatomical diversity, ranging from 4.3 to 17 cm proximally and 10.5 to 18.4 cm distally.</div><div>In unraveling the morphological complexities surrounding FHL impingement, this study provides valuable insights into the biomechanical intricacies of the foot. These findings not only deepen our understanding of musculoskeletal anatomy but also pave the way for future investigations into the dynamic interplay between structure and function in the lower extremities.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 511-515"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of glucagon-like peptide-1 receptor agonists on postoperative outcomes following ankle fracture open reduction and internal fixation","authors":"Joshua Morningstar BS ,&nbsp;Bradley J. Lauck BA ,&nbsp;Nicholas Bank MD ,&nbsp;Trapper Lalli MD","doi":"10.1053/j.jfas.2025.05.002","DOIUrl":"10.1053/j.jfas.2025.05.002","url":null,"abstract":"<div><div><span><span><span><span>Glucagon-like peptide-1 receptor agonists (GLP-1RA) are quickly growing in popularity as effective tools in the management of diabetes and weight loss. Despite this increased usage, there is a paucity of literature investigating the use of GLP-1RA in patients with ankle fractures. This study aims to compare the outcomes of patients undergoing ankle fracture </span>open reduction<span> and internal fixation (ORIF) receiving therapy with GLP-1RA to those not receiving treatment. A retrospective analysis was performed utilizing the TriNetX research network to query patients who underwent ankle fracture ORIF between 2000–2024. Two cohorts were established according to preoperative GLP-1RA usage with 1:1 matching by propensity scores for demographics and comorbidities. Primary outcomes included the risk of postoperative complications<span> (i.e. infection, sepsis, </span></span></span>wound dehiscence<span>, cellulitis, thrombosis, </span></span>nonunion<span>, reoperation, revision, etc.) at 30-days, 90-days, 1-year, and 5-years. There were 123,546 patients not taking GLP-1RA and 1,173 patients taking GLP-1RA who underwent ORIF for an ankle fracture, with </span></span>propensity score matching resulting in two cohorts of 1,173 patients each. After matching, there were no significant differences in demographics or comorbidities, including a 75.6 % prevalence of diabetes mellitus and 68.7 % prevalence of overweight or obesity in both cohorts. At 30-days postoperatively, the no GLP-1RA cohort had a significantly higher rate of removal of hardware (Odds Ratio [OR] 1.953, 95 % Confidence Interval (CI) 1.062-3.591); no other complications demonstrated significant differences at 30-days, 90-days, 1-year, or 5-years postoperatively. These findings further underscore the low risk of preoperative GLP-1RA usage noted in other orthopaedic procedures.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 644-648"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023051","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":"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 MD ,&nbsp;Aylin Ayyıldız MD ,&nbsp;Banu Kuran MD","doi":"10.1053/j.jfas.2025.03.011","DOIUrl":"10.1053/j.jfas.2025.03.011","url":null,"abstract":"<div><div><span><span><span>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 </span>quality of life in the treatment of plantar heel pain secondary to </span>plantar fasciitis<span> and a calcaneal spur<span>. 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), </span></span></span>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.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 541-545"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","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}

{"title":"Are immediate postoperative X-rays of value in foot surgery patients?","authors":"Rahul Mishra DPM ,&nbsp;John M. Giurini DPM, FACFAS","doi":"10.1053/j.jfas.2025.03.016","DOIUrl":"10.1053/j.jfas.2025.03.016","url":null,"abstract":"<div><div><span>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<span> 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 </span></span>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.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 566-569"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","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}

{"title":"Nationwide surgical trends for bunionectomies in medicare beneficiaries: An increase in lapidus bunionectomy procedure","authors":"Ahad A. Kesaria BS ,&nbsp;Sterling J. DeShazo BS ,&nbsp;Oluwatofe Alimi MD ,&nbsp;Vinod K. Panchbhavi MD, FACS, FAOA, FABOS, FAAOS","doi":"10.1053/j.jfas.2025.03.019","DOIUrl":"10.1053/j.jfas.2025.03.019","url":null,"abstract":"<div><div><span>Both orthopedic surgeons and podiatric surgeons perform the Hallux Valgus<span> (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 &amp; Medicaid Services. Bunionectomies were identified using </span></span><span><em>Current procedural terminology</em></span><span> [CPT] codes (28292, 28296, 28297, 28298, 28299 from 2013 to 2022 and 28295 from 2017 to 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 and 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.</span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 581-587"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","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}

{"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 DPM, AACFAS ,&nbsp;Lawrence M. Fallat DPM, FACFAS","doi":"10.1053/j.jfas.2025.03.009","DOIUrl":"10.1053/j.jfas.2025.03.009","url":null,"abstract":"<div><div><span>This retrospective case series investigated the treatment outcomes for hallux rigidus<span>. 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<span> (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 </span></span></span>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.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 526-533"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","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}

{"title":"Are we putting our best foot forward? The effect of insurance type on ankle fracture complications and delays in care: a retrospective two-year analysis","authors":"Nolan M. Reinhart ,&nbsp;Jackson P. Tate ,&nbsp;Chauncey A. Bridges ,&nbsp;James Clemmons ,&nbsp;Murphy P. Martin ,&nbsp;Olivia C. Lee ,&nbsp;William F. Sherman","doi":"10.1053/j.jfas.2025.04.009","DOIUrl":"10.1053/j.jfas.2025.04.009","url":null,"abstract":"<div><div><span><span>This study investigates the influence of insurance type on delays in surgical management and postoperative complications<span><span> in patients with closed operative ankle fractures. A </span>retrospective cohort study was conducted using the PearlDiver Mariner database, analyzing 37,706 ankle fracture patients who underwent </span></span>open reduction<span><span> internal fixation (ORIF). Patients were grouped by insurance type (Medicaid vs private insurance), and the time from fracture diagnosis to surgery was compared. Complications including hardware infection, revision surgery, mechanical failure, </span>nonunion, malunion, and postoperative wound issues were analyzed within two years post-surgery. A higher proportion of Medicaid patients had surgical delays beyond 10 days from initial presentation compared to privately insured patients (28.6 vs 22.2 %, </span></span><em>p</em><span> &lt; 0.001). Medicaid patients had higher rates of any orthopedic complications (odds ratio (OR): 1.27, 95 % confidence interval (CI): 1.19 - 1.37), including revision ORIF (OR: 1.33, CI: 1.16 - 1.54), mechanical failure (OR:1.24, CI: 1.03 - 1.49), nonunion or malunion (OR: 1.35, 1.17 - 1.55), and posttraumatic arthritis (OR: 1.26, 1.08 - 1.48). Although complications like wound infection and amputation were more frequent among Medicaid patients, these differences were not statistically significant. Medicaid patients experience longer delays in surgical management and higher rates of complications after ankle fractures compared to privately insured patients.</span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 624-628"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006216","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":"Trends in computed tomography utilization among emergency department patients with foot and ankle trauma","authors":"Soham Ghoshal BA ,&nbsp;Alexander H King MS ,&nbsp;Michael Pang BS ,&nbsp;C. Michael Hood MD ,&nbsp;Aaron D Sodickson MD, PhD ,&nbsp;Michael S Gee MD, PhD ,&nbsp;Michael H Lev MD ,&nbsp;Mitchel B Harris MD ,&nbsp;Marc D Succi MD","doi":"10.1053/j.jfas.2025.04.007","DOIUrl":"10.1053/j.jfas.2025.04.007","url":null,"abstract":"<div><div>The aim of this study was to assess the number of foot/ankle computed tomography<span> (CT) exams ordered per encounter for patients presenting to the emergency department (ED) with foot and ankle trauma over a 5-year period. Secondary aims included evaluating the positivity rate of foot/ankle CT exams and identifying factors associated with receiving a CT foot/ankle. This retrospective study analyzed data from a large urban Level-1 trauma center between 2016 and 2021. Patients were identified by charted chief complaints related to foot and ankle trauma. The primary outcome was the number of CT foot/ankle exams ordered per patient in a given period. A univariate chi-square analysis was conducted to evaluate differences in patient presentations and imaging rates across the study period.</span></div><div>Over the 5-year span, there were 9,845 patient encounters, with a significant increase in CT foot/ankle orders from 2.4 % to 6.6 % (<em>p</em> &lt; 0.001). The CT positivity rate, defined as CTs with positive findings, declined from 95.2 % in 2016 to 84.1 % in 2021 (<em>p</em> &lt; 0.001). Black patients had lower odds of receiving CT scans compared to White patients, as did Medicare recipients compared to Medicaid recipients (<em>p</em> &lt; 0.001). Factors such as age (OR: 1.02 per year), year of visit (OR: 2.66 for 2021), time of day (OR: 1.62 for evening arrivals), and arrival by EMS (OR: 5.60) were significantly associated with higher CT order rates.</div><div>This study highlights a marked increase in CT utilization for foot and ankle trauma with a corresponding decline in the rate of positive findings. Further research is necessary to explore the reasons behind this trend and to identify potential workflow or protocol adjustments to improve imaging efficacy.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 613-618"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046069","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}