Journal of Foot & Ankle Surgery最新文献

{"title":"Retrospective comparison of minimal and extensive fixation strategies in operatively treated ankle fractures.","authors":"Tal Frenkel Rutenberg, Ran Atzmon, Uri Barak, Tal Luria, Yona Kosashvili, Shai Shemesh","doi":"10.1053/j.jfas.2026.09.002","DOIUrl":"10.1053/j.jfas.2026.09.002","url":null,"abstract":"<p><strong>Background: </strong>Ankle fractures are among the most common orthopedic injuries, with open reduction and internal fixation (ORIF) being the standard treatment for displaced fractures. This retrospective study compared operative time, radiographic and complication outcomes between two fixation strategy categories, minimal fixation and extensive fixation, in operatively treated ankle fractures.</p><p><strong>Methods: </strong>A retrospective review included 95 patients treated surgically for displaced Danis Weber B or C ankle fractures between January 2017 and November 2019. Patients were grouped by fixation strategy at index surgery, minimal versus extensive hardware, selected by the treating surgeon. Demographic, intraoperative, and hospitalization data were collected. Presentation and follow-up radiographs were assessed for fracture classification, maintenance of reduction, fracture healing, and hardware-related complications. Revision surgeries were recorded, and outcomes were compared between groups.</p><p><strong>Results: </strong>Twenty-seven patients underwent minimal fixation, most commonly with a posterior antiglide plate. Sixty-eight patients underwent extensive fixation, typically a one-third tubular plate with extensive screw placement. Demographics were similar, and most fractures were Weber B, supination external rotation. Operative time was shorter with minimal fixation, with a mean of 58.7 minutes versus 86.6 minutes (p < 0.001). Postoperative complication and revision rates were not statistically different. Loss of reduction was more frequent with minimal fixation, at 14.8% versus 2.9%, approaching significance (p = 0.053).</p><p><strong>Conclusions: </strong>Minimal fixation for unstable ankle fractures showed comparable early radiographic outcomes and complication rates to more extensive lateral or anatomic plate fixation, with significantly shorter operative time. Findings should be interpreted cautiously given surgeon selected fixation and group heterogeneity.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901398","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":"Clinical outcomes following staged management of bimalleolar and trimalleolar ankle fractures.","authors":"Yunus Elmas, Orhun Çelik","doi":"10.1053/j.jfas.2026.09.004","DOIUrl":"10.1053/j.jfas.2026.09.004","url":null,"abstract":"","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901446","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":"2025 podiatric physician workforce analysis based on health resources & services administration (HRSA) projections.","authors":"Andrew J Meyr, Jeneen Elagha","doi":"10.1053/j.jfas.2026.09.001","DOIUrl":"10.1053/j.jfas.2026.09.001","url":null,"abstract":"<p><strong>Background: </strong>Workforce shortages in the profession of medicine are currently experienced and anticipated to worsen across most specialties, and unfortunately, podiatric medicine and surgery is no exception to this trend.</p><p><strong>Purpose: </strong>The objective of this investigation was to evaluate contemporary and short-term future podiatric physician workforce patterns utilizing open-access US government databases.</p><p><strong>Study design: </strong>Epidemiologic descriptive analysis.</p><p><strong>Methods: </strong>State-specific podiatric physician workforce estimates and projections for 2025 and 2035 were investigated utilizing information from the Health Resources & Services Administration (HRSA), the National Downloadable File from the Centers for Medicare & Medicaid Services (CMS), and podiatric medical school matriculant and graduate information from the American Association of Colleges of Podiatric Medicine (AACPM).</p><p><strong>Results: </strong>The HRSA estimated a demand for 21,280 podiatric physicians in 2025, with a supply estimate of 19,460, for a shortage of 1,810. Only three states demonstrated an estimated podiatric workforce surplus in 2025, while there were 9 states with an estimated podiatric physician shortage >200 physicians. The HRSA further estimates a demand for 23,920 podiatric physicians in 2035, with a supply estimate of 19,240, for an estimated shortage of 4680. Seventeen states might be expected to have estimated podiatric physician shortages >200 in 2035 including four states with expected estimated podiatric physician shortages >500 (Texas, California, Florida, and Georgia).</p><p><strong>Conclusion: </strong>It is our hope that this information might be utilized by local, state and national podiatric organizations to assist in student and physician recruitment in active anticipation of future trends pertaining to patient access to podiatric care.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901409","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":"Clinical outcomes of optimized versus plain prefabricated insoles for mechanical foot pain in subtle Cavus foot: A randomized controlled trial","authors":"Chuan Guan Ng BPodM,&nbsp;Trina Wong BSc (Hons) Podiatry, MSc Sports Medicine Exercise & Health,&nbsp;Sean Wei Loong Ho MBBS, FRCS,&nbsp;Muhammad Farhan Mohd Fadil MBBS, FRCS","doi":"10.1053/j.jfas.2026.04.011","DOIUrl":"10.1053/j.jfas.2026.04.011","url":null,"abstract":"<div><h3>Background</h3><div>Subtle cavus foot (SCF), identified by the “peek-a-boo” sign and a positive Coleman block-test, is frequently associated with mechanical foot pain. While prefabricated insoles are commonly used in clinical practice, evidence supporting their effectiveness in SCF – particularly when modified according to SCF-specific design principles – is limited.</div></div><div><h3>Purpose</h3><div>This prospective randomized controlled trial compared Specifically Optimized Prefabricated Insoles (SOPI) with unmodified Plain Prefabricated Insoles (PPI) in individuals with clinically identified SCF and mechanical foot pain.</div></div><div><h3>Methods</h3><div>Twenty-nine participants were randomized; 26 completed the study (13 per group). SOPI were modified in-office using forefoot valgus wedging and first-ray fill reduction, while PPI were provided as-is. The primary outcome was the Foot Function Index (FFI), assessed at baseline and at 1, 2, and 3 months. Baseline FFI total and subscale scores were comparable between groups.</div></div><div><h3>Results</h3><div>At 3 months, the SOPI group demonstrated greater improvements than the PPI group in FFI total scores (mean difference 12.2, 95%CI: 5.2–19.3, <em>P</em> =.002), FFI pain scores (15.0, 95%CI: 5.9–24.1, <em>P</em> =.006), FFI disability scores (13.5, 95%CI: 5.2–21.8, <em>P</em> =.004), and FFI activity limitation scores (4.9, 95%CI: 0.5–9.3, <em>P</em> =.015), with differences exceeding reported minimal clinically important differences.</div></div><div><h3>Conclusion</h3><div>Our preliminary data suggest that SCF-specific optimization of prefabricated insoles may improve pain and function over three months compared to unmodified insoles. However, these findings are inconclusive due to the underpowered sample size and should be interpreted as hypothesis-generating. Confirmation in larger, adequately powered studies with longer follow-up is required.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 156.e1-156.e9"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786850","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":"Weightbearing CT-based predictive surgical planning for joint-sparing reconstruction of progressive collapsing foot deformity","authors":"Wolfram Grün MD,&nbsp;Pierre-Henri Vermorel MD,&nbsp;Antoine Acker MD,&nbsp;Emily J. Luo MHSc,&nbsp;Enrico Pozzessere MD,&nbsp;Scott J. Ellis MD,&nbsp;Francois Lintz MD, PhD,&nbsp;Cesar de Cesar Netto MD, PhD","doi":"10.1053/j.jfas.2026.05.012","DOIUrl":"10.1053/j.jfas.2026.05.012","url":null,"abstract":"<div><h3>Background</h3><div>Progressive Collapsing Foot Deformity (PCFD) is a complex multiplanar deformity commonly treated with osteotomy-based reconstruction in flexible cases. Although weightbearing CT (WBCT) has improved assessment of PCFD, WBCT-based predictive planning models remain unexplored.</div></div><div><h3>Purpose</h3><div>To evaluate the accuracy of a WBCT-based predictive surgical planning model in estimating postoperative alignment following reconstruction for flexible PCFD.</div></div><div><h3>Study design</h3><div>Retrospective cohort study</div></div><div><h3>Methods</h3><div>Thirty-four patients with PCFD who underwent reconstruction with medial displacement calcaneal osteotomy, lateral column lengthening, and/or first-ray plantarflexion osteotomy and had preoperative and 3-month postoperative WBCT were included. The model estimated postoperative hindfoot moment arm (HMA), axial talus–first metatarsal angle (TFMA-A), talonavicular coverage angle (TNCA), and sagittal talus–first metatarsal angle (TFMA-S) using correction magnitudes. Predicted alignment was compared with postoperative WBCT measurements using Bland–Altman analysis, mean absolute error (MAE), root-mean-square error (RMSE), and paired t-tests.</div></div><div><h3>Results</h3><div>Predictive accuracy was highest for HMA, with a mean bias of +2.73 mm (<em>p</em> = 0.005), narrowest limits of agreement (−7.66 mm to +13.12 mm), and lowest MAE and RMSE values (approximately 2.9 mm and 3.7 mm). TFMA-A, TNCA, and TFMA-S demonstrated wider limits of agreement (approximately −17° to +21°) and greater case-level variability, although no significant systematic differences between predicted and postoperative values were observed (<em>p</em> = 0.21–0.90).</div></div><div><h3>Conclusions</h3><div>A WBCT-based predictive surgical planning model estimated postoperative alignment accurately for hindfoot valgus correction, while predictions of midfoot/forefoot abduction and arch collapse demonstrated greater individual variability. Despite this variability, the model accurately reproduced mean multiplanar correction, supporting patient-specific surgical planning in PCFD.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 170.e1-170.e6"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983994","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":"Surgical outcomes of insertional Achilles tendinopathy: A comparison of techniques with and without FHL transfer","authors":"Güneş Ateş MD,&nbsp;Saffet B. Korkut MD,&nbsp;Abdurrahman Vural MD,&nbsp;Mehmet A. Tokgöz MD,&nbsp;Hamza Özer MD","doi":"10.1053/j.jfas.2026.05.010","DOIUrl":"10.1053/j.jfas.2026.05.010","url":null,"abstract":"<div><h3>Background</h3><div>Insertional Achilles tendinopathy may require surgery when nonoperative treatment fails. Flexor hallucis longus (FHL) tendon transfer is used as an adjunct in advanced insertional degeneration.</div></div><div><h3>Purpose</h3><div>To compare 1-year outcomes, minimal clinically important difference (MCID) achievement, and complications between FHL transfer with debridement/retrocalcaneal ostectomy and debridement/ostectomy alone.</div></div><div><h3>Study design</h3><div>Retrospective comparative cohort study (indication-based group allocation).</div></div><div><h3>Methods</h3><div>Thirty consecutive patients treated surgically between 2017 and 2023 were reviewed retrospectively. Preoperative magnetic resonance imaging (MRI) planimetry guided selection: patients with &gt;50% degeneration underwent FHL transfer plus debridement and retrocalcaneal ostectomy (n = 15), whereas patients with ≤50% degeneration underwent debridement and ostectomy alone (n = 15). Outcomes were assessed preoperatively and at 1 year using the Victorian Institute of Sport Assessment–Achilles (VISA-A), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AH), Foot and Ankle Ability Measure (FAAM), Foot and Ankle Disability Index (FADI), and visual analog scale (VAS) pain. MCID was calculated using a distribution-based method.</div></div><div><h3>Results</h3><div>Both groups improved significantly at 1 year (all p &lt; 0.05). No between-group differences were observed for VAS, AOFAS-AH, FAAM, or FADI (all p &gt; 0.05). The FHL group had higher postoperative VISA-A scores (65.9 ± 15.3 vs 49.9 ± 19.7; p = 0.031) and higher VISA-A MCID achievement (93.3% vs 66.6%; p = 0.046). Minor wound complications occurred in 4 patients (2/15 in each group).</div></div><div><h3>Conclusions</h3><div>Both surgical approaches improved pain and function at 1 year. In this indication-based cohort, adding FHL transfer for &gt;50% MRI-defined degeneration was associated with higher Achilles-specific function (VISA-A) without increased wound complications.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 168.e1-168.e6"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984047","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 the effect of osteotomy type, screw type, and configuration on stability in medial malleolus osteotomy: Biomechanical analysis","authors":"Furkan Soy MD,&nbsp;Erkan Kıyak MD,&nbsp;Ozan Pehlivan MD,&nbsp;Sancar Serbest MD","doi":"10.1053/j.jfas.2026.04.001","DOIUrl":"10.1053/j.jfas.2026.04.001","url":null,"abstract":"<div><h3>Background</h3><div>Access to the medial dome of the talus may sometimes require medial malleolus osteotomy (MMO) in ankle surgeries.</div></div><div><h3>Purpose</h3><div>This study compared the biomechanical stability of cortical screws and headless compression screws used in double and triple screw configurations with oblique and chevron MMO.</div></div><div><h3>Study Design</h3><div>This study was conducted using 64 artificial distal tibial bone models (Selbones®, Kayseri, Turkey) for simulated MMO. The models were randomly divided into eight groups based on osteotomy techniques, screw types, and fixation configurations.</div></div><div><h3>Methods</h3><div>For each model, axial load values (newtons [N]) required to achieve 3 mm and 5 mm displacement, stiffness (N/mm), and photographic joint step formation (mm) were measured.</div></div><div><h3>Results</h3><div>Axial load values varied significantly among the groups at both displacement levels (p &lt; 0.05). The oblique MMO group fixed with two compression screws showed the lowest stiffness, while the chevron MMO group fixed with three cortical screws exhibited the highest stiffness. No significant differences were found among the groups regarding joint step formation at a 5 mm displacement. Furthermore, triple screw configurations demonstrated a significantly higher load-bearing capacity and stiffness compared to double screw configurations, regardless of the screw type or MMO technique used (p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>The oblique and chevron MMO techniques, along with fixation methods using cortical and headless compression screws, exhibited similar biomechanical performance. However, triple screw fixation offers superior biomechanical stability compared to double screw constructs. Among the methods tested, the chevron MMO fixed with three cortical screws demonstrated the most favorable biomechanical properties.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 148.e1-148.e6"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640424","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":"Union rates of Weber B fibular fractures: A retrospective comparison of lateral locking plate fixation with and without interfragmentary lag screws","authors":"Payaam P. Tavakoli DPM,&nbsp;Phoram B. Vyas DPM,&nbsp;Kevin Huntsman DPM,&nbsp;Eric Duffin DPM,&nbsp;Paul Brancheau DPM, FACFAS","doi":"10.1053/j.jfas.2026.03.007","DOIUrl":"10.1053/j.jfas.2026.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Plate fixation with an interfragmentary lag screw is often used for Weber B fibular fractures. However, consensus is lacking regarding whether lateral locking plate fixation without a lag screw is also a viable option for Weber B fractures.</div></div><div><h3>Purpose</h3><div>Compare union rates of Weber B fibular fractures fixated using a lateral locking plate and lag screw versus a lateral locking plate-only.</div></div><div><h3>Study Design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on patients who underwent ankle open reduction internal fixation (ORIF) at a single institution between 01/01/2022 and 01/01/2024. Patients had a minimum of a 12 month follow-up. Primary outcome measured included fracture union within 12 weeks which was defined as radiographic evidence of bridging callus across the fracture site with resolution of fracture line, painless weightbearing, and minimal or no tenderness on palpation over the fracture site. Secondary outcomes included time to union and complication rates.</div></div><div><h3>Results</h3><div>Seventy-one patients were included, 41 of which were treated with a plate and lag screw, and 30 with a plate-only. There was no significant difference in union rates (plate + lag screw: 97.56% vs plate-only 93.33%, <em>p</em> = 0.38) or time to union (plate + lag screw: 8.45 weeks vs plate-only 9.10 weeks, <em>p</em> = 0.23). The plate-only group showed a slightly lower complication rate, although not statistically significant (<em>p</em> = 0.76).</div></div><div><h3>Conclusion</h3><div>With no significant differences observed in union rates, time to union, or complication rates, plate-only fixation seems to be a reliable alternative when insertion of an interfragmentary lag screw may not be feasible.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 144.e1-144.e4"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437091","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":"Safety and feasibility of percutaneous flexor digitorum longus needle tenotomy: A cadaveric study across surgeon experience level","authors":"Antonella Henson-Vendrell BS,&nbsp;Devon Niewohner DPM, AACFAS,&nbsp;Hayden Bush DPM,&nbsp;Lindsay LeSavage DPM, AACFAS,&nbsp;Garrett Bullock PT, DPT, DPhil,&nbsp;Ashleigh Wells Medda DPM, FACFAS,&nbsp;Paula Gangopadhyay DPM, FACFAS","doi":"10.1053/j.jfas.2026.05.002","DOIUrl":"10.1053/j.jfas.2026.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous flexor tenotomy is used to correct lesser toe deformities but is frequently performed without direct visualization. This study evaluated the anatomic safety and feasibility of percutaneous flexor digitorum longus needle tenotomy and assessed whether performance and practicability varied by surgeon experience.</div></div><div><h3>Study Design</h3><div>Cadaveric study.</div></div><div><h3>Methods</h3><div>Fifty-four toes (digits 2–4) from nine cadaveric specimens underwent standardized percutaneous tenotomy using an 18-gauge needle performed by a podiatric attending, a third-year chief resident, and a first-year resident (18 toes per operator). Post-procedural dissections were performed to assess neurovascular integrity and tendon transection. Tendon widths were measured to calculate absolute and proportional resection. Analysis of covariance compared tendon resection depth across training levels while adjusting for original tendon width. Logistic regression estimated odds of complete transection.</div></div><div><h3>Results</h3><div>All procedures preserved the plantar digital arteries and nerves. Complete tendon transection occurred in 10 of 54 cases (18.5%): 3 attending (16.7%), 3 chief resident (16.7%), and 4 PGY1 (22.2%). Complete misses occurred in 7 attending (38.9%), 3 chief resident (16.7%), and 5 PGY1 (27.8%) cases. Mean tendon resection measured 1.56 ± 1.42 mm for the attending, 2.78 ± 1.80 mm for the chief resident, and 2.61 ± 2.15 mm for the PGY1.</div></div><div><h3>Conclusion</h3><div>Percutaneous flexor digitorum longus tenotomy with an 18-gauge needle demonstrated consistent anatomic safety across experience levels but infrequently achieved complete tendon transection. These findings suggest that complete transections may be difficult to consistently achieve percutaneously and may not be required for clinical correction.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 163.e1-163.e5"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous long flexor needle tenotomy of toes: a simple, safe, and effective procedure for diabetic foot salvage and intertrigo. Single-centre retrospective cohort study","authors":"Rajendran Purushothaman Dr. MBBS, MS, DNB (GEN.SURGERY), MRCS(EDIN), M.Ch, DNB (PLASTIC SUR) (AURA PLASTIC SURGERY),&nbsp;Prasanna Kumar Gupta Dr. MBBS, MD,&nbsp;R. Vikram Kumar Dr. MBBS, MS, M.Ch","doi":"10.1053/j.jfas.2026.05.011","DOIUrl":"10.1053/j.jfas.2026.05.011","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes causes toe deformities leading to trophic ulcers, intertrigo, and amputations.</div></div><div><h3>Purpose</h3><div>Percutaneous long flexor tenotomy rapidly heals flexible claw toe ulcers with low recurrence, outperforming conservative offloading and strongly recommended by International Working Group for Diabetic Foot (IWGDF) guidelines.</div></div><div><h3>Methods and study design</h3><div>This retrospective cohort study analysed single author cases from February 2019 to April 2026, evaluated percutaneous long flexor tenotomy effectiveness in resolving diabetic toe pathologies including ulcer healing, callosity prevention, fungal lesion clearance, resolution timelines, and rates of recurrence and complications.</div></div><div><h3>Results</h3><div>Of 49 percutaneous long flexor tenotomies in 25 patients for intertrigo and trophic toe changes across all toes, mean follow-up was 16.93 months, with healing times of 38.5 days for intertrigo and 27.4 days for trophic changes; no serious complications occurred, recurrences were minimal and manageable yielding 4.08 percent failure, and 9 transfer lesions resolved after secondary procedures.</div></div><div><h3>Conclusion</h3><div>Our cohort demonstrated high healing rates for intertrigo and trophic toe changes, with low failure rates, manageable recurrences and transfer lesions, and minimal complications affirming broad safety and efficacy of the procedure. This procedural efficacy is particularly significant given the high rates of diabetic foot complications, where even minor toe deformities can precipitate severe ulceration and subsequent limb loss.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 169.e1-169.e8"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989844","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}