Journal of Foot & Ankle Surgery最新文献

{"title":"Determination of pathogens in deep surgical site infections following sinus tarsi approach calcaneal fracture surgery via open reduction internal fixation or primary arthrodesis - Implications for prophylaxis and treatment","authors":"Robin Eelsing ,&nbsp;Jens A. Halm ,&nbsp;Noam Nieboer ,&nbsp;Caspar J. Hodiamont ,&nbsp;Tim Schepers","doi":"10.1053/j.jfas.2025.04.004","DOIUrl":"10.1053/j.jfas.2025.04.004","url":null,"abstract":"<div><div><span>High rates of surgical site infections<span><span> (SSI) have been reported after calcaneal fracture surgery. The aims of the current study were to re-evaluate the rate of deep SSIs after </span>ORIF<span> of displaced intra-articular calcaneal fractures via the sinus tarsi approach, to identify different types of bacteria in the first obtained cultures and to determine the accuracy of the initially started (empiric) antibiotics prior to the results of the cultures. A search was performed from August 2012 to December 2023 using the specific surgical code for this procedure. Besides subject and surgery characteristics, the occurrence of deep SSI, the causative pathogens, and subsequent treatment strategies were documented. A total of 391 patients were screened for wound complications, among these patients fifteen deep SSI were found after a sinus tarsi approach (STA) (3.4%). The median age of patients was 57 (IQR 22) years, the majority of these patients identified as male (n=13, 87%) and were smokers (n=10, 67%). The most prevalent microorganisms were </span></span></span><span><span>Staphylococcus aureus</span></span> (present in 73.3% of cultures) and <span><span>Enterobacter cloacae</span><em> complex</em></span> (present in 53.3% of cultures). Eight patients had infections with multiple species of microorganisms. Given the fact that an <em>Staphylococcus aureus</em> and/or <em>Enterobacter cloacae complex</em><span> were present in more than half of the cultures, we recommend targeting empiric antibiotic<span> treatment at both gram-positive and gram-negative microorganisms once a deep SSI is suspected after calcaneal fracture surgery.</span></span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 597-601"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038461","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":"Subscription Information","authors":"","doi":"10.1053/S1067-2516(25)00216-9","DOIUrl":"10.1053/S1067-2516(25)00216-9","url":null,"abstract":"","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Page A2"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005272","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":"Does central-splitting or complete detachment provide better clinical results in surgical treatment of Haglund's disease? A 2 to 6 years retrospective comparative follow-up study","authors":"Piyanuch Musikachart,&nbsp;Theerawoot Tharmviboonsri,&nbsp;Bavornrit Chuckpaiwong,&nbsp;Penpun Lertwattanachai,&nbsp;Thos Harnroongroj","doi":"10.1053/j.jfas.2025.04.006","DOIUrl":"10.1053/j.jfas.2025.04.006","url":null,"abstract":"<div><div>A central-splitting and complete detachment of the Achilles tendon are common surgical approaches in Haglund's disease surgery. The objective of this study was to compare the 2- to 6-year clinical and radiographic outcomes between central-splitting and complete Achilles tendon detachment. The study involved patients with Haglund's disease who underwent surgery at our institution from 2018 to 2023. Demographic data and preoperative visual analogue scale (VAS) for pain and the Foot and Ankle Ability Measure (FAAM) for Activities of Daily Living (ADL) were collected. At the final follow-up, postoperative VAS for pain, FAAM for ADL, and plantar-flexion strength was evaluated. Postoperative imaging was analyzed using the parallel pitch line and the Chauveaux-Liet angle to evaluate the ‘radiographic complete bone removal’. A total of 77 patients were recruited; 35 treated using central-splitting and 42 using the complete detachment approach. There was no statistically significant difference in demographic characteristics among the groups. The result demonstrated that FAAM for ADL was statistically significant higher in central splitting detachment as mean 87.4 (SD = 4.2) vs 82.4 (SD = 6.4), <em>p</em> &lt; 0.0001. There was no statistically significant difference for the VAS for pain, plantar-flexion strength, radiographic complete bone removal and complications. Central-splitting detachment could provide a significantly better functional outcome compared to complete detachment of Achilles tendon for the Haglund's disease surgery during 2 to 6 years of follow-up.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 608-612"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006275","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":"Defining the patient acceptable symptom state (PASS) for PROMIS after Hallux Rigidus correction surgery","authors":"Allison L. Boden MD ,&nbsp;Stone R. Streeter BS ,&nbsp;Seif El Masry BS ,&nbsp;Grace M. DiGiovanni BA ,&nbsp;Matthew S. Conti MD ,&nbsp;Scott J. Ellis MD","doi":"10.1053/j.jfas.2025.03.008","DOIUrl":"10.1053/j.jfas.2025.03.008","url":null,"abstract":"<div><div><span><span>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 </span>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 (</span><em>p</em> &lt; 0.05). Patients who did not undergo first metatarsophalangeal (MTP) fusion were more likely to reach the PASS threshold for the Physical Function domain (<em>p</em> = 0.045). For the Pain Intensity domain, younger patients were more likely to meet the thresholds (<em>p</em><span><span> = 0.005). Patient sex, BMI, and use of either cheilectomy or Akin/Moberg </span>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.</span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 521-525"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","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}

{"title":"Effect of surgery for ankle osteoarthritis on locomotive syndrome","authors":"Kanu Shimokawa MD,&nbsp;Hidenori Matsubara MD, PhD,&nbsp;Satoshi Kato MD, PhD,&nbsp;Toshifumi Hikichi MD,&nbsp;Yuki Fushitani MD,&nbsp;Yusuke Nakazawa MD,&nbsp;Satoru Demura MD, PhD","doi":"10.1053/j.jfas.2025.05.001","DOIUrl":"10.1053/j.jfas.2025.05.001","url":null,"abstract":"<div><div><span><span>Locomotive syndrome (LS) is characterized by a decline in locomotor function due to musculoskeletal disorders<span>. However, few studies have explored its association with ankle osteoarthritis (AOA) or surgical impact. This study evaluated LS and its improvement following </span></span>corrective osteotomy<span> (CO) or arthrodesis for AOA and compared outcomes between procedures. LS stages, ranging from 0 (healthy) to 3 (most declined), were assessed preoperatively and at 12 months postoperatively using the stand-up test (ability to rise from different heights), two-step test (maximum stride length over two strides), and GLFS-25 (self-reported locomotor function). Pre- and postoperative comparisons and group differences were analyzed, with </span></span><em>p</em> &lt; 0.05 considered significant. Forty patients were included. All patients had a preoperative LS stage 1 to 3, with a prevalence of LS stage 3 of 57.5 %. At 12 months after surgery, the prevalence of LS stage 1 to 3 was 95.0 %, but the prevalence of LS stage 3 decreased to 30.0 %. At least one LS stage improved postoperatively in 19 patients (47.5 %). There was no significant difference between pre- and post-operative stand-up test results (<em>p</em> = 0.74), but the two-step test and GLFS-25 improved significantly postoperatively (two step: <em>p</em> = 0.01, GLFS-25: <em>p</em> &lt; 0.001). The GLFS-25 improved significantly postoperatively in both groups (corrective osteotomy: <em>p</em> = 0.001, Arthrodesis: <em>p</em> = 0.01); however, the two-step test improved significantly postoperatively only in the corrective osteotomy group (corrective osteotomy: <em>p</em> = 0.02, Arthrodesis: <em>p</em> = 0.44). In conclusion, ankle osteoarthritis may be a factor affecting LS, and corrective osteotomy tended to be more effective in improving the two-step test.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 638-643"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative rehabilitation practices and procedures following ankle arthroscopy in France","authors":"Jean-Charles Giunta MD ,&nbsp;Mo Saffarini MEng, MBA, FRSM ,&nbsp;Floris van Rooij MSc ,&nbsp;Ankitha Kumble BSc ,&nbsp;Philippe Beaudet MD","doi":"10.1053/j.jfas.2025.04.002","DOIUrl":"10.1053/j.jfas.2025.04.002","url":null,"abstract":"<div><div>The purpose was to compare the rehabilitation practices and procedures following arthroscopic ankle lateral ligament<span> repair (ALLR) (reconstruction/Broström repair) among high-volume and low-volume surgeons in France. The hypothesis was that there would be no differences in practices and procedures between high-volume and low-volume surgeons. In 2023, an online questionnaire was emailed to members of the francophone arthroscopy<span> society (SFA). Fifty-two surgeons responded, of which 10 (19.2%) were excluded as they did not perform arthroscopic ALLR. The questionnaire focused on four main topics: (i) surgeon experience and technique, (ii) immobilisation, (iii) weight-bearing, and (iv) cryotherapy<span>. Surgeons were divided into high- (≥35 cases/year) and low-volume (&lt;35 cases/year) surgeons, according to the number of ankle arthroscopies performed. A greater proportion of high-volume surgeons prescribe less restrictive immobilisation compared to low-volume surgeons (46% vs 22%). A smaller proportion of high-volume surgeons restrict immediate weight-bearing compared to low-volume surgeons (8% vs 33%). A greater proportion of high-volume surgeons would prescribe crutches only if patients request them, compared to low-volume surgeons (79% vs 50%). A greater proportion of high-volume surgeons prescribe cryotherapy compared to low-volume surgeons, more frequently (87% vs 78%) and immediately following surgery (46% vs 22%). This survey revealed that high-volume surgeons prescribe less restrictive immobilisation and allow earlier weight-bearing following arthroscopic ALLR, compared to low-volume surgeons. The clinical relevance is that low-volume surgeons should gain greater confidence in prescribing less restrictive immobilisation and immediate weight-bearing, based on experience of high-volume peers, which could help improve outcomes of arthroscopic ALLR and reduce healthcare and economic burdens.</span></span></span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 588-591"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797011","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":"Evaluating the role of fluoroscopy in calcaneal pin placement","authors":"Fatih Barça MD,&nbsp;Ekin Barış Demir MD,&nbsp;Mustafa Fatih Sarı MD,&nbsp;Mutlu Akdoğan MD,&nbsp;Yalım Ateş MD,&nbsp;Halis Atıl Atilla MD","doi":"10.1053/j.jfas.2025.03.017","DOIUrl":"10.1053/j.jfas.2025.03.017","url":null,"abstract":"<div><div><span>Although fluoroscopy-assisted calcaneal pin placement for ankle-spanning external fixation<span><span><span> or skeletal traction was advocated in the literature, evidence for necessity of </span>fluoroscopy<span> for this application is lacking. This study aimed to compare the calcaneal pin locations and complications of patients who underwent pin placement with and without fluoroscopy guidance. In this retrospective cohort study, adult patients that underwent external fixation for </span></span>ankle fractures<span><span> between October 2022 and May 2024 were included. The primary outcome was the rate of the pins that were inside the safe zone. Secondary outcomes were the distance of pins to the tip of medial malleolus and the posteriormost point of </span>calcaneus<span> and complications such as neurovascular deficit and calcaneal fracture. Eighty-two patients (mean age 47±16.4 - min. 18 - max. 89, 54.9 % male) were involved in the study. Forty-five patients (group 1) had their pins placed without fluoroscopy assistance and thirty-seven patients (group 2) with fluoroscopy assistance. Five patients (11.1 %) in group 1 and seven patients (18.9 %) in group 2 had their pins placed outside the safe zone (</span></span></span></span><em>P =</em> 0.320). Distance of the hole from medial malleolus was mean 38.8 ± 7.9 mm for group 1 and 51.3 ± 8.32 mm for group 2 (<em>P</em> &lt; 0.001), and distance from posteriormost point of calcaneus was mean 25.2 ± 6.3 mm for group 1 and 21.4 ± 7.9 mm for group 2 (<em>P</em> = 0.019). No neurovascular complications or calcaneal fracture were seen during follow-up. In conclusion, fluoroscopy guidance does not provide any additional benefit for placing calcaneal pins.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 570-573"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732542","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":"Direct or indirect reduction internal fixation for posterior ankle fractures: A systematic review and meta-analysis","authors":"GuiSong Yu ,&nbsp;YuPeng Dong ,&nbsp;YuBo Cui ,&nbsp;ZhiJun Yang ,&nbsp;Xing Fu ,&nbsp;Dian Li ,&nbsp;WenLong Yang ,&nbsp;FengYun Yang","doi":"10.1053/j.jfas.2025.03.014","DOIUrl":"10.1053/j.jfas.2025.03.014","url":null,"abstract":"<div><div><span>Direct or indirect internal fixation for posterior ankle fractures<span> remains a controversial topic. While direct plate or screw internal fixation is believed to provide better reduction, it may also cause more severe soft tissue damage<span><span>, while indirect screw internal fixation is thought to result in less damage but may carry the risk of poor reduction. We conducted this meta-analysis to investigate the clinical efficacy and safety of direct versus indirect reduction internal fixation for posterior ankle fractures. The Preferred Reporting Items for Systematic Evaluation and Meta-Analysis (PRISMA) guidelines were used to search the China Knowledge Network database (CNKI), PubMed, Web of Science, Embase, and other databases from the year of establishment- February 2025, and relevant journals were manually searched to collect the relevant literature, and articles that met the requirements were screened and analyzed. Meta-analysis was conducted using RevMan 5.4 software, and a systematic evaluation was carried out when the data from the included studies could not be synthesized. A total of 17 articles involving 1538 study subjects were included, and the results showed that there were no statistical differences in postoperative AOFAS scores, complications, and Dorsiflexion restriction between ankle fractures after direct plate or screw reduction and fixation and those after indirect screw reduction and fixation; however, the Radiological evaluation&gt;2 mm and </span>Osteoarthritis (</span></span></span><em>P</em> &lt; 0.05) were statistically different. Direct reduction and fixation of posterior ankle fractures has better imaging performance and reduces the incidence of postoperative arthritic events.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 665-675"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674638","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":"Inter-reader reliability in multi-plane and multi-time point Hallux valgus correction evaluation on post-operative weight-bearing radiographs from a prospective multi-center trial and correlation with patient reported outcome measures","authors":"Shyam S. Ramachandran ,&nbsp;Seth Reine ,&nbsp;Holden Archer ,&nbsp;Jennifer Koay ,&nbsp;Dane K. Wukich MD ,&nbsp;Avneesh Chhabra MD","doi":"10.1053/j.jfas.2025.04.011","DOIUrl":"10.1053/j.jfas.2025.04.011","url":null,"abstract":"<div><div>The primary purpose of this study was to determine interreader reliability (IRR) of hallux valgus<span> (HV) related parameters on different time-points in dorsoplanar and coronal planes, i.e. hallux valgus angle (HVA), metatarsal rotation, sesamoid subluxation<span>, metatarsal sesamoid osteoarthritis, tibial sesamoid point, and lateral round sign. The secondary purpose was to correlate these measurements with patient-reported outcome measures (PROMs) at the initial presentation for HV surgery and at 6 weeks, 4 months, 6 months, 12 months, and 24 months. Radiographic imaging and PROMs were collected at 5 different postoperative time points. Two musculoskeletal radiologists independently performed all readings and foot measurements blinded to each other’s reads and the clinical information. Intraclass coefficient and kappa were obtained for interreader analysis. A partial spearman rank order was used to correlate radiographic foot measurements and PROMs. Across all 5 follow-up time points (6 weeks, 4 months, 6 months, 12 months, and 24 months), we found excellent IRR for HVA and poor reliability for lateral round sign, sesamoid subluxation, and metatarsal-sesamoid OA. We found excellent IRR for TSP at all follow-up time points except for at 6 weeks. There was a weak, positive correlation between sesamoid subluxation and PROMIS depression score at 24-month follow-up (R=0.21), and a negative correlation between metatarsal-sesamoid OA and PROMIS social score at 24-month follow-up (R=-0.21). We report excellent reproducibility for HVA in post-operative radiographs but variable- poor to excellent IRR for a range of HV-related parameters assessed on the axial view. There were no major trends in the correlation between the quantitative radiographic foot measurements and PROMs except for some weak correlations.</span></span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 634-637"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056195","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":"Distal tibial osteophytes are more accurate than medial malleolar anatomy when using patient specific instrumentation in total ankle replacement","authors":"Jason George DeVries DPM, FACFAS ,&nbsp;Andrew Regal DPM, FACFAS ,&nbsp;Tisileli S. Tuifua MD ,&nbsp;Brandon M. Scharer DPM, FACFAS","doi":"10.1053/j.jfas.2025.03.012","DOIUrl":"10.1053/j.jfas.2025.03.012","url":null,"abstract":"<div><div><span>Total ankle replacement<span> (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°, </span></span><em>p</em> = 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, <em>p</em> = 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, <em>p</em> = 0.04. While both groups show good accuracy, alignment based on the distal tibial osteophytes is more accurate than using the medial malleolus.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 546-551"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","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}