Journal of Foot & Ankle Surgery最新文献_第5页

A comparative study of postoperative clinical outcomes of lateral ankle ligament repair for early-stage ankle osteoarthritis in middle-aged and elderly patients 中老年早期踝关节骨关节炎患者踝关节外侧韧带修复术后临床效果的比较研究。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-09-01 DOI: 10.1053/j.jfas.2025.05.003

Taihei Miura MD, PhD, Yasuyuki Jujo MD, Jun Horng Tan MBBS, FHKCOS, FHKAM (Ortho), FRCSEd (Ortho), Kazuaki Okugura PT, Yukinori Mori PT, Kenta Komesu PT, Masato Takao MD, PhD

{"title":"A comparative study of postoperative clinical outcomes of lateral ankle ligament repair for early-stage ankle osteoarthritis in middle-aged and elderly patients","authors":"Taihei Miura MD, PhD, Yasuyuki Jujo MD, Jun Horng Tan MBBS, FHKCOS, FHKAM (Ortho), FRCSEd (Ortho), Kazuaki Okugura PT, Yukinori Mori PT, Kenta Komesu PT, Masato Takao MD, PhD","doi":"10.1053/j.jfas.2025.05.003","DOIUrl":"10.1053/j.jfas.2025.05.003","url":null,"abstract":"<div><div><span>Although lateral ankle ligament repair has demonstrated favorable postoperative outcomes, few studies have focused on elderly patients. The aim of this study was to compare the postoperative clinical outcomes of lateral ankle ligament repair in middle-aged and elderly patients with early-stage ankle </span>osteoarthritis (OA). This study was a retrospective analysis of 99 patients aged 40 years or older with chronic lateral ankle instability (LAI) associated with ankle OA who were followed up for at least 12 months after surgery. The patients were divided into two groups: 60 patients in the middle-aged group (40-64 years) and 39 patients in the elderly group (≥65 years), all of whom underwent lateral ankle ligament repair. The recovery time to preoperative walking levels and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) scores preoperatively and postoperatively were investigated and compared between the two groups. Compared with the preoperative scores, SAFE-Q scores improved significantly across all items in both groups at 12 months post-surgery. There was no difference in pain or pain-related scores between the two groups up to 12 months post-surgery. Furthermore, all patients recovered to their preoperative walking levels or above. However, the elderly group took significantly longer to recover after surgery than the middle-aged group did. Lateral ankle ligament repair yields favorable clinical outcomes even in elderly patients. However, elderly patients took significantly longer to recover walking levels after surgery than middle-aged patients. Therefore, preoperative patient education and postoperative rehabilitation protocols may need to be adjusted accordingly.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 649-654"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cover 1 -- cover prints black and PMS 261 封面1 -封面印刷黑色和PMS 261

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-09-01 DOI: 10.1053/S1067-2516(25)00214-5

引用次数: 0

The role of local flap reconstruction for limb salvage in patients with moderate to severe medial arterial calcification 局部皮瓣重建在中重度内侧动脉钙化患者保肢中的作用。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-09-01 DOI: 10.1053/j.jfas.2025.03.013

Rachel N. Rohrich BS , Karen R. Li BBA , Ryan P. Lin MD , Sami Ferdousian MS , Isabel A. Snee BS , Roumina Adab BS , Jayson N. Atves DPM, FACFAS , John S. Steinberg DPM, FACFAS , Richard C. Youn MD , Karen K. Evans MD , Cameron M. Akbari MD , Christopher E. Attinger MD

{"title":"The role of local flap reconstruction for limb salvage in patients with moderate to severe medial arterial calcification","authors":"Rachel N. Rohrich BS , Karen R. Li BBA , Ryan P. Lin MD , Sami Ferdousian MS , Isabel A. Snee BS , Roumina Adab BS , Jayson N. Atves DPM, FACFAS , John S. Steinberg DPM, FACFAS , Richard C. Youn MD , Karen K. Evans MD , Cameron M. Akbari MD , Christopher E. Attinger MD","doi":"10.1053/j.jfas.2025.03.013","DOIUrl":"10.1053/j.jfas.2025.03.013","url":null,"abstract":"<div><div><span>The medial arterial calcification (MAC) scoring system (Figure 1) predicts adverse limb events. This study applies MAC scoring to patients undergoing local flap reconstruction. To do so, we reviewed patients that underwent foot and ankle local flaps from January 2010 to November 2022. Radiographs were used to assign MAC scores: absent (MAC=0-1), moderate (MAC=2-3), or severe (MAC≥4). 182 patients underwent local flap reconstruction: 104 (57.1 %) absent MAC, 32 (17.6 %) moderate MAC, and 46 (25.3 %) severe MAC. Patients with severe MAC demonstrated significantly higher rates of diabetes mellitus (</span><em>p</em> = 0.001), end-stage renal disease (<em>p</em> < 0.001), and peripheral neuropathy (<em>p</em> < 0.001), and more often required a vascular intervention before reconstruction (<em>p</em><span> = 0.001). Flap-related outcomes and major limb amputation<span> rates were statistically comparable among MAC groups. By a median of 16.5 (IQR: 36.6) months, limb salvage was 84.1 % and not independently associated with MAC on multivariable analysis. Postoperative vascular intervention (absent: 10.7 % vs. moderate: 28.1 % vs. severe: 17.4 %; </span></span><em>p</em><span> = 0.054), podiatric reoperation (absent: 35.6 % vs. moderate: 40.6 % vs. severe: 56.5 %; </span><em>p</em> = 0.056), and mortality (absent: 19.4 % vs. moderate: 34.4 % vs. 32.6 %; <em>p</em> = 0.102) were not independently associated with MAC on multivariable analysis. Given these results, local flaps are a viable option in patients with MAC. If utilizing a vasculo-plastic approach, severe MAC should not prevent limb salvage efforts via local flap reconstruction.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 552-558"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The influence of pre-operative reduction quality on post-operative wound complications in ankle fractures: A review of 247 cases 术前复位质量对247例踝关节骨折术后伤口并发症的影响

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-09-01 DOI: 10.1053/j.jfas.2025.04.010

Rye Yern Yap MRCS, Peter Logan MRCS, Mohammad Iqbal MRCS, Vishwajeet Kumar FRCS Tr & Orth, Zaid Al-Wattar FRCS Tr & Orth

{"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 MRCS, Peter Logan MRCS, Mohammad Iqbal MRCS, Vishwajeet Kumar FRCS Tr & Orth, Zaid Al-Wattar FRCS Tr & Orth","doi":"10.1053/j.jfas.2025.04.010","DOIUrl":"10.1053/j.jfas.2025.04.010","url":null,"abstract":"<div><div><span><span><span><span>Opinions vary on the definition of an adequate pre-operative reduction for unstable ankle fractures that require surgical fixation. We hypothesized that residual tibiotalar </span>subluxation may impair post-operative </span>wound<span><span><span> healing. This study aimed to evaluate the influence of pre-operative reduction quality on the rate of wound complications following ankle fracture fixation. A </span>retrospective cohort study<span> 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 </span></span>subluxation of > 2mm on post-manipulation radiographs. Wound complication was defined as any wound problem requiring additional dressing care, </span></span>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, </span><em>p</em><span> = 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.</span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 629-633"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","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}

引用次数: 0

Sedentary lifestyle and hallux valgus: Unraveling the causal pathways and the mediating role of calcium homeostasis through mendelian randomization 久坐不动的生活方式和拇外翻：通过孟德尔随机化揭示钙稳态的因果途径和中介作用。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-09-01 DOI: 10.1053/j.jfas.2025.04.003

Maolin Liu , Yan Liu , Miao Sun , Zhongyao Zeng , Yuanzhi Song , Erlong Jia , Shengde Wu

{"title":"Sedentary lifestyle and hallux valgus: Unraveling the causal pathways and the mediating role of calcium homeostasis through mendelian randomization","authors":"Maolin Liu , Yan Liu , Miao Sun , Zhongyao Zeng , Yuanzhi Song , Erlong Jia , Shengde Wu","doi":"10.1053/j.jfas.2025.04.003","DOIUrl":"10.1053/j.jfas.2025.04.003","url":null,"abstract":"<div><div><span><span>The causal relationships between hallux valgus (HV), sedentary </span>behavior and </span>calcium homeostasis<span> remain unclear. This study aimed to explore these associations using Mendelian randomization<span><span> (MR) analysis. Leisure screen time (LST) was used as an indicator of sedentary behavior, while seven traits and three diseases were selected to represent calcium homeostasis. Two-sample MR was performed to assess the causal effect of sedentary behavior and calcium homeostasis on HV. Two-step MR was conducted to quantify the mediating roles of calcium homeostasis-related traits in the association between sedentary behavior and HV. Our results showed that longer LST was strongly associated with higher risk of HV (odds ratio (OR) = 1.1902, 95 %CI = 1.0129–1.3986, p = 0.0343). By contrast, </span>serum calcium (S-Ca) levels were negatively associated with HV risk (OR = 0.7530, 95 %CI = 0.5675–0.9992, p = 0.0494). Mediation analyses found that S-Ca played an important mediating role in the effect of LST on HV (proportion mediated = 10.4 %). Our results extend the understanding of the pathogenesis of HV, and highlight the importance of preoperative metabolic optimization and postoperative behavioral and calcium supplementation strategies to enhance surgical outcomes and mitigate recurrence.</span></span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 592-596"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes of open or closed treatment of foot fractures: A database study comparing patients with and without diabetes 足部骨折开放或封闭治疗的结果：一项比较糖尿病患者和非糖尿病患者的数据库研究。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-09-01 DOI: 10.1053/j.jfas.2025.05.004

Dhruv Nandakumar , Benjamin M. Conover , Matthew J. Johnson DPM, FACFAS , Katherine M. Raspovic DPM, FACFAS , Dane K. Wukich MD

{"title":"Outcomes of open or closed treatment of foot fractures: A database study comparing patients with and without diabetes","authors":"Dhruv Nandakumar , Benjamin M. Conover , Matthew J. Johnson DPM, FACFAS , Katherine M. Raspovic DPM, FACFAS , Dane K. Wukich MD","doi":"10.1053/j.jfas.2025.05.004","DOIUrl":"10.1053/j.jfas.2025.05.004","url":null,"abstract":"<div><div>Treatment of ankle and foot fractures<span><span> in patients with diabetes mellitus (DM) is challenging, and complications may arise. Although much data exists on complication rates in tibial, fibular, and malleolar fractures<span>, there exists a comparable lack of data on complication rates in fractures of the tarsal, metatarsal, and phalanx bones of the foot. Therefore, we aimed to compare post-procedural outcomes after such fractures in diabetic vs non-diabetic patients. A commercially available de-identified database was searched using ICD-10 codes for the open or closed surgical treatment in patients with fractures of the </span></span>calcaneus, cuboid, navicular, talus, cuneiforms, metatarsals, and phalanges from 2010 to 2023. Patients with at least 1 year of post-procedural follow-up were included. We then separated patients into two groups: those with diabetes (108,603, 26.4 %) and those without diabetes (302,464, 73.6 %).</span></div><div>Post-procedural complications assessed including those related to hardware when surgical treatment was pursued (reoperation, non-union, malunion, delayed union, wound disruption<span><span>, surgical site infection) and health complications after fracture treatment (AKI, </span>DVT, MI, pneumonia, sepsis) were assessed at 1 year and odds ratios were used to compare rates of these complications in diabetics vs non-diabetics for each bone. Rates of complications after fracture treatment were found to be significantly higher in all bones for diabetic patients compared to non-diabetic patients.</span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 655-659"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Iatrogenic medial malleolar fracture and stress fracture considerations in total ankle joint replacement: A multicenter retrospective study 全踝关节置换术中医源性内踝骨折和应力性骨折：一项多中心回顾性研究。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-09-01 DOI: 10.1053/j.jfas.2025.04.008

Dr. James M. Cottom DPM, FACFAS (Director) , Dr. Jay S. Badell DPM, MS, FACFAS , Dr. Karl W. Dunn DPM, FACFAS , Dr. Josh Ekladios DPM

{"title":"Iatrogenic medial malleolar fracture and stress fracture considerations in total ankle joint replacement: A multicenter retrospective study","authors":"Dr. James M. Cottom DPM, FACFAS (Director) , Dr. Jay S. Badell DPM, MS, FACFAS , Dr. Karl W. Dunn DPM, FACFAS , Dr. Josh Ekladios DPM","doi":"10.1053/j.jfas.2025.04.008","DOIUrl":"10.1053/j.jfas.2025.04.008","url":null,"abstract":"<div><div>Total ankle replacement<span><span> (TAR) is a challenging but rewarding treatment option for primary or post-traumatic tibiotalar osteoarthritis<span><span><span>. Acute and latent postoperative stress fractures of the </span>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 </span>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 </span></span>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.</span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 619-623"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","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}

引用次数: 0

Satisfactory patient reported outcomes at five years following primary repair with suture tape augmentation for anterior talofibular ligament injury 对距腓骨前韧带损伤进行缝合带增强术初次修复后5年的患者报告结果令人满意。

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-09-01 DOI: 10.1053/j.jfas.2025.03.010

Paul McMillan MBChB, MSc , William T. Wilson MBChB, BSc(MedSci), FRCS (Tr & Orth) MFSEM(UK) , Graeme P. Hopper MBChB, MSc, MRCS, MFST, MD, FRCS (Tr & Orth) , Gordon MacKay MBChB, MD, FRCS (Tr & Orth)

{"title":"Satisfactory patient reported outcomes at five years following primary repair with suture tape augmentation for anterior talofibular ligament injury","authors":"Paul McMillan MBChB, MSc , William T. Wilson MBChB, BSc(MedSci), FRCS (Tr & Orth) MFSEM(UK) , Graeme P. Hopper MBChB, MSc, MRCS, MFST, MD, FRCS (Tr & Orth) , Gordon MacKay MBChB, MD, FRCS (Tr & Orth)","doi":"10.1053/j.jfas.2025.03.010","DOIUrl":"10.1053/j.jfas.2025.03.010","url":null,"abstract":"<div><div>The Brostrom technique is widely accepted as the gold standard surgical intervention for the treatment of chronic lateral ankle instability. Concerns with persistent postoperative instability, incomplete restoration of preinjury biomechanical strength, and variable return-to-sport rates have, however, led to growing interest in novel augmentation procedures. Suture tape augmentation, which reinforces the anterior talofibular ligament and acts as a secondary stabilizer, is one such method. This study assesses 5-year patient-reported outcomes of primary repair with suture tape augmentation for anterior talofibular ligament injuries<span>. Seventy-seven patients undergoing anterior talofibular ligament repair with suture tape augmentation were prospectively followed for at least 5-years. The visual analogue scale for pain (VAS), veteran rands 12 (VR-12) score, functional foot index (FFI), and the foot and ankle ability measure sports subscale (FAAM-S) were assessed at baseline, 2-year follow-up and 5-year follow-up. Of the seventy-seven patients initially included, sixty-eight (88.3%) completed follow-up. The median VAS, VR-12, FFI, and FAAM-S scores all demonstrated significant improvement at both 2-year and 5-year follow-up, compared to preoperative baseline. Only the FFI demonstrated improvement between the 2-year and 5-year follow-up timepoints. In conclusion, primary repair with suture tape augmentation for anterior talofibular ligament injury demonstrates satisfactory patient-reported outcomes at a minimum of 5-year follow-up. These results suggest that this technique should be considered as an alternative to conventional Brostrom repair for treatment of lateral ankle instability.</span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 534-540"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Percutaneous cannulated screw fixation vs open reduction and plate fixation for displaced intra-articular Sanders II and III calcaneal fracture: A two-center retrospective propensity-matched analysis. 经皮空心螺钉固定与切开复位钢板固定治疗移位的关节内Sanders II和III跟骨骨折：一项双中心回顾性倾向匹配分析

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-08-26 DOI: 10.1053/j.jfas.2025.08.008

Qingbing Jiang, Yifeng Shang, Xiong Liao, Wei Su

{"title":"Percutaneous cannulated screw fixation vs open reduction and plate fixation for displaced intra-articular Sanders II and III calcaneal fracture: A two-center retrospective propensity-matched analysis.","authors":"Qingbing Jiang, Yifeng Shang, Xiong Liao, Wei Su","doi":"10.1053/j.jfas.2025.08.008","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.08.008","url":null,"abstract":"<p><strong>Background: </strong>The optimal surgical strategy for treating displaced intra-articular calcaneal fractures remains controversial.</p><p><strong>Purpose: </strong>The purpose of this retrospective cohort study was to compare the clinical and radiologic outcomes of percutaneous cannulated screw fixation versus open reduction and plate fixation via the sinus tarsi approach in patients with displaced intra-articular Sanders II or III calcaneal fractures.</p><p><strong>Study design: </strong>A retrospective analysis was performed on the records of patients with displaced Sanders II or III calcaneal fractures.</p><p><strong>Methods: </strong>We analyzed data from 124 patients using propensity score matching applied at a 1:1 ratio. The primary outcome was assessed using the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale for evaluating ankle function. Secondary outcomes included radiological outcomes, operative time, postoperative Visual Analogue Scale, wound complication rates, and hardware removal rates.</p><p><strong>Results: </strong>There was no statistical difference in the American Orthopaedic Foot and Ankle Society ankle-hindfoot Scale (p=.104) and radiological outcomes (Böhler's angle, p=0.21; Gissane's angle, p=0.29) between the two groups. The percutaneous cannulated screw fixation group demonstrated better ankle-hindfoot complex motion, shorter operative time (65±35 mins vs 95±40 mins), lower postoperative Visual Analogue Scale (5±1 vs 8±1.5), fewer wound complications (3.2 % vs 9.6 %), and no hardware removal needed (0 % vs 14.5 %).</p><p><strong>Conclusion: </strong>This study suggests that both techniques achieved comparable functional and radiographic outcomes for displaced intra-articular Sanders II or III calcaneal fractures; however, percutaneous cannulated screw fixation demonstrated favorable advantages in several aspects.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Are interfragmentary lag screws necessary in surgical treatment of Weber B ankle fractures? 在韦伯B型踝关节骨折的手术治疗中是否需要椎间拉力螺钉？

IF 1.3 4区医学

Journal of Foot & Ankle Surgery Pub Date : 2025-08-22 DOI: 10.1053/j.jfas.2025.08.007

Alyssa Schreiber, Jane Brennan, Andrea Johnson, Adrienne Spirt, Elizabeth Friedmann, David Keblish, Justin Turcotte

{"title":"Are interfragmentary lag screws necessary in surgical treatment of Weber B ankle fractures?","authors":"Alyssa Schreiber, Jane Brennan, Andrea Johnson, Adrienne Spirt, Elizabeth Friedmann, David Keblish, Justin Turcotte","doi":"10.1053/j.jfas.2025.08.007","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.08.007","url":null,"abstract":"<p><strong>Background: </strong>Traditionally, open reduction and internal fixation (ORIF) for Weber B fibular fractures involves placement of a lag screw across the fracture plane along with plate fixation.</p><p><strong>Purpose: </strong>To compare outcomes of Weber B fractures treated with plate-only (PO) vs. plate and lag screw (PLS) fixation.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>Retrospective review of 318 patients undergoing ORIF for Weber B fractures (2022-2024) was performed. Univariate and multivariate statistics were used to compare patient characteristics and outcomes of those treated with PLS (n=167) vs. those treated with PO (n=151) fixation.</p><p><strong>Results: </strong>Patients in the PO-group were older, had a greater comorbidity burden (measured as Charlson Comorbidity Index [CCI]), and were more likely to have osteoporosis/osteopenia and diabetes than those in the PLS-group. Further, the PO-group was more likely to present with a trimalleolar fracture. Similar rates of complications (PO: 20.5 vs. PLS: 22.2%, p=0.829), reoperations (PO: 7.9 vs. PLS: 9.0%, p=0.897) and reporting \"normal or nearly normal\" levels of function at 6-months postoperatively (PO: 54.8 vs. PLS: 60.2%, p=0.630) were observed. After adjusting for age, CCI, osteoporosis/osteopenia, fracture type, and surgical setting in the multivariate regression models there were no significant differences in complication rates, reoperation rates, or patient-reported outcomes at 6-months postoperatively between groups.</p><p><strong>Conclusion: </strong>Surgical correction of Weber B fractures with a fibular plate yielded similar outcomes with and without placement of a lag screw. While further studies are needed to confirm these findings, plate-only fixation of Weber B ankle fractures appears to be a safe technique.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976935","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}

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