Journal of Foot & Ankle Surgery最新文献

{"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}

{"title":"Description of anatomical differences in 3D bone morphology between female individuals with progressive collapsing foot deformity and asymptomatic controls.","authors":"Takuma Miyamoto, Rich J Lisonbee, Kassidy Knutson, Hiroaki Kurokawa, Akira Taniguchi, Yasuhito Tanaka, Amy L Lenz","doi":"10.1053/j.jfas.2025.08.003","DOIUrl":"10.1053/j.jfas.2025.08.003","url":null,"abstract":"<p><strong>Background: </strong>Progressive collapsing foot deformity (PCFD) represents a multifaceted three-dimensional condition. However, there has been limited discussion regarding how the morphology of each bone affects PCFD.</p><p><strong>Purpose: </strong>To determine morphological differences within each bone of the foot and ankle in females affected by PCFD compared to asymptomatic controls.</p><p><strong>Study design: </strong>Comparative cross-sectional study.</p><p><strong>Methods: </strong>We hypothesized the medial column bones would exhibit the most substantial shape differences between groups. We developed multiple statistical shape models (SSMs) to analyze the 3D shape of the distal tibia, distal fibula, talus, calcaneus, navicular, cuboid, cuneiforms, and metatarsals. We quantified and compared results between 23 female PCFD patients and 23 asymptomatic females.</p><p><strong>Results: </strong>SSM analyses revealed significant modes of variation across several bones. Notably, the fibula showed reduced fibular tip height in PCFD patients. The talus exhibited decreased lateral and posterior processes and an inferior, adducted talar head shift. The calcaneus had a narrowed posterior facet and anteriorly shifted anterior-medial facet. In PCFD patients, the navicular tuberosity was displaced toward the body with medial-inferior articular defects. The cuboid showed increased prominence of the tuberosity and beak.</p><p><strong>Conclusion: </strong>These SSM results provide novel characterization of the 3D shape of bones from tibia to metatarsals in PCFD and asymptomatic females. Patients with PCFD exhibited distinct 3D shape differences in the distal fibula, talus, calcaneus, navicular, and cuboid, suggesting that PCFD is primarily characterized by deformities of the hindfoot bones.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976852","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":"Heterotopic ossifications in anterior and lateral approach total ankle replacement: A retrospective evaluation.","authors":"Giammarco Gardini, Silvio Caravelli, Carlo Capodagli, Giulio Vara, Stefano Ratti, Marco Di Ponte, Massimiliano Mosca","doi":"10.1053/j.jfas.2025.08.001","DOIUrl":"10.1053/j.jfas.2025.08.001","url":null,"abstract":"<p><p>Heterotopic periarticular ossifications (HO) are a frequent short to mid-term complication following Total Ankle Replacement (TAR). Historically two primary surgical approaches exist-Lateral Approach (LA) and Anterior Approach (AA)-each bound with different prosthetic designs. However, there is no consensus on the incidence, real clinical impact, or need for reintervention of HO between these approaches, nor on the necessity of prophylactic treatments. This retrospective, monocentric, comparative study (evidence level III) involved radiological classification of patients using the modified Brooker Classification System (mBCS) by two independent orthopedic surgeons. A total of 105 patients undergoing LA or AA TAR at the same center were included. Radiographic HO was observed in 84 patients (80 %). Of these, 19 (23 %) required surgical intervention due to symptomatic HO. In the AA group (62 patients, Vantage Exactech prosthesis), 45 (73 %) developed HO, with 10 having sufficient symptoms which were treated with arthrolysis. In the LA group (43 patients, Trabecular Metal Zimmer prosthesis), 39 (91 %) developed HO, with 9 requiring arthrolysis. HO was more prevalent in the LA group than in the AA group (91 % vs. 73 %). A direct correlation was found between clinical scores (FAAM and Pain Score) and HO severity. Prosthesis with LA more frequently develop HO than AA. In addition, young patients, delayed ankle mobilization and weightbearing can be accounted as risk factors in the development of HOs; conversely smoking, BMI, duration of surgery and post-traumatic arthritis were not found to have a significant impact.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976975","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":"Risk factors for surgical site infections in patients with pilon fractures: A systematic review and meta-analysis.","authors":"Pei Zhen Li, Jia Wei He, Xian Sheng Xia","doi":"10.1053/j.jfas.2025.08.006","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.08.006","url":null,"abstract":"<p><strong>Background: </strong>Pilon is a severe ankle fracture, and surgical site infections is an important postoperative complication that often leads to catastrophic consequences. Understanding its risk factors is crucial for optimizing patient outcomes and improving clinical management strategies.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science, and the Cochrane Library for prospective and retrospective studies related to surgical site infections in patients with Pilon fractures, covering the period from January 2000 to March 2025. Following the screening and quality assessment of eligible studies, data were extracted and a meta-analysis was conducted utilizing Stata 16.0 and RevMan 5.3 software.</p><p><strong>Result: </strong>Ten studies involving 4,120 patients were included in the analysis. The meta-analysis revealed that the pooled incidence of surgical site infections was 17 % (95 % CI: 12 %-23 %). Significant risk factors identified for surgical site infections in patients with Pilon fractures included age, diabetes, hypertension, albumin, open fracture, AO/OTA fracture type(≥C), preoperative hospital stay, and surgical duration.</p><p><strong>Conclusion: </strong>This study identified several significant risk factors linked to surgical site infections in patients with Pilon fractures. Surgeons should closely monitor high-risk populations, optimize perioperative management, and implement effective preventive measures to prevent unnecessary complications.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976995","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":"Evaluation of the clinical and radiological outcomes of syndesmotic screws not parallel to the ankle joint.","authors":"Abdurrahman Aydın, Muhammed Bilal Kürk","doi":"10.1053/j.jfas.2025.08.005","DOIUrl":"10.1053/j.jfas.2025.08.005","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the clinical and radiological outcomes of parallel and non-parallel placements of a single syndesmotic screw relative to the ankle joint line in the coronal plane used to enhance tibiofibular stability after syndesmosis injuries in ankle trauma surgery.</p><p><strong>Methods: </strong>Eighty-nine patients with isolated Weber B and C fractures treated from January 2021 to December 2024 were evaluated. They were divided into two groups based on the angulation of the syndesmotic screw: Group 1 (49 patients) had screws angled between -3° and +3° (parallel), while Group 2 (40 patients) had nonparallel screws. Comparisons were made on surgical duration, fluoroscopic shots needed for fixation, intraoperative fluoroscopic shots, postoperative medial clear space, ankle range of motion (ROM) at 3 and 6 months, American Orthopaedic Foot and Ankle Society (AOFAS) scores at those intervals, rates of implant fracture or failure, and radiolucencies around implants.</p><p><strong>Results: </strong>The angulation of the syndesmotic screw was significantly different between the groups, measuring 1.87 ± 0.77 in Group 1 and 4.66 ± 1.68 in Group 2 (p < 0.001). Surgical duration averaged 51.32 ± 7.71 minutes in Group 1 compared to 40.62 ± 6.75 minutes in Group 2 (p = 0.027). At 3 months, ankle ROM was 32.95 ± 4.11 in Group 1 and 30.55 ± 3.44 in Group 2 (p = 0.026), but no significant difference was found at 6 months (p = 0.078). AOFAS scores showed significant differences at 3 months (p < 0.001) but not at 6 months (p = 0.862) CONCLUSION: The study found that syndesmotic screws placed parallel or nonparallel to the joint in the coronal plane had similar clinical outcomes.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876550","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":"Functional and neuromuscular effects of rehabilitation in acute ankle sprain and chronic ankle instability.","authors":"Andrea De Fazio, Giorgio Fravolini, Elena Gabrielli, Matteo Turchetta, Marianna Citro, Fabrizio Forconi, Giulio Maccauro, Raffaele Vitiello","doi":"10.1053/j.jfas.2025.08.004","DOIUrl":"10.1053/j.jfas.2025.08.004","url":null,"abstract":"<p><strong>Background: </strong>Lateral ankle sprains (LAS) are common injuries that may progress to chronic ankle instability (CAI), characterized by recurrent sprains, proprioceptive deficits, and neuromuscular impairments.</p><p><strong>Purpose: </strong>This study evaluated the impact of rehabilitation on functional outcomes and electromyographic (EMG) parameters in patients with acute LAS and CAI.</p><p><strong>Study design: </strong>Prospective observational cohort study.</p><p><strong>Methods: </strong>Between August 2022 and September 2023, 119 patients (73 with acute LAS, 46 with CAI) were assessed at baseline (T0) and after a three-months rehabilitation program (T1). Assessments included range of motion (ROM), muscle strength, surface EMG, balance tests (Y-Balance, Foot Lift, Side Hop, 6-m Hop), and the FAAM questionnaire. Rehabilitation consisted of individualized protocols integrating gym-based exercises and hydrotherapy, targeting ROM restoration, proprioceptive training, and muscle strengthening.</p><p><strong>Results: </strong>LAS patients demonstrated significant baseline impairments in plantarflexion ROM (49.32 ± 13.37 vs. 61.76 ± 17.67; p = 0.01) and Foot Lift Test performance (168 ± 191.28 vs. 18.52 ± 58.38; p = 0.01). Post-rehabilitation, both groups showed improvements in ROM, strength, and functional scores. CAI patients achieved greater proprioceptive gains (Y-Balance, Side Hop), while LAS patients exhibited superior recovery in plantarflexion strength. However, EMG analysis revealed persistent neuromuscular deficits in both groups.</p><p><strong>Conclusion: </strong>Despite clinical improvements, persistent EMG deficits, especially in CAI, indicate incomplete neuromuscular recovery. These findings highlight the limitations of standard rehabilitation protocols and underscore the need for personalized neuromuscular interventions and objective return-to-sport criteria. Future research should aim to refine diagnostic tools, standardize protocols, and incorporate technology-assisted rehabilitation to improve long-term outcomes.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862552","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":"Cadaveric evaluation of MIS akin variation on length and angular correction.","authors":"Steven R Cooperman, Jaeyoon Kim, Orlando Martinez, Lauren M Christie, Roberto A Brandão","doi":"10.1053/j.jfas.2025.07.010","DOIUrl":"10.1053/j.jfas.2025.07.010","url":null,"abstract":"<p><strong>Background: </strong>Hallux abductovalgus, or bunion deformity, is a common forefoot condition with numerous described techniques for surgical correction. Minimally invasive surgery (MIS) is gaining popularity in the foot and ankle community; however, limited data exists regarding the degree of correction achievable with MIS Akin osteotomies.</p><p><strong>Purpose: </strong>To compare the angular and length changes produced by oblique and transverse Akin osteotomies using two burr sizes (2.0 and 2.9 mm) in a cadaveric model.</p><p><strong>Ethics: </strong>The authors state that every effort was made to follow all local and international ethical guidelines and laws that pertain to the use of human cadaveric donors in anatomical research. As a cadaveric study, no IRB review was required.</p><p><strong>Study design: </strong>Level IV cadaveric study METHODS: Twenty thawed above-knee cadaveric limbs (ten bilateral pairs) were used. Matched pairs underwent either oblique or transverse osteotomies, with the left limbs treated using a 2.0 mm burr and the right limbs with a 2.9 mm burr. Angular correction of the longitudinal axis of the proximal phalanx and medial cortical bone shortening were measured.</p><p><strong>Results: </strong>The 2.9 mm burr produced significantly greater angular correction and bone shortening than the 2.0 mm burr across all groups (p = 0.002). For oblique osteotomies, the 2.9 mm burr achieved a mean correction of 9.40° versus 4.43° with the 2.9 mm burr (p = 0.037). For transverse osteotomies, angular correction was 14.87° with the 2.9 mm burr compared to 6.64° with the 2.0 mm burr (p = 0.037) CONCLUSION: Burr size and osteotomy orientation significantly affect the degree of correction in MIS Akin osteotomies. These findings support careful preoperative planning and deliberate burr selection to optimize surgical outcomes.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776704","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":"Diplomacy in foot and ankle surgery, a systematic review of divisive literature within the field.","authors":"Christopher Hyer, Cameron Meyer, Jae Yoon Kim, Orlando Martinez, Roberto Brandão","doi":"10.1053/j.jfas.2025.08.002","DOIUrl":"10.1053/j.jfas.2025.08.002","url":null,"abstract":"<p><p>Foot and ankle pathology is most often managed by orthopedic surgeons and podiatric surgeons. Over time, podiatric surgery has been privy to literature criticizing its influence on patient outcomes, hospital systems, and the orthopedic community. To better understand where this literature is coming from, the authors performed a literature search through PubMed, Google Scholar, and Cochrane Database using the following search terms: \"surgeon type, podiatric surgeon, orthopedic surgeon, foot and ankle, podiatry, and doctors of podiatric medicine.\" Included studies were assessed for study characteristics and outcomes. Article categories included: journal, year of publication, level of evidence, degree of primary author, presence of a podiatric surgeon (DPM) on author panel, discussion of training discrepancies, and outcome variable utilized. We identified seventeen thousand two hundred twenty-nine articles through our search method. Seventeen studies met inclusion and exclusion criteria. Reviewers were blinded to authorship and asked to state whether or not training discrepancies were mentioned in the papers between DPM and orthopedic surgery. Eight (47 %) studies were found to discuss training discrepancies. Seven (87.5 %) of these articles discussing training discrepancy were found to be primarily authored by orthopedic surgeons. The authors concluded that, published articles which question professional work of a differing medical degree tends to support the degree of the primary author. More attention is needed to create a collaborative interprofessional relationship among these two societies. A stronger podiatric surgery research effort is necessary to support its influence on the community, hospitals, and surgical literature. Level of Evidence: Level 4.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812643","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":"Anatomical variations of the deep plantar arterial arch: surgical implications for partial foot amputations and soft tissue reconstruction.","authors":"Jessica L Morehouse, Jordan M Konstanty, Anna C Cacini, Jamie M Stern, Sara S Sloan","doi":"10.1053/j.jfas.2025.07.012","DOIUrl":"10.1053/j.jfas.2025.07.012","url":null,"abstract":"<p><strong>Background: </strong>The forefoot receives its primary blood supply through the deep plantar arterial arch, typically formed by an anastomosis between the deep branch of the lateral plantar artery and the deep plantar artery. Accurate identification and localization of the deep plantar arch are critical during flap procedures and transmetatarsal amputations to minimize the risk of vascular compromise.</p><p><strong>Purpose: </strong>To assess the anatomical variability, dominance patterns, and location of the deep plantar arch to inform surgical planning and reduce intraoperative vascular complications.</p><p><strong>Study design: </strong>This was a descriptive anatomical study conducted through cadaveric dissection.</p><p><strong>Methods: </strong>Eighty-nine feet from 45 formalin-embalmed cadavers were dissected, with associated arteries traced from their origins and external diameters measured to determine arterial dominance. Distances from key anatomic landmarks were recorded to identify the arch's position within the foot.</p><p><strong>Results: </strong>The deep plantar arch was present in all specimens. Lateral plantar artery dominance and deep plantar artery dominance were each observed in 42.70%, while co-dominance occurred in 12.36%, and medial plantar artery dominance in 2.25%. On average, the arch was located 58.48% of the distance from the calcaneal tuberosity to the distal phalanx. Medial deviation of the arch was found to be influenced by biological sex and the type of vascular dominance.</p><p><strong>Conclusion: </strong>The deep plantar arch demonstrates variability in both its dominance patterns and anatomic position. These findings underscore the importance of preoperative vascular assessment to optimize surgical outcomes and reduce the risk of ischemic complications during forefoot procedures.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765759","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":"Efficiency of the combination of Wide Awake Local Anesthesia No Tourniquet (WALANT) and sciatic nerve block for Achilles tendon repair: A preliminary study of feasibility.","authors":"Sébastien Bloc, Cyril Quemeneur, Cécile Naudin, David Barouk, Guillaume Dufour, Mario Bucciero, Anaelle Fedida, Matthieu Karoubi, Xavier Deloin, Romain Rousseau, Marc Elkaim, Anthony Wajsfisz, Fréderic Le Saché","doi":"10.1053/j.jfas.2025.07.009","DOIUrl":"10.1053/j.jfas.2025.07.009","url":null,"abstract":"<p><strong>Background: </strong>Various anesthetic techniques are available for surgical repair of Achilles tendon rupture. The main limitation of peripheral nerve blocks is the risk of failure that can be attributed to the failure of the \"tourniquet\" block or of the \"surgical\" block.</p><p><strong>Purpose: </strong>This retrospective study assessed the feasibility and the reproducibility of the association of WALANT technique to sciatic nerve block for Achilles tendon repair surgery.</p><p><strong>Study design: </strong>Data from 34 adult patients scheduled for Achilles tendon repair were collected retrospectively from January 2022 to April 2023.</p><p><strong>Methods: </strong>Sciatic nerve block (15 ml of Ropivacaine 0.375 %) and WALANT (30 ml of lidocaine 1 % with epinephrine) were performed under ultrasound guidance 30 minutes before surgery. A pneumatic thigh tourniquet was applied but not inflated. The primary endpoint was the efficiency of the combination of sciatic nerve block and WALANT, defined by anesthetic and hemostasis qualities.</p><p><strong>Results: </strong>Efficacy of the combination of sciatic nerve block and WALANT was 91.2 %: one patient required sedation due to pain during skin incision (percutaneous technique), and two others due to discomfort. The hemostatic quality of WALANT was appropriate in 100 % of cases, no pneumatic tourniquet was required.</p><p><strong>Conclusion: </strong>The combination of sciatic nerve block and WALANT infiltration provides an efficient and reproducible technique for the Achilles tendon repair. It avoids the need for a pneumatic tourniquet and limits the risk of peripheral nerve block failure.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735027","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}