Journal of Foot & Ankle Surgery最新文献

{"title":"Posterior plating via posterolateral approach for posterior malleolar fractures: Effect on flexor hallucis longus morphology and function—a cohort study","authors":"Mahmut Kalem,&nbsp;Merve Dursun Savran,&nbsp;Peri Kından Baltacı,&nbsp;Namık Kemal Altınbaş,&nbsp;Ercan Şahin","doi":"10.1053/j.jfas.2026.05.004","DOIUrl":"10.1053/j.jfas.2026.05.004","url":null,"abstract":"<div><h3>Background</h3><div>Posterior plating through the posterolateral approach for posterior malleolar fractures (PMF) has been advocated for direct reduction and stable fixation, but its effect on the flexor hallucis longus (FHL) muscle has not yet been clearly defined.</div></div><div><h3>Purpose</h3><div>To evaluate postoperative changes in FHL morphology and function after posterior plating of PMFs through a posterolateral approach.</div></div><div><h3>Study design</h3><div>Retrospective cohort with cross-sectional follow-up assessment.</div></div><div><h3>Methods</h3><div>Sixty-eight patients who underwent fixation of PMFs with a posterior one-third tubular plate through a posterolateral approach were evaluated at a minimum of 1 year after surgery. Mean age was 43.81 ± 14.36 years, and mean follow-up was 21.01 ± 10.81 months. The operated side was compared with the contralateral side for hallux range of motion, unilateral heel rise (UHR) performance, maximum voluntary isometric contraction (MVIC) strength, and ultrasonographic FHL thickness and cross-sectional area (CSA). Clinical outcomes were assessed using the Foot Function Index (FFI).</div></div><div><h3>Results</h3><div>The operated side showed significantly lower hallux plantarflexion and dorsiflexion, UHR and MVIC performance, and FHL thickness and CSA than the contralateral side (all p &lt; .001). No checkrein deformity was observed. Mean FFI was 2.37 ± 2.42.</div></div><div><h3>Conclusion</h3><div>Posterior plating of posterior malleolar fractures through a posterolateral approach was associated with measurable alterations in FHL muscle morphology but these alterations were not reflected in patient-reported outcomes, and ROM values remained within functional limits.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 164.e1-164.e8"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935166","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 treatment options for tibialis anterior tendon ruptures","authors":"Cameron Meyer DPM, AACFAS,&nbsp;Lucas Herrington DPM,&nbsp;Julia C. Tolin DPM,&nbsp;Karissa Badillo DPM, AACFAS,&nbsp;Chase Kiefer DPM,&nbsp;Alissa Parker DPM,&nbsp;Patrick Burns DPM, FACFAS,&nbsp;Jeffrey Manway DPM, FACFAS,&nbsp;Jarrett Cain DPM, MSc, FACFAS","doi":"10.1053/j.jfas.2026.04.016","DOIUrl":"10.1053/j.jfas.2026.04.016","url":null,"abstract":"<div><h3>Background</h3><div>Tibialis anterior tendon (TAT) ruptures are rare injuries with limited literature. While operative intervention may improve function and reduce pain, the optimal timing and choice of surgical technique remain unclear.</div></div><div><h3>Purpose</h3><div>To review the management of TAT ruptures across three institutions within the same academic health system and to evaluate surgical management patterns.</div></div><div><h3>Methods</h3><div>Patients greater than 18 years of age with TAT rupture or pathology treated between 2007 and 2024 by three board-certified foot and ankle surgeons were included. Minimum follow-up was three months. Patients without TAT pathology or inadequate follow-up were excluded. Data on demographics, treatment modality, rupture size, time to surgery, and complications were collected.</div></div><div><h3>Results</h3><div>Twenty TAT ruptures in 19 patients were identified. Eleven cases were managed conservatively, and nine surgically (five EHL tendon transfers, four direct tendon repairs). Larger rupture deficits were associated with shorter time to operative intervention. No infections were reported, and one re-rupture occurred in the direct repair group. Postoperative recovery allowed return to full muscle strength in all surgical cases. Both surgical approaches demonstrated favorable functional outcomes, and conservative management was effective in low-demand patients with smaller deficits.</div></div><div><h3>Conclusion</h3><div>Both direct repair and EHL tendon transfer provide reliable restoration of strength and function with low complication rates in appropriately selected patients. Conservative management remains a reasonable alternative for small defects or low-demand individuals. This study contributes to the limited literature on TAT ruptures and supports further prospective research with standardized follow-up to refine indications, timing, and technique for surgical repair.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 160.e1-160.e6"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787130","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 distal minimally invasive metatarsal osteotomy and open chevron osteotomy in the treatment of hallux valgus (HV): A network meta-analysis","authors":"Congqiang Rao,&nbsp;Xiaolian Lu,&nbsp;Binggang Xiong,&nbsp;Minghua Li","doi":"10.1053/j.jfas.2026.05.007","DOIUrl":"10.1053/j.jfas.2026.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Hallux valgus (HV) is a prevalent foot deformity with complex pathogenesis.</div></div><div><h3>Purpose</h3><div>This study aims to compare distal minimally invasive osteotomy and open chevron osteotomy for HV treatment.</div></div><div><h3>Study design</h3><div>A Network Meta-Analysis</div></div><div><h3>Methods</h3><div>The meta-analysis consisted of 14 studies (842 patients) from PubMed, Web of Science, Embase, and Cochrane Library (until April 2026). The retrieval strategies comprised the terms ‘hallux valgus’, ‘percutaneous’, ‘minimally invasive surgery’, ‘mica’ and ‘chevron’. Outcomes included hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), and AOFAS scores, which were calculated leveraging a 95 % credible interval (CI). Study quality was evaluated adopting NIH tools, and statistical analysis was carried out utilizing R (version 4.4.1).</div></div><div><h3>Results</h3><div>A total of 14 articles involving 842 participants were included in this study. The results indicated that, compared with open chevron osteotomy, minimally invasive transverse osteotomy showed a more effective therapeutic effect in improving the HVA ([SD: -1.5, 95 % CI (-2.5, -0.39)] (SUCRA = 98.17 %) and IMA ([SD: -0.76, 95 % CI (-1.3, -0.20)] (SUCRA=98.82 %). In terms of improving the DMAA, minimally invasive chevron osteotomy (SD: -5.8, 95 % CI: -8 to -3.7; SUCRA = 98.80 %) and minimally invasive transverse osteotomy (SD: -2.6, 95 % CI: -3.9 to -1.4; SUCRA = 54.18 %) were both more effective. Minimally invasive chevron osteotomy ranked highest in terms of AOFAS score (SUCRA=81.53 %). However, This estimate was associated with a wide CI [SMD:2.4, 95 %CI(0.48,4.3)].</div></div><div><h3>Conclusion</h3><div>Minimally invasive transverse osteotomy is more effective for radiographic correction (HVA/IMA), whereas minimally invasive chevron osteotomy appears to improve functional outcomes. These findings suggest potential differences between the techniques but should be interpreted in light of indirect comparisons and study heterogeneity.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 174.e1-174.e10"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943638","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 postoperative complications in Lisfranc injuries treated with open reduction and internal fixation: A multicenter study","authors":"Yugo Minoura,&nbsp;Yasuhiko Takegami,&nbsp;Hiroaki Nakashima,&nbsp;Kenichi Mishima,&nbsp;Marie Mabuchi,&nbsp;Shiro Imagama","doi":"10.1053/j.jfas.2026.04.015","DOIUrl":"10.1053/j.jfas.2026.04.015","url":null,"abstract":"<div><h3>Background</h3><div>Lisfranc injuries compromise foot stability and may lead to chronic instability and post-traumatic arthritis if inadequately treated. Open reduction and internal fixation (ORIF) is a standard surgical option, but multicenter data on risk factors for postoperative complications remain limited.</div></div><div><h3>Purpose</h3><div>To identify risk factors for postoperative complications and reoperation after ORIF for Lisfranc injuries.</div></div><div><h3>Study Design</h3><div>Multicenter retrospective cohort study.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 172 adult patients who underwent joint-preserving ORIF for Lisfranc injuries at 11 hospitals between 2014 and 2024. No cases of primary arthrodesis were included. Patient demographics, injury characteristics, and fixation methods were analyzed. Multivariate logistic regression was performed to identify independent predictors of postoperative complications and reoperation.</div></div><div><h3>Results</h3><div>Postoperative complications occurred in 119 patients (70.0%), most commonly post-traumatic arthritis (29.7%), malunion (22.1%), and sensory impairment (13.4%). Reoperation was required in 44 patients (25.6%), most commonly for unplanned implant removal (14.0%). Open fractures (adjusted odds ratio [AOR], 2.79; 95% confidence interval [CI], 1.23-6.35; p = 0.015) and high-energy injuries (AOR, 2.13; 95% CI, 1.07-4.26; p = 0.032) were independently associated with postoperative complications. Combined screw and plate fixation (AOR, 0.23; 95% CI, 0.069-0.79; p = 0.019) and screw fixation alone (AOR, 0.43; 95% CI, 0.20-0.94; p = 0.033) were associated with lower complication risk. No independent predictors of reoperation were identified.</div></div><div><h3>Conclusion</h3><div>Open fractures and high-energy injuries were independent risk factors for postoperative complications after ORIF for Lisfranc injuries. More robust fixation constructs, particularly combined screw and plate fixation, may help reduce complication risk.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 159.e1-159.e5"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787122","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":"Beyond the foot: Proximal joint adaptations following lisfranc injury as suggested by gait and pedobarographic analysis","authors":"Engin Eceviz MD,&nbsp;Oğuzhan Özyaman MD,&nbsp;Hüsnü Yılmaz MD,&nbsp;Ömer Hekim PT,&nbsp;Onur Gökmen MD,&nbsp;Hüseyin Bilgehan Çevik MD","doi":"10.1053/j.jfas.2026.04.013","DOIUrl":"10.1053/j.jfas.2026.04.013","url":null,"abstract":"<div><h3>Background</h3><div>Anatomic reduction is the gold standard for Lisfranc injuries; however, its relationship with functional recovery remains controversial.</div></div><div><h3>Purpose</h3><div>To evaluate gait and functional parameters in patients with Lisfranc injuries treated with open reduction and internal fixation (ORIF), and determine whether radiographic anatomic alignment ensures full functional recovery.</div></div><div><h3>Study Design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>Thirty patients who underwent ORIF with anatomic reduction for Myerson Type B2 Lisfranc injuries between 2020 and 2024 were retrospectively evaluated. Clinical assessment included the American Orthopaedic Foot &amp; Ankle Society (AOFAS) midfoot score and ankle range of motion (ROM). Three-dimensional gait analysis and pedobarographic measurements were compared between the affected and unaffected sides.</div></div><div><h3>Results</h3><div>The mean AOFAS midfoot score was 93.63, and ankle ROM did not differ between sides (<em>p</em> ≥ 0.05). However, peak plantar flexion (<em>p</em> = 0.001), sagittal plane ROM (<em>p</em> ≤ 0.001), and ankle power generation (<em>p</em> ≤ 0.001) were reduced on the affected. Knee joint absorption power also decreased on the affected side, suggesting a compensatory mechanism (<em>p</em> = 0.031). Spatiotemporal analysis indicated trends toward reduced step length and shorter stance phase on the affected side (<em>p</em> ≤ 0.05). However, these differences were not statistically significant following Holm–Bonferroni correction.</div></div><div><h3>Conclusions</h3><div>Despite achieving anatomic reduction, full functional recovery after Lisfranc injury may not always be achieved. Objective gait analysis revealed persistent functional deficits despite high clinical scores and radiographic alignment. Reduced ROM and power, along with altered knee mechanics, suggest that Lisfranc injuries may affect not only the foot but also the ankle and knee.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 158.e1-158.e5"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787980","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 first tarsometatarsal joint arthrodesis joint preparation using a single versus double portal approach with a 3.0 mm MIS burr","authors":"Lauren M. Christie DPM, FACFAS,&nbsp;Cameron Meyer DPM, AACFAS,&nbsp;Orlando Martinez DPM,&nbsp;Jae Yoon Kim DPM, AACFAS,&nbsp;Chad A. Smith DPM, AACFAS,&nbsp;Randall C. Thomas DPM, FACFAS,&nbsp;Roberto A. Brandão DPM, FACFAS","doi":"10.1053/j.jfas.2026.03.005","DOIUrl":"10.1053/j.jfas.2026.03.005","url":null,"abstract":"<div><h3>Background</h3><div>The first tarsometatarsal joint (TMTJ) arthrodesis is a common, reproducible procedure performed for severe hallux valgus correction and first TMTJ arthritis. As technology innovations evolve, minimally invasive surgery (MIS) is becoming popular and starting to be utilized for first TMTJ arthrodesis.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to evaluate the efficacy of first TMTJ preparation using a 3.0 mm MIS burr through a single versus double portal approach. Additionally, we evaluated surrounding soft tissue structures at risk for iatrogenic injury.</div></div><div><h3>Study Design</h3><div>This was an anatomic study comprised of 17 cadaveric specimens.</div></div><div><h3>Methods</h3><div>Preparation of the first TMTJ was performed through a single portal for all right specimens and a double portal for all left specimens using a 3.0 mm burr for two-minutes. The specimens were then dissected and surrounding soft tissue structures were evaluated. After joint disarticulation, the cartilage resection surface area ratios were evaluated.</div></div><div><h3>Results</h3><div>The total medial cuneiform and first metatarsal base ratio was 64.80% and 70.71% respectively. There was no significant difference in cartilage debridement of the medial cuneiform (<em>P</em> = 0.33) or first metatarsal base (<em>P</em> = 0.35) in the single versus the double portal group. No damage to the extensor hallucis longus (EHL) nor medial dorsal cutaneous nerve (MDCN) was noted.</div></div><div><h3>Conclusion</h3><div>In conclusion, the authors believe that with adequate time and experience, successful joint preparation of the first TMTJ can be achieved using both a single or double portal approach with minimal iatrogenic risk to surrounding soft tissue and neurovascular structures.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 145.e1-145.e6"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445598","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":"Arthroscopic treatment of osteochondral lesions of the talus using platelet-rich fibrin biological scaffold.","authors":"Tiago Soares Baumfeld, Matheus Kuffner, Bruno Magalhães Gomes Macedo, Eli Avila Souza Junior, Benjamim Dutra Macedo, Daniel Soares Baumfeld","doi":"10.1053/j.jfas.2026.08.025","DOIUrl":"10.1053/j.jfas.2026.08.025","url":null,"abstract":"<p><strong>Background: </strong>Osteochondral lesions of the talus (OLT) are a frequent cause of chronic ankle pain and functional limitation. Single-stage biological strategies such as autologous platelet-rich fibrin (PRF) have been proposed as scaffolds to potentially enhance repair.</p><p><strong>Methods: </strong>This retrospective case series evaluated patients with symptomatic OLT treated arthroscopically with lesion preparation and application of an intraoperatively prepared autologous PRF scaffold (advanced platelet-rich fibrin [A-PRF] and injectable platelet-rich fibrin [i-PRF]), with a minimum clinical follow-up of 8 months (mean 3.8 years). Outcomes included the American Orthopaedic Foot and Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS) subscales, visual analogue scale (VAS) for pain, return to sports, and complications.</p><p><strong>Results: </strong>Thirty-six patients (14 women, 22 men; mean age 39 years) were included. AOFAS improved from 54.1 to 82.6 (p < 0.001) and VAS pain decreased from 7.58 to 2.69 (p < 0.001) at final follow-up. FAOS domains improved substantially, including quality of life (25.2 to 63.9). More than 80% of patients returned to sports at a mean of 7.6 months. The complication rate was 11%, including transient paresthesia, superficial wound infection, and one reoperation.</p><p><strong>Conclusion: </strong>Arthroscopic treatment of OLT augmented with an autologous PRF scaffold was associated with improved pain and function at mid-term follow-up with an acceptable complication profile. Comparative studies are needed to determine the incremental benefit of PRF over marrow stimulation alone.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876727","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":"Comparative outcomes of autograft versus rhPDGF-BB in rearfoot and ankle arthrodesis: A propensity-matched TriNetX analysis","authors":"David Ahn BA,&nbsp;Avani Chopra BS,&nbsp;Abhiram Dawar BA,&nbsp;Gnaneswar Chundi BS,&nbsp;Tuckerman Jones MD,&nbsp;Zachary Fuller MD,&nbsp;Mark Fisher MBS,&nbsp;Scott Tucker MD,&nbsp;Michael Aynardi MD,&nbsp;Sheldon S. Lin MD","doi":"10.1053/j.jfas.2026.04.012","DOIUrl":"10.1053/j.jfas.2026.04.012","url":null,"abstract":"<div><h3>Background</h3><div>Recent evidence suggests that recombinant human platelet-derived growth factor (rhPDGF-BB) may enhance fusion and reduce donor-site morbidity in foot and ankle arthrodesis. However, direct large-scale comparisons between those receiving autograft and rhPDGF-BB remain limited, particularly for high-risk or revision procedures.</div></div><div><h3>Purpose</h3><div>To address this gap, we utilized the TriNetX research database to compare fusion outcomes and complication profiles between rhPDGF-BB and autograft in tibiotalocalcaneal (TTC), pantalar, or triple arthrodesis.</div></div><div><h3>Methods</h3><div>The TriNetX database for patients who underwent tibiotalocalcaneal, pantalar, or triple arthrodesis from 2003 to 2023, with at least one‐year follow‐up. A 1:1 propensity score match controlled for age, sex, body mass index, nicotine dependence, and comorbidities. Postoperative complications included implant-related infection, surgical site infection, superficial skin infection, infection‐related reoperation, wound disruption, osteolysis, nonunion, and hardware removal. Statistical analyses were conducted on TriNetX using Z-tests for pairwise comparisons, with significance set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>A total of 209 patients in the rhPDGF-BB cohort and 7,109 in the autograft cohort were identified. The rhPDGF-BB cohort was older and had higher rates of diabetes, HIV, and several other comorbidities (all p &lt; 0.05). After propensity matching (n = 208 per cohort), the rhPDGF-BB cohort had a lower nonunion rate (OR 0.36; 95% CI 0.19-0.69; p = 0.001) with no other significant outcome differences.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that rhPDGF-BB may be associated with lower nonunion rates compared with autograft without increased complications. Given the observational design, these results should be considered hypothesis-generating and warrant validation in prospective randomized studies.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 157.e1-157.e7"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822956","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":"Gender variations and relative durability associated with the Doctor of Podiatric Medicine (DPM) degree","authors":"Jeneen Elagha DPM,&nbsp;Moraith G. North (Executive Director),&nbsp;Andrew J. Meyr DPM, FACFAS (Professor)","doi":"10.1053/j.jfas.2026.04.002","DOIUrl":"10.1053/j.jfas.2026.04.002","url":null,"abstract":"<div><h3>Background</h3><div>Women have historically been and continue to be underrepresented in the profession of medicine, particularly within surgical subspecialties. And as gender gap concerns intersect with national workforce shortage projections, it is in the interest of both the medical profession and patients to recognize and remedy gender-related factors contributing to female surgeon attrition.</div></div><div><h3>Purpose</h3><div>The objective of this investigation was to further describe the podiatric specialty with a specific analysis of gender differences and the relative durability of the Doctor of Podiatric Medicine (DPM) degree.</div></div><div><h3>Study Design</h3><div>Epidemiologic descriptive analysis.</div></div><div><h3>Methods</h3><div>The National Downloadable File produced by the Centers for Medicare &amp; Medicaid Services (CMS) provides demographic information of all physicians with an active National Provider Identifier (NPI) number. The file last updated on 7/8/2025 was downloaded, and data related to those physicians with a credential of “DPM” was extracted and analyzed for medical school graduation year and gender. We further examined podiatric medical school matriculant data available through the American Association of Colleges of Podiatric Medicine (AACPM).</div></div><div><h3>Results</h3><div>A shrinking gender gap was observed from 1990 to 2025 with the number of female graduates from podiatric medical schools surpassing the number of male matriculants in 2024. With that said, more male podiatric physicians with an active NPI were observed than female podiatric physicians from each graduation year 1990 to 2021.</div><div>A majority (&gt;50%) of all graduates of podiatric medical school over the 35-year period since 1990 possess an active NPI indicating current active practice. A large majority (∼80%) of graduates since 2006 possess an active NPI indicating current active practice.</div></div><div><h3>Discussion</h3><div>The results of this investigation provide objective information of the shrinking gender gap in the podiatric specialty, as well as the relative durability of the DPM degree being associated with sustained clinical practice for both men and women.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 149.e1-149.e4"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640427","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":"Deltoid release in varus ankle deformity: Radiographic and clinical outcomes following total ankle arthroplasty","authors":"Jae Yoon Kim DPM, AACFAS,&nbsp;Caroline Ko DPM, AACFAS,&nbsp;Jake Loitz DPM, AACFAS,&nbsp;Frances Svidler DPM,&nbsp;Shiyun Zhu MPH,&nbsp;Kathy Le MPH,&nbsp;Maylynn Tam DPM, FACFAS,&nbsp;Danny Choung DPM, FACFAS","doi":"10.1053/j.jfas.2026.04.008","DOIUrl":"10.1053/j.jfas.2026.04.008","url":null,"abstract":"<div><h3>Background</h3><div>While deltoid ligament release is commonly performed during total ankle arthroplasty (TAA) to assist with correction of varus deformity, its quantitative contribution and durability remain insufficiently defined.</div></div><div><h3>Purpose</h3><div>To evaluate the effectiveness and short-term stability of deltoid ligament release in correcting end-stage ankle arthritis with varus deformity during total ankle arthroplasty.</div></div><div><h3>Study Design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on 496 patients who underwent TAA by five surgeons between January 2010 and December 2019, with a minimum one-year follow-up. Patients with varus deformity localized to the ankle joint were included and those with neutral or valgus alignment or prior rearfoot fusion were excluded. Immediate postoperative correction and maintenance of coronal alignment were compared between patients with and without deltoid ligament release using two-sample <em>t</em>-tests and difference-in-differences analyses.</div></div><div><h3>Results</h3><div>Forty-five patients met inclusion criteria, with a mean follow-up of 4.52 ± 2.00 years. Thirteen patients (28.9%) underwent deltoid ligament release and thirty-two patients (71.1%) did not. The deltoid release group demonstrated greater preoperative deformity (14.88° vs. 10.70°, <em>p</em> = 0.040) and achieved a significantly larger mean correction (12.81° vs. 7.86°, <em>p</em> &lt; 0.001). Difference-in-differences analysis showed an additional mean correction of –4.95° (95% CI: –9.03° to –0.87°). Postoperative alignment was similar between groups (2.07° vs. 2.84°, <em>p</em> = 0.403), with no significant coronal alignment changes between one- and two-year follow-up (<em>p</em> &gt; 0.100).</div></div><div><h3>Conclusion</h3><div>Deltoid ligament release is an effective adjunct for achieving and maintaining neutral coronal alignment in severe varus ankle deformities undergoing TAA without rearfoot fusion.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 5","pages":"Pages 153.e1-153.e5"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700592","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}