Foot & ankle specialist最新文献

{"title":"Electromyographic Analysis of Large Muscle Activity in Progressive Collapsing Foot Deformity.","authors":"Aanchal Bhatia, Shiv Manik Ajoy, Dev Anand Galagali, Ramesh Debur","doi":"10.1177/19386400241265547","DOIUrl":"10.1177/19386400241265547","url":null,"abstract":"<p><p>BackgroundThere are various deformities described in the spectrum of Progressive Collapsing Foot Deformity (PCFD) which not only have adverse effects on the foot but also on the entire lower limb. Early lower limb muscular fatigue and pain during exertion is the most common complaint of patients with PCFD. Surface electromyography (sEMG) provides an accurate assessment of muscle activity. In this study, we aim to compare the activities of quadriceps, hamstrings, and gastrosoleus muscle groups of adult patients with PCFD with normal lower limbs and correlate the radiological parameters and functional effects of PCFD with the activities.MethodsThirty patients with bilateral PCFD and 30 controls underwent weight-bearing anteroposterior (AP), lateral, and hindfoot alignment radiographs of the foot. Radiographic parameters of PCFD were assessed. Surface electromyography was used to assess the quadriceps, hamstrings, and gastrosoleus activities, and this was compared between the 2 groups and correlated with radiological measurements of PCFD. Tegner activity questionnaire was used to assess the functional effects of collapsed arch.ResultsElectrical activities of all muscle groups were significantly higher in cases than controls. Meary's angle and hindfoot moment arm had significant correlations with hamstring activity (P = .013) and gastrosoleus activity (P = .027), respectively. Tegner scores of cases were significantly lower than those of controls (P = .041).ConclusionsThe PCFD causes an increase in activity of large muscles of the affected lower limb which act on joints other than those in the foot. This finding may be due to several compensatory mechanisms that counteract the deforming forces. This may be a cause for the frequent complaint, early fatigue, and hence functional impairment. However, most radiological parameters did not correlate with muscle activities and larger study size may be required for further association.Levels of Evidence:Diagnostic: Level 3.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"269-275"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes in Drainage Ankle Disarticulation vs Guillotine Transtibial Amputation in the Staged Approach to Below-Knee Amputation.","authors":"Alissa M Mayer, Nicole K Cates, Eshetu Tefera, Kevin K Ragothaman, Kenneth L Fan, Karen K Evans, John S Steinberg, Christopher E Attinger","doi":"10.1177/19386400241253880","DOIUrl":"10.1177/19386400241253880","url":null,"abstract":"<p><p>A transtibial amputation is the traditional primary staged amputation for source control in the setting of non-salvageable lower extremity infection, trauma, or avascularity prior to progression to proximal amputation. The primary aim of the study is to compare preoperative risk factors and postoperative outcomes between patients who underwent transtibial amputation versus ankle disarticulation in staged amputations. A retrospective review of 152 patients that underwent staged below the knee amputation were compared between those that primarily underwent transtibial amputation (N = 70) versus ankle disarticulation (N = 82). The mean follow-up for all 152 patients was 2.1 years (range = 0.04-7.9 years). The odds of incisional healing were 3.2 times higher for patients with guillotine amputation compared to patients with ankle disarticulation (odds ratio [OR] = 3.2, 95% confidence interval [CI] = 1.437-7.057). The odds of postoperative infection is 7.4 times higher with ankle disarticulation compared to patients with guillotine amputation (OR = 7.345, 95% CI = 1.505-35.834). There were improved outcomes in patients that underwent staged below the knee amputation with primarily guillotine transtibial amputation compared to primarily ankle disarticulation. Ankle disarticulation should be reserved for more distal infections, to allow for adequate infectious control, in the aims of decreasing postoperative infection and improving incisional healing rates.<b>Levels of Evidence:</b> <i>3, Retrospective study</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"254-261"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Resilience on Outcomes After Total Ankle Arthroplasty.","authors":"Joseph A S McCahon, Joseph Massaglia, Tara G Moncman, Samantha Riebesell, Selene G Parekh, David I Pedowitz, Joseph N Daniel","doi":"10.1177/19386400241274601","DOIUrl":"10.1177/19386400241274601","url":null,"abstract":"<p><p>BackgroundResiliency is the ability to recover from stressful events and has been shown to correlate with patient outcomes following certain orthopaedic procedures. The purpose of this study was to determine the relationship between resiliency and outcomes following TAA.MethodsA retrospective analysis of patients undergoing primary TAA between April 2015 and September 2022 was performed (N = 83). Data included demographics, comorbidities, complications, preoperative and postoperative visual analog scale (VAS) pain and Foot and Ankle Ability Measure (FAAM) functional scores, Brief Resilience Scale (BRS) scores, and surgical satisfaction. Patients were defined as having low resilience (LR), normal resilience (NR), or high resilience (HR) based on a BRS score of <3, 3-4.30, and >4.3, respectively.ResultsHigh resilience patients had significantly higher postoperative FAAM ADL, Sports, and Overall scores as well as a significantly greater increase from preoperative scores compared with LR and NR patients. Low resilience patients had significantly lower FAAM Sports and Overall scores compared with normal and high resilience patients. BRS scores positively correlated with postoperative FAAM scores. We found no difference in satisfaction or VAS between the 3 cohorts. Multivariate regression analysis identified BRS scores to be an independent predictor for greater changes in FAAM scores following TAA.ConclusionAlthough functional improvements following TAA are expected, patients with higher resilience at baseline are more likely to experience greater improvements in functional outcomes following surgery.Level of Evidence:Level III.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"302-308"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depressive Disorder and Trimalleolar Fractures: An Analysis of Outcomes and Costs.","authors":"Maddie Fudala, Lindsay Blank, Ameer Tabbaa, Ariel Rodriguez, Charles Conway, Aaron Lam, Afshin E Razi, Amr Abdelgawad","doi":"10.1177/19386400241267019","DOIUrl":"10.1177/19386400241267019","url":null,"abstract":"<p><p>IntroductionStudies have suggested a strong association between depression and poor outcomes following various orthopaedic surgeries. However, depression's impact on complications following open reduction/internal fixation (ORIF) of trimalleolar fractures has not been elucidated. Therefore, this study aimed to determine whether depression is associated with higher rates of readmissions and medical complications following ORIF of trimalleolar fractures.MethodsA database query from January, 2020, through March, 2021, identifying adults who underwent trimalleolar ORIF generated 50 154 patients. Those with depression were matched 1:1 to controls without depression by age, sex, chronic obstructive pulmonary disease, anxiety, and other prominent comorbidities. Primary endpoints compared 90-day all-cause readmissions and medical complications. Odds ratios (ORs) of the effect of depression on readmissions and medical complications were calculated.ResultsPatients with depression who underwent ORIF of trimalleolar fractures had significantly higher odds of being readmitted within 90 days of the initial procedure (OR: 1.37; P < .0001). Ninety-day odds of developing medical complications were significantly higher (OR: 4.61; P < .0001) in patients with depression compared with patients within the control group.ConclusionPatients with depression undergoing trimalleolar ORIF face an increased risk of readmission and multiple postoperative complications. Orthopaedic surgeons should factor depression into their preoperative evaluation, given the already high burden of complications following ORIF of trimalleolar fractures.Level of Evidence:Level III: Retrospective cohort study.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"282-287"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Painful Peroneal Tendon Subluxation in a Patient With a Prior Ankle Fusion.","authors":"Richard A Zell, Ananya Mehta","doi":"10.1177/19386400241251908","DOIUrl":"10.1177/19386400241251908","url":null,"abstract":"<p><p>This case report describes a patient who underwent an ankle fusion using a lateral approach and fibular-onlay strut 14 years ago. She presented with increasing lateral ankle pain and giving way. Despite bracing and steroid injections, she had continued symptoms and surgery for hardware removal was recommended. While under anesthesia, she was found to have subluxation of her peroneal tendons. Operative findings included impingement of the peroneal brevis on the screw head from her fibular-onlay strut and a peroneal tendon tear. Hardware removal, a peroneal tenodesis, and reconstruction of the peroneal retinaculum were performed with a good clinical result.<b>Level of Evidence:</b> V (case report).</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"237-240"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Extremity Hockey Puck Impaction Fractures in Professional Hockey Players: A Case Series and Review of the Literature.","authors":"Nicholas G Ambus, Max Swiergol, Nathan C Sherman, Leonard Daniel Latt","doi":"10.1177/19386400241268354","DOIUrl":"10.1177/19386400241268354","url":null,"abstract":"<p><p>Hockey is a contact sport notorious for injuries. The hockey puck is a projectile that can impart substantial energy when it impacts a player. Hockey puck impact is a frequent and underreported cause of injury. This case report describes the clinical course of 3 professional hockey players who sustained injuries to the lower leg and ankle from projectile hockey pucks. Each player sustained a unique injury with associated complications affecting return to play. We aim to bring attention to this injury mechanism that can cause significant morbidity among players.<b>Levels of Evidence:</b> IV.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"295-301"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of First Metatarsal Shortening and Sagittal Displacement on Forefoot Pressure in Minimally Invasive Hallux Valgus Correction.","authors":"Andres Lopez, Yianni Bakaes, Giselle Porter, Glenn Shi, Paisley Myers, J Benjamin Jackson, Tyler Gonzalez, Edward T Haupt","doi":"10.1177/19386400241261129","DOIUrl":"10.1177/19386400241261129","url":null,"abstract":"<p><p>BackgroundMinimally invasive (MIS) treatment of hallux valgus (HV) deformity is increasing in popularity. A 2-mm diameter burr is used to create a distal first metatarsal osteotomy prior to capital fragment translation and fixation. The metatarsal will shorten by the burr's diameter (2 mm). Plantar or dorsal capital fragment displacement may also cause load transference and possibly transfer metatarsalgia. The purpose of this study is to examine the effect of MIS HV on forefoot loading mechanics with respect to metatarsal shortening and sagittal plane displacement.MethodsFour lower-limb cadaveric specimens were studied. A pedobarography pressure-sensing mat was used to record forefoot plantar pressure in a controlled weight-bearing stance position. Control and postosteotomy measurements were obtained with the capital fragment fixated in 3 possible positions: 0 mm, 5 mm dorsal, and 5 mm plantar displacement. Pedobarography data yielded pressure data within measurable graphical depictions. Raw mean contact pressure measurements were taken under the first and fourth metatarsal heads to establish medial and lateral forefoot loading pressure ratios. An a priori power analysis was performed based on previous peer-reviewed pedobarographic data, and our study was adequately powered.ResultsAround 40 measurements were recorded, and ratios of medial-to-lateral forefoot loading were constructed. Medial forefoot pressure control versus 0 mm displacement, and control versus dorsal displacement were not found to be statistically significant (<i>p</i> = 0.525, <i>p</i> = 0.55, respectively). Medial pressure significantly increased when comparing control versus plantar displacement (<i>P</i> = .006). Lateral pressure significantly increased with dorsal displacement of the osteotomy (<i>P</i> = .013).ConclusionOur study found that MIS HV correction did not cause an increase in lateral forefoot pressure loading when sagittal plane displacements were controlled. Plantar displacement increased medial loading, and dorsal displacement increased lateral loading. It may be valuable for surgeons to consider metatarsal head position postosteotomy, as a decrease in medial loading and subsequent increase in lateral loading may lead to lateral forefoot pain and transfer metatarsalgia.Levels of Evidence:IV.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"276-281"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study for Surgical Treatment of Acute Distal Tibiofibular Syndesmotic Lesions Using the Modified Suture-Button Fixation Versus Static Syndesmotic Screw Fixation.","authors":"Mohamed Jlidi, Walid Bouaicha, Siwar Sbaihi, Hedi Gharbi, Mouldi Lamouchi, Karim Mallek, Salma Jaziri, Selim Daas","doi":"10.1177/19386400241256440","DOIUrl":"10.1177/19386400241256440","url":null,"abstract":"<p><p>IntroductionSeveral techniques to treat acute distal tibiofibular instability are described consisting in static and dynamic fixation procedures. The aim of our work is to compare the outcomes of acute syndesmotic injury fixation between the modified technique of dynamic fixation using the suture-button principle as an efficient and low-cost method and the classic static fixation.MethodsIt is a prospective study including patients presenting with acute syndesmotic injury. After fracture fixation, residual syndesmotic instability was managed using syndesmotic screw in group A and dynamic fixation with a double Ethibond suture in group B. Functional results were assessed using the American Orthopaedic Foot and Ankle Society score (AOFAS) score. Radiological evaluation was done by a postoperative computed tomography (CT) scan of both ankles and plain X-rays of the ankle after surgery and at 18 months.ResultsGroup A included 20 patients meanwhile 35 patients were in group B. The reduction was satisfactory in the 2 groups according to the postoperative CT scan measurements. The mean healing time in group A was 49.65 days and 51.49 days in group B (P = .45). We did not find any significant difference in terms of loss of reduction in the 2 groups. The return to work was faster in group B (P = .04). Patients in group B had better AOFAS score (P = .03) and ankle range of motion than those in group A. The difference was statistically significant (P = .02 for dorsal flexion and P = .001 for plantar flexion). For group A, we did not note any early complications. Meanwhile, 7 patients developed skin complications in group B (P = .03). However, no significant difference was found in terms of late complications.ConclusionsThe modified dynamic suture-button fixation remains a therapeutic alternative in low-income countries that could achieve better outcomes than static fixation, with easy postoperative follow-up.Levels of Evidence:<i>Level II</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"241-253"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral Ankle Ligament Repair Is Not Only for Young Patients: Trends in Incidence and Demographics.","authors":"Lauren N Ellis, Anthony L Karzon, Jason T Bariteau, Sam A Labib, Rishin J Kadakia, Michelle M Coleman","doi":"10.1177/19386400241266361","DOIUrl":"10.1177/19386400241266361","url":null,"abstract":"<p><p>The purpose of this study was to examine the changes in annual incidence and patient population undergoing lateral ankle ligament repair (LALR) for the surgical treatment of chronic ankle instability. The IBM Watson Health MarketScan Database was queried for patients who underwent LALR from January 2009 to December 2019 based on CPT code 27698. Volume and incidence per 100 000 population were determined for annual sums, gender, age, and geographical regions based on population estimates from the United States Census Bureau. Future annual volumes were statistically projected with linear regression modeling to the year 2032. Overall, 160 457 LALR procedures were identified in the database from 2009 to 2019. Annual incidence increased 76.6% from 3.46 to 6.11 cases per 100 000 population, while estimates of annual volumes are projected to increase 61.5% from 19 829 to 32 033 procedures to the year 2032. Interestingly, the greatest increase in incidence was observed among patients above 70 years old, which might suggest older patients are staying active longer and desiring elective procedures to maintain their activity levels. As the incidence of LALR increases in older patients, more research will be needed to understand the unique surgical considerations and risk factors impacting patient-reported outcomes.<b>Level of Evidence:</b> Level IV.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"288-294"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gunshot Injury With Bone Defect of the First Metatarsal Bone: A Presentation of 2 Cases Treated With an Iliac Crest Structural Graft, Internal Fixation, and Bone Morphogenic Protein 2.","authors":"Elisabeth Ellingsen Husebye, Geir Stray Andreassen, Are Haukåen Stødle","doi":"10.1177/19386400241278026","DOIUrl":"10.1177/19386400241278026","url":null,"abstract":"<p><p>Gunshot injuries to the foot with segmental bone defects can be challenging to treat. When the vascularity is intact and the soft tissues allows, the goal should be to reconstruct the bony defect. We present 2 cases of a gunshot injury to the foot with a defect of the first metatarsal bone. Both cases were treated, with favorable outcome, with a structural iliac crest graft, internal fixation, and bone morphogenic protein 2.<b>Level of Evidence:</b> V, cases series, technical.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"317-324"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}