Foot & ankle specialist最新文献

{"title":"Impact of Insurance Type on Timing of Diagnosis and Surgical Treatment of Acute Achilles Tendon Ruptures: A 2-Center Retrospective Cohort Study.","authors":"Omar Samara, Isabel Herzog, Hyewon Kim, Teren Yedikian, Tyler Stewart, Balazs Galdi, Sheldon S Lin","doi":"10.1177/19386400261495193","DOIUrl":"https://doi.org/10.1177/19386400261495193","url":null,"abstract":"<p><p>Introduction/PurposeDelayed treatment of acute Achilles tendon rupture is associated with worse outcomes and higher complication rates. Prior studies suggest reduced access to care among Medicaid and uninsured patients. This study examines the effect of insurance status on the timing of diagnosis and surgical treatment among patients undergoing surgical repair of acute Achilles tendon rupture.MethodsA retrospective chart review was conducted of patients aged ≥18 years with acute traumatic Achilles tendon ruptures identified by Current Procedural Terminology codes 27650 and 27654 at 2 hospitals between January 2017 and December 2023. Dates of injury, emergency department presentation, initial outpatient orthopaedic evaluation, and surgical intervention were recorded. Only patients who ultimately underwent operative repair were eligible for inclusion; because case ascertainment relied on surgical procedure codes, the cohort does not capture patients managed nonoperatively or those who never reached surgical care. Insurance status was categorized as private or Medicaid/uninsured. Postoperative complications, including re-rupture, infection, venous thromboembolism, wound dehiscence, return to the operating room, and mortality, were documented. Between-group comparisons of continuous variables were performed using the Mann-Whitney U test, given non-normal distribution of the underlying data; independent 2-tailed t-tests were performed as a secondary, confirmatory analysis. Significance was set at P < .05.ResultsThirty-eight surgically treated patients met the inclusion criteria, including 23 with private insurance and 15 who were Medicaid or uninsured. Median age was 35.2 years, and 89.5% were male. All time intervals are reported as medians. Time from injury to emergency department presentation was longer in the Medicaid/uninsured group but not statistically significant (1.0 vs 0.0 days; Mann-Whitney U P = .079). Medicaid/uninsured patients experienced significantly longer delays from injury to initial outpatient orthopaedic evaluation (17.0 vs 4.0 days; Mann-Whitney U P = .024) and from injury to surgery (30.0 vs 10.0 days; Mann-Whitney U P = .045). Time from orthopaedic evaluation to surgery did not differ significantly between groups (11.0 vs 6.0 days; Mann-Whitney U P = .206). Postoperative complications were infrequent in both groups; the study was not powered for comparison of complication rates and none was performed.ConclusionAmong surgically treated patients, those with Medicaid or no insurance experienced significantly longer delays to initial orthopaedic evaluation and to surgical repair compared with privately insured patients, highlighting disparities in access to timely orthopaedic care within this surgically treated population.Level of Evidence:<i>III</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261495193"},"PeriodicalIF":2.1,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208177","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":"Knotless Suture Repair For Chronic Lateral Ankle Instability: A Systematic Review and Single-Arm Meta-Analysis.","authors":"Christian A Than, Hussein Jaber, James Nasr, Kosta G Tzanis, Dana Hegazy, Carl-Gabriel McGovern, Shayndhan Sivanathan, Kesavan Sivanesan, Yasmine J Khair, Hayato Nakanishi, Constantinos Loizou","doi":"10.1177/19386400261485359","DOIUrl":"https://doi.org/10.1177/19386400261485359","url":null,"abstract":"<p><p>IntroductionThere is a need to assess the use of knotless sutures in cohorts with chronic ankle instability (CAI).MethodsA literature search of Embase, Ovid MEDLINE, Cochrane Library and Scopus was conducted from each database's inception to August 15, 2025. Eligible studies reported patients with CAI undergoing foot and ankle surgery with knotless suture repair. This review was registered in PROSPERO (ID: CRD420251106305).ResultsA total of 11 studies comprising 476 patients met the eligibility criteria. American Orthopaedic Foot and Ankle Society (AOFAS) scores preoperatively were 63.23 (95% confidence interval [CI]: 60.60-65.86, <i>I</i>² = 91%) and at final follow-up were 90.67 (95% CI: 88.09-93.24, <i>I</i>² = 96%). Karlsson-Peterson (KP) scores preoperatively were 62.75 (95% CI: 61.16-64.34, <i>I</i>² = 79%) and at final follow-up were 88.03 (95% CI: 84.20-91.87, <i>I</i>² = 97%). Visual analog scale (VAS) scores preoperatively were 5.80 (95% CI: 4.34-7.25, <i>I</i>² = 100%) and at final follow-up were 1.23 (95% CI: 0.74-1.72, <i>I</i>² = 96%). Anterior drawer preoperatively was 7.37 mm (95% CI: 5.21-9.53, <i>I</i>² = 98%) and postoperatively was 3.12 mm (95% CI: 1.08-5.16, <i>I</i>² = 99%). Talar tilt preoperatively was 7.00⁰ (95% CI: 3.92-10.08, <i>I</i>² = 98%) and postoperatively was 3.11⁰ (95% CI: 2.76-3.46, <i>I</i>² = 29%). The overall complication rate was 6% (95% CI: 0.03-0.09, <i>I</i>² = 57%). The reoperation rate was 2% (95% CI: -0.01-0.03, <i>I</i>² = 0%).ConclusionBased on low-quality evidence, knotless repair appears associated with improved functional scores and a low complication rate in this pooled analysis. Direct comparative studies against traditional Broström-Gould knotted approaches are warranted to determine the gold standard in CAI repair moving forward.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261485359"},"PeriodicalIF":2.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198211","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":"Adipose-Derived Orthobiologics and Extracellular Vesicles in Foot and Ankle Surgery: Current Evidence and Clinical Limitations.","authors":"Alexander Tham, Jared Rubin, James J Butler, Samuel R Montgomery, Nathaniel P Mercer, Bradley A Lezak, Edward Mojica, Lefko Charalambous, John G Kennedy","doi":"10.1177/19386400261497293","DOIUrl":"https://doi.org/10.1177/19386400261497293","url":null,"abstract":"<p><p>Interest in adipose-derived orthobiologics and extracellular vesicles (EVs) has expanded as clinicians seek minimally invasive treatments for musculoskeletal disorders. However, culture-expanded adipose-derived stromal cells, stromal vascular fraction, microfragmented adipose tissue (MFAT), and isolated EVs are biologically and regulatorily distinct products. This narrative review summarizes their biological rationale, processing, clinical evidence, regulatory considerations, and potential application in foot and ankle surgery. Randomized studies in knee osteoarthritis suggest that MFAT may provide symptomatic improvement, but it has not consistently demonstrated superiority over other orthobiologic injections, and the certainty of evidence remains low. Preclinical EV studies provide biological plausibility for effects on tendon healing, tendon-to-bone integration, and cartilage repair. However, substantial heterogeneity in cellular source, preparation, dose, and experimental model limits translation. Human orthopaedic EV evidence remains confined to early studies in knee osteoarthritis using placental or umbilical cord derived products, with limited and conflicting evidence of efficacy and no completed studies specific to the foot and ankle. No adipose-derived regenerative medicine or EV product is Food and Drug Administration-approved for an orthopaedic indication. Current evidence therefore does not support routine clinical use or claims of tissue regeneration. Standardized product characterization and well-designed comparative trials are required to establish safety, efficacy, and appropriate clinical applications.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261497293"},"PeriodicalIF":2.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167840","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":"Host-Related Predictors of Wound Complications After Elective Ankle Hardware Removal.","authors":"Ana Santamaría López, Cristina Cuéllar Torres, María Pontón Sarrio, Elisa Martín Nieto, Pablo C Arviza Lorenzo","doi":"10.1177/19386400261491412","DOIUrl":"https://doi.org/10.1177/19386400261491412","url":null,"abstract":"<p><p>IntroductionElective ankle hardware removal is classified as a clean surgical procedure, although postoperative wound complications remain a relevant source of morbidity. The role of routine preoperative antibiotic prophylaxis in this setting remains uncertain.MethodsA retrospective observational study was conducted including patients who underwent elective ankle hardware removal between 2019 and 2025. The primary outcome was postoperative wound complications. Univariate analysis and multivariable logistic regression were performed.ResultsA total of 160 patients were included, and wound complications occurred in 13 patients (8.1%). In univariate analysis, older age, higher body mass index, active smoking, peripheral vascular disease, and an estimated glomerular filtration rate <90 mL/min/1.73 m² were associated with wound complications. The exploratory high clinical-risk group had a higher complication rate than the low-risk group (14.3% vs 1.5%; P = .007). In the multivariable analysis, age (odds ratio [OR] 1.067; 95% confidence interval [CI] 1.014-1.122; P = .012), body mass index (OR 1.166; 95% CI 1.025-1.325; P = .019), and active smoking (OR 4.90; 95% CI 1.19-20.00; P = .028) were associated with wound complications. Wound complication rates were identical between patients who did and did not receive preoperative cefazolin (7.7% vs 7.7%; P = 1.000).ConclusionsThese findings highlight older age, BMI, and active smoking as factors to consider during preoperative risk assessment before elective ankle hardware removal. No association between preoperative antibiotic prophylaxis and wound complications was observed; however, this finding should be interpreted cautiously given the limited number of patients who received preoperative antibiotics.Level of Evidence:<i>Level III, retrospective observational study</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261491412"},"PeriodicalIF":2.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139522","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":"Foot and Ankle Care in the News: Media Representation Across Provider Types.","authors":"Ryan Garemani, John J Czarnecki, Ishaan Kumar, Selene G Parekh","doi":"10.1177/19386400261491414","DOIUrl":"https://doi.org/10.1177/19386400261491414","url":null,"abstract":"<p><p>BackgroundOnline news media increasingly shapes patient understanding of musculoskeletal disease and influences care-seeking behavior. Foot and ankle (F&A) conditions are managed by overlapping specialties, yet their representation in public-facing media coverage is undefined.MethodsA cross-sectional analysis of patient education Google News articles was conducted for 4 foot and ankle pathologies: bunions, flatfoot deformity, plantar fasciitis, and Achilles tendonitis. Articles published January 1, 2025, to January 1, 2026, were retrieved via standardized incognito searches conducted on February 22, 2026. Outcome variables included publisher type, clinician specialty, and clinician demographics.ResultsOf 835 articles screened, 333 met inclusion criteria, yielding 437 sources quoted. Podiatrists dominated media coverage of bunions (57%), flatfoot deformity (82%), and plantar fasciitis (76%), while orthopaedic surgeons represented the majority of Achilles tendonitis news articles (60%). Overall gender distribution was balanced (50% male), although Achilles tendonitis coverage skewed notably male (77%). Private practice providers outnumbered academic providers across most conditions; Achilles tendonitis was the exception, skewing heavily academic (78%).ConclusionsF&A representation in news media varies by condition. Overall, podiatry dominates coverage in F&A news media, revealing inequity in public exposure. The high rate of excluded articles across searches suggests limited substantive media coverage of these pathologies overall. Together, these findings highlight an opportunity to broaden representation in consumer health media, especially from orthopedists and academics.Levels of Evidence:<i>Level IV Evidence: Epidemiology Study (Cross-Sectional Descriptive Analysis)</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261491414"},"PeriodicalIF":2.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139491","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":"Achilles Tendon Rupture Repaired With TeKBrace Augmentation: A Case Report.","authors":"Stephen Arndt","doi":"10.1177/19386400261476784","DOIUrl":"10.1177/19386400261476784","url":null,"abstract":"<p><p>Achilles tendon rupture is a common injury among active adults and frequently requires surgical repair in high-demand patients. Augmentation techniques have been developed to improve repair strength and reduce re-rupture risk, particularly in cases of degenerative tendon tissue. TeKBrace, a woven polyester mesh, provides mechanical reinforcement while allowing biologic integration. We present the case of a 36-year-old recreational athlete who underwent open Achilles tendon repair with TeKBrace augmentation following an acute rupture. Intraoperative findings of degenerative tendon tissue and mild gapping under tension supported the decision to augment the repair. At 6 months, the patient demonstrated symmetric ankle range of motion and approximately 90% restoration of plantarflexion strength compared with the contralateral limb. The patient demonstrated excellent functional recovery and returned to recreational basketball without pain or limitation at 9 months, and no complications or re-rupture were observed. This case highlights the biomechanical rationale and clinical utility of TeKBrace scaffold augmentation in selected patients, although larger studies with longer follow-up are needed to better define its clinical effectiveness.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"14S-17S"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708813","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":"Osteochondral Fragment Fixation: Proceedings of the International Congress on Cartilage Repair of the Ankle.","authors":"Alexander Tham, Jared Rubin, James J Butler, Paloma Gauthier, John G Kennedy, Samuel B Adams, Carol L Andrews, Chayanin Angthong, Jorge P Batista, Onno L Baur, Steven Bayer, Christoph Becher, Gregory C Berlet, Lorraine A T Boakye, Roberto Buda, James D F Calder, Gian L Canata, Dominic S Carreira, Thomas O Clanton, Jari Dahmen, Pieter D'Hooghe, Christopher W DiGiovanni, Malcolm E Dombrowski, Mallory Ehlers, Richard D Ferkel, Eric I Ferkel, Paulo N F Ferrao, Eric Giza, Arianna L Gianakos, Mark Glazebrook, Mohamed Gomaa, Simon Görtz, Amgad M Haleem, Kamran S Hamid, Laszlo Hangody, Charles P Hannon, Daniel Haverkamp, Jay Hertel, Beat Hintermann, MaCalus V Hogan, Kenneth J Hunt, Eoghan T Hurley, Jon Karlsson, Stephen R Kearns, Gino M M J Kerkhoffs, Hak Jun Kim, Siu Wah Kong, Sebastian Krebsbach, Sameh A Labib, Kaj T A Lambers, Jin Woo Lee, Keun Bae Lee, Jeffrey S Ling, Umile Giuseppe Longo, Alberto Marangon, Graham McCollum, Kirk McCullough, Adam W Mitchell, Peter N Mittwede, Christopher D Murawski, Stefan Nehrer, Raluca Nicolescu, Philipp Niemeyer, James A Nunley, Martin O'Malley, Cristian Ortiz, David O Osei-Hwedieh, Jochen Paul, Christopher J Pearce, Helder Pereira, Rohan Phadke, Adam Popchak, Marcelo P Prado, Steven M Raikin, Mikel L Reilingh, Guilluame Robert, Benjamin B Rothrauff, Lew C Schon, Helene Simpson, Niall A Smyth, Carolyn M Sofka, Pietro Spennacchio, James W Stone, Martin Sullivan, Masato Takao, Yasuhito Tanaka, Hajo Therman, David B Thordarson, Rocky Tuan, Victor Valderrabano, Christian J A van Bergen, Pim A D van Dijk, C Niek Van Dijk, Francesca Vannini, Tanawat Vaseenon, Monika Volesky, Raymond C Walls, Markus Walther, Martin Wiewiorski, Xiangyang Xu, Youichi Yasui, Hua Yinghui, Ichiro Yoshimura, Alastair S E Younger, Urszala Zdanowicz, Zijun Zhang","doi":"10.1177/19386400261485740","DOIUrl":"10.1177/19386400261485740","url":null,"abstract":"<p><p>BackgroundThe optimal approach to fixation techniques in cartilage repair of the ankle remains unclear due to the predominance of low-quality evidence and limited high-level studies. To address this gap, an international group of experts convened to establish consensus-based recommendations grounded in the best available evidence, formulated during the 2017 International Congress on Cartilage Repair of the Ankle.MethodsSeventy-five multidisciplinary experts from 25 countries and 1 territory participated in a structured Delphi-based consensus process. Eleven working groups were tasked with reviewing specific topics within cartilage repair of the ankle, conducting systematic literature reviews, and grading evidence to support each statement. Statements lacking full agreement were further discussed and refined before final voting. Consensus strength was defined as consensus (51%-74%), strong consensus (75%-99%), or unanimous (100%).ResultsFifteen consensus statements related to fixation techniques were developed and all achieved strong consensus, with a minimum agreement level of 82%. These statements provide standardized guidance on indications, technical considerations, and expected outcomes for fixation procedures in osteochondral lesions of the talus.ConclusionThis synthesis of the international expert consensus statements offers unified recommendations to guide the use of fixation techniques in the management of osteochondral lesions of the talus, fostering greater consistency in clinical practice, research methodology, and future guideline development.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261485740"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119391","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":"Chondromyxoid Fibroma of the Metatarsals: Outcomes of En Bloc Resection and Intercalary Fibular Allograft Reconstruction in a Series of 9 Patients.","authors":"Khodamorad Jamshidi, Seyed Mohammad Mohammadi, Shahabaldin Beheshti Fard, Alireza Mirzaei","doi":"10.1177/19386400261491409","DOIUrl":"https://doi.org/10.1177/19386400261491409","url":null,"abstract":"<p><p>BackgroundThe optimal surgical and reconstructive strategies for chondromyxoid fibroma (CMF) of the metatarsal bones remain controversial. This study examined the outcomes of en bloc resection followed by fibular strut allograft reconstruction in 9 patients with aggressive or recurrent metatarsal CMF.MethodsNine patients were included in this retrospective case series. Indications for this approach included thin cortex, cortical breakdown, or local recurrence. Outcomes were recurrence, radiographic union, limb function, and surgical complications.ResultsAt a median follow-up of 8 years, no local recurrence was recorded in this series. Radiographic union at both host-allograft junctions was achieved in 8 of 9 patients. The median Musculoskeletal Tumor Society score was 30. The median Toronto Extremity Salvage Score was 96. Complications were infrequent and manageable.ConclusionEn bloc resection followed by fibular strut allograft reconstruction appears to provide durable local tumor control and encouraging functional outcomes in patients with aggressive or locally recurrent metatarsal CMF.Level of Evidence:<i>IV (Therapeutic study; case series</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261491409"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119347","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":"Computerized Tomography for Diagnosing Traumatic Arthrotomies of the Ankle.","authors":"Elizabeth Cho, Ryan LeDuc, Hector Castillo, Michael S Pinzur, Kamran S Hamid, Adam P Schiff","doi":"10.1177/19386400251314167","DOIUrl":"10.1177/19386400251314167","url":null,"abstract":"<p><p>BackgroundOwing to the risk for septic arthritis, traumatic arthrotomies are an urgent surgical problem for the treating orthopaedic surgeon. Traditionally, diagnosis is with the saline load test (SLT), although in the awake patient is an invasive and potentially painful procedure. While computerized tomography (CT) has been shown to be a reliable diagnostic tool for traumatic arthrotomies of other joints, its role has only recently been investigated in the setting of ankle arthrotomy.MethodsEight fresh-frozen mid-tibia ankle cadaveric specimens were included for study. Baseline CT scans were performed to confirm intact ankle joint capsules with absence of intra-articular air. Ankle arthrotomies were performed under fluoroscopic guidance with vertical 1 cm incisions made at the anteromedial or anterolateral portals. After arthrotomy, all ankles underwent a second CT scan, and images were evaluated for the presence of intra-articular air. Finally, SLT was performed and the volume of saline required for extravasation was recorded.ResultsOf 8 ankles, 100% (n = 8) demonstrated intra-articular air on CT scan following arthrotomy. Computerized tomography scan and SLT both demonstrated 100% sensitivity and specificity for diagnosing ankle arthrotomies. Average saline volume necessary for extravasation (and positive SLT) was 4 mL (range: 2-7 mL) and did not differ by foot position.ConclusionIn this small cadaveric study, CT scan and SLT were both able to detect 100% (n = 8) of traumatic ankle arthrotomies with 100% sensitivity and specificity. Further comparative study of CT scan and SLT for detection of traumatic ankle arthrotomy in a clinical setting is warranted.Levels of Evidence:<i>Level IV</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"461-465"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048696","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":"Determination of Pathogens in Surgical Site Infections in Ankle Fractures and Implications for Empirical Antibiotic Treatment.","authors":"Hannah Plasmeijer, Jasper Tausendfreund, Martine Hoogewerf, Diederick Penning, Pieter Joosse, Tim Schepers, Erik Tanis","doi":"10.1177/19386400241313418","DOIUrl":"10.1177/19386400241313418","url":null,"abstract":"<p><p>Surgical site infections (SSIs) are the most common complication after surgery for ankle fractures. This retrospective study aimed to determine the pathogens cultured in SSI and their antimicrobial susceptibility patterns to provide a recommendation for empirical therapy. Patients who underwent surgical treatment for an ankle fracture were included. Cases were screened for the occurrence of SSI and divided into superficial (short course [total of <2 weeks] of oral antibiotics) and deep SSI (surgical debridement and long course [total of >2 weeks] antibiotics). Culture results, antimicrobial susceptibility patterns, empirical antibiotic regimen, type and timing of culture collection, and treatment strategies were collected from electronic health records. In total, 81 (9%) out of 931 patients developed an SSI (39 (48%) superficial SSI and 42 (52%) deep SSI). The most common pathogens in 16 superficial SSI and 37 deep SSI with positive cultures were <i>Staphylococcus aureus</i>, cultured in 11 (69%) superficial SSI and 23 (62%) deep SSI, and <i>Enterobacter cloacae</i> species, cultured in 5 (31%) superficial SSI and 12 (32%) deep SSI. Higher frequencies of gram-negative bacteria and polymicrobial infections were found in deep SSI. It is recommended to aim for empirical treatment at gram-positive and gram-negative microorganisms in the case of both superficial and deep SSI.<b>Level of Evidence:</b> Prognostic, Level 2: Retrospective.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"451-460"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048794","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}