Foot & ankle specialist最新文献

{"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":"Limb Salvage by Means of Hindfoot Arthrodesis Utilizing Bulk Allograft and External Fixation.","authors":"Carl Brandon Lindberg, Rishika Lagisetti, Amol Saxena","doi":"10.1177/19386400241251519","DOIUrl":"10.1177/19386400241251519","url":null,"abstract":"<p><p>FormatRetrospective Review.Length of follow-up18 months.ClassificationRearfoot and Ankle Reconstruction.MethodologyLevel 4 Retrospective Review.ProceduresA retrospective review was performed of 6 patients who had undergone limb salvage procedures between January 2016 and April 2019. Patients underwent surgery due to severe limb-threatening diagnosis including Charcot and/or osteomyelitis. Salvage arthrodesis was performed with bulk femoral head allograft incorporation using a hexapod external fixation system. The external fixation was retained for an average of 16 weeks. All patients were followed for a postoperative period of 16 months.ResultsSuccessful rearfoot arthrodesis and limb salvage was achieved in ⅚ (83%) of patients.DiscussionThis review demonstrates that limb salvage and arthrodesis are possible using femoral head allograft incorporation by external fixation alone. The involved patients had resolution of the osteomyelitis and Charcot deformity, salvage arthrodesis of the rearfoot and avoidance of a major limb amputation.Levels of Evidence:IV.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"231-236"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923549","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}

{"title":"Anatomical Structures at Risk in Percutaneous Distal Bunionette Correction.","authors":"Shrey Nihalani, Mila Scheinberg, Matthew McCrosson, Matthew T Yeager, Robert W Rutz, Mathew Hargreaves, Zuhair J Mohammed, Swapnil Singh, Ashish Shah","doi":"10.1177/19386400241256705","DOIUrl":"10.1177/19386400241256705","url":null,"abstract":"<p><p>Bunionette deformity is an incredibly pervasive issue in our society with almost a quarter of individuals being affected by it. As it is so common, there are numerous techniques and approaches to correct the deformity. Currently, there is a growing trend that favors percutaneous osteotomy of the bunionette. As there are multiple osteotomy sites, there are anatomical considerations that must be made at each one. The purpose of this study was to investigate the anatomic structures at risk during distal osteotomy of bunionette deformity using a Shannon burr. Using 11 fresh cadaver specimens, the fifth metatarsal was accessed through a carefully marked portal. A Shannon burr was employed for the osteotomy. Dissections were performed to assess potential damage to critical structures, including the lateral dorsal cutaneous nerve (LDCN), abductor digiti minimi (ADM), and extensor digitorum longus (EDL). Measurements were taken from the osteotomy site to each structure. The distal osteotomy site was on average greater than 8 mm from the EDL and ADM, whereas it was 1.64 mm from the LDCN. The Shannon burr made contact with and transected the LDCN on 2 occasions. However, previous studies have highlighted potential anatomical variations of the LDCN that arise distally. The study underscored the challenges posed by minimally invasive approaches to treating bunionette deformity and highlighted the need for cautious consideration when using percutaneous methods.<b>Level of Clinical Evidence:</b> 5.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"262-268"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238889","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 Use of Antibiotic-Impregnated Cement for Infection or Mechanical Support in Diabetic Foot Osteomyelitis: A Systematic Review and Meta-Analysis.","authors":"Kaissar Yammine, Jad Mansour, Joeffroy Otayek, Bilal Alqaysi, Jimmy Daher, Chahine Assi","doi":"10.1177/19386400241274624","DOIUrl":"10.1177/19386400241274624","url":null,"abstract":"<p><p>BackgroundDiabetic foot infections are difficult to eradicate and could lead to serious complications such as multiple surgeries, amputation and mortality. Culture-based IV antibiotics and particularly amputation are usually the available options. Only few studies articles reported the use of cement impregnated with antibiotics to fill temporarily or permanently a bone defect, but with no evidence synthesis yet. Therefore, this study aims at assessing the outcomes of the use of antibiotic-impregnated cement for infection or mechanical support in diabetic foot osteomyelitis.MethodsA systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We searched multiple electronic databases using the terms \"osteomyelitis AND cement AND diabetic AND foot.\" The quality of the included studies was evaluated using the Joanna Briggs Institute Appraisal Tool.ResultsSix studies met the inclusion criteria combining 82 patients with 85 procedures. With a mean follow-up period of 22 ±14.6 months, the meta-analytical results were as follows: (1) the weighted healing rate was 85.2%, (2) 63.6% of cement were kept in place, (3) 8.2% of cement had to be exchanged, (4) 24.4% of placed cement had to be removed, (5) minor amputation following cement placement was 13.4%, and (6) the rate of secondary surgery was 18.7%, with arthrodesis being the most common (94%).ConclusionThere are limited studies available detailing the outcomes of cement use in diabetic foot osteomyelitis. In the case of the difficult-to-heal osteomyelitis of the diabetic foot and whenever a peripheral bone rim could be preserved, filling the void within to deliver local infection control and to assure mechanical resistance for ambulation could be a non-radical limb preserving option.Level of EvidenceLevel IV.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":"19 3","pages":"309-316"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846575","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":"Guided Percutaneous Hallux Valgus Surgery: Advancing Into the Future With the Fourth-Generation Technique. Outcomes and Complications.","authors":"David Campillo-Recio, Inés Farré-Galofré, Eduardo Quezada-Peralta, Glòria Albertí-Fitó, Juan-Antonio Calle-García","doi":"10.1177/19386400251382286","DOIUrl":"10.1177/19386400251382286","url":null,"abstract":"<p><p>BackgroundThe aim of this study is to describe the surgical technique, outcomes, and complications associated with fourth-generation percutaneous hallux valgus correction using a guided system.MethodsProspective case series of 28 patients, aged 16 and older (5 men and 23 women), averaging 56.89 years, who underwent surgery for hallux valgus with at least 12 months of follow-up.ResultsThe preoperative American Orthopaedic Foot & Ankle Society (AOFAS)-hallux score increased from 63.8 to 89.7 (P < .001) at 12 months post-surgery. The visual analog scale (VAS) score decreased from 6 to 0.16 (P < .001) in the same period. The preoperative intermetatarsal angle (IMA) decreased from 13.38° to 2.72° (P < .001) post-surgery, while the Hallux valgus angle (HVA) decreased from 23.01° to 5.2° (P < .001). There were 3 complications including 1 superficial wound infection, 1 malpositioning of the screws and 1 hypertrophic non-union.ConclusionThe described percutaneous hallux valgus surgery appears to be reliable, with consistent improvements in clinical outcomes and radiological results. The guided technique is promising in order to reduce common complications.Level of Evidence:Level IV, prospective case series.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"325-332"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544096","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":"Incidence Rates of Total Ankle Replacements and Ankle Fusions in the Scandinavian Countries Between 2016 and 2023.","authors":"Mads Sundet, Johan Fintland, Lars Ebskov","doi":"10.1177/19386400261451596","DOIUrl":"https://doi.org/10.1177/19386400261451596","url":null,"abstract":"<p><strong>Background: </strong>Total ankle replacement (TAR) has developed rapidly during the last decades, and there is solid evidence that this is a good treatment for end-stage ankle arthritis (ESAA). Whether these improved outcomes have translated into a higher utilization of TARs compared with ankle fusions (AFs) in Scandinavia is unknown. The aim of this study was to report the incidences of TAR and AF in the Scandinavian countries and to report any trends in these incidences during the last 8 years.</p><p><strong>Methods: </strong>Data were collected from the official patient registries of the three countries for the period 2016-2023, using NOMESCO codes for TAR and AF. To evaluate the capacity for highly specialized foot and ankle surgery, data about triple fusions and calcaneal osteotomies were also collected. Trends in incidence rates were evaluated with negative binomial regression.</p><p><strong>Results: </strong>During the period, 5667 AFs and 2012 TARs were performed in the three countries, which gives an ankle replacement percentage (ARP) of 26% for the whole region. Denmark had a higher total procedure volume, a higher number of TAR, and a higher ARP than the other countries (38% vs 20% for the two other countries, P ≤ .001). There was an increasing incidence of TAR during the period in Denmark and Sweden, while there was a decrease in Norway.</p><p><strong>Conclusion: </strong>The incidence of TAR and the ARP vary between the Scandinavian countries, where Denmark has a much higher incidence of TARs than the other two countries. In the last 8 years, the incidence of TARs has been stable in Denmark, increasing in Sweden and decreasing in Norway.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261451596"},"PeriodicalIF":2.1,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102460","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":"Defining the Patient Acceptable Symptom State (PASS) for PROMIS After Hallux Valgus Correction Surgery.","authors":"Allison L Boden, Stone R Streeter, Seif El Masry, Grace DiGiovanni, Agnes D Cororaton, Matthew S Conti, Scott J Ellis","doi":"10.1177/19386400261451600","DOIUrl":"https://doi.org/10.1177/19386400261451600","url":null,"abstract":"<p><strong>Background: </strong>The patient acceptable symptom state (PASS) is defined as the symptom threshold beyond which a patient is satisfied with the outcome of their surgery. PASS thresholds have been utilized throughout the orthopedics literature but have not yet been identified for hallux valgus (HV) deformity. This study aimed to establish PASS thresholds for using Patient-Reported Outcome Measurement Information System (PROMIS) scores in patients undergoing HV deformity correction.</p><p><strong>Methods: </strong>A retrospective review of 286 patients who underwent HV deformity correction was performed using data from an institutional outcome registry. PASS thresholds were determined using 2-year postoperative PROMIS scores and patient Likert scale responses to 2 validated anchor questions: the Satisfied Scale and the Delighted-Terrible Scale. The impact of patient demographics and surgical factors on the likelihood of meeting PASS thresholds were compared using independent t tests and Pearson's chi-square tests.</p><p><strong>Results: </strong>The PASS threshold values for patients undergoing surgical management of HV ranged from 41.6 to 65.1 depending on the PROMIS domain and anchor question. For both anchor questions, the PASS thresholds for PROMIS physical function (PF) and pain intensity (PIntens) were found to be 50.3 and 41.5, respectively. Seventy-one percent (203/286) of patients met the PASS threshold for PF and 72.4% (207/286) of patients met the PASS threshold for PIntens. The PASS thresholds for the other 4 PROMIS domains varied by anchor question. Higher preoperative PROMIS scores and lower body mass index were associated with an increased likelihood of meeting the PASS thresholds. Patients who underwent first metatarsophalangeal fusion were less likely to reach the PASS threshold for the PROMIS PF domain.</p><p><strong>Conclusions: </strong>Foot and ankle surgeons may be able to use these results to guide treatment plans. Furthermore, the results may be helpful in counseling and educating patients on the likelihood of obtaining a satisfactory result following HV correction surgery.<b>Level of Evidence:</b> <i>Level III, Retrospective review</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261451600"},"PeriodicalIF":2.1,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102412","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":"Improving the Severity Classification System of Diabetes-Related Foot Infections: Necrosis is a Better Predictor of Amputation Than Systemic Inflammatory Response.","authors":"Justin J Kim, Jennifer Fernandez, Ho D Kim, Kelli J McConnehey, Brian M Schmidt","doi":"10.1177/19386400261448434","DOIUrl":"https://doi.org/10.1177/19386400261448434","url":null,"abstract":"<p><strong>Background: </strong>The International Working Group on the Diabetic Foot (IWGDF)/Infectious Disease Society of America (IDSA) classification system of diabetes-related foot infection (DFI) severity requires a severe infection to have the systemic inflammatory response syndrome (SIRS). Subsequent attempts to improve this classification system to include other clinically relevant characteristics (eg, necrosis and osteomyelitis) have not reliably predicted patient outcomes such as amputation. The purpose of this study was to propose an improved classification system based on clinically relevant predictors of amputation at our institution.</p><p><strong>Methods: </strong>This was a single-center, retrospective cohort study of 270 unique patients with 346 DFIs. We determined the association between clinical characteristics of each DFI (eg, cellulitis, abscess, necrosis, osteomyelitis, and SIRS) and amputation within 90 days of presentation. We derived a new severity classification system based on the presence of necrosis and compared the performance of this classification system to the IWGDF/IDSA classification system.</p><p><strong>Results: </strong>Our \"necrosis classification system\" predicted that mild, moderate, and severe DFI had a 20% (95% confidence interval [CI] 2%, 38%), 40% (95% CI [33%, 47%]), and 74% (95% CI [64%, 84%]) risk of amputation within 90 days of presentation, respectively, and discriminated between moderate and mild, and severe and moderate DFI. The IWGDF/IDSA classification system predicted that mild, moderate, and severe DFI had a 29% (95% CI [9%, 49%]), 43% (95% CI [36%, 50%]), and 54% (95% CI [44%, 63%]) risk of amputation within 90 days of presentation, respectively, and did not discriminate between moderate and mild, or severe and moderate DFI.</p><p><strong>Conclusion: </strong>This necrosis classification system discriminated the risk of amputation at 90 days better than the IWGDF/IDSA classification system. Our new classification system may have greater clinical relevance but needs to be validated to confirm its generalizability.<b>Level of evidence:</b> <i>Level III: Retrospective comparative study</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261448434"},"PeriodicalIF":2.1,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977565","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":"Cadaveric Evaluation of Calcaneal Autograft Harvest: Can We Optimize Bone Harvesting?","authors":"Cameron Meyer, Orlando Martinez, Lauren Christie, Isaac Wilmot, David Calderwood, Jaeyoon Kim, Mark A Prissel, Terrence M Philbin","doi":"10.1177/19386400261441130","DOIUrl":"https://doi.org/10.1177/19386400261441130","url":null,"abstract":"<p><p>Bone autografts are commonly used to augment arthrodesis sites and enhance the biologic environment necessary for successful fusion. Autogenous bone may be harvested from several donor locations, including the anterior and posterior iliac crest, proximal and distal tibia, and notably the calcaneus. Complication rates of calcaneal graft harvest have varied widely in the literature with several different techniques from open to percutaneous methods. The purpose of this study was to assess optimal zones of graft volume while minimizing donor-site morbidity. Twenty, ten matched-pairs, fresh-frozen cadaveric below-knee specimens were used for this study. The posterior tuber of the calcaneus was measured in height and equally divided into 3 distinct zones. A 7-mm Medline bone graft harvester was inserted perpendicular to the lateral calcaneal wall and advanced in a single pass to obtain cancellous autograft from the calcaneus. Graft volume as well as distance to adjacent structures at risk were measured. We found no statistical significance in graft volume among the three zones; however, we did note a significant difference in distance from the sural nerve between zones 1 and 2, and between zones 1 and 3. We found an average volume of 0.59, 0.41, and 0.61 grams³ for zones 1, 2, and 3, respectively. These findings suggest calcaneal bone graft harvest remains a safe procedure and enables to obtain consistent graft volume. Further clinical studies are recommended to confirm these results and guide future surgical practices.<b>Level of Evidence:</b> <i>Level IV: Cadaveric study</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261441130"},"PeriodicalIF":2.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864835","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}