Foot & ankle specialist最新文献

{"title":"Hands-On or Gloved Approach? Unveiling Patient Experiences in Orthopaedic Foot and Ankle Clinics.","authors":"Andrea Rincon, Yvonne Conway, Samuel K Simister, Frank Sierra, Shannon Tse, Christopher Kreulen, Eric Giza","doi":"10.1177/19386400251333477","DOIUrl":"https://doi.org/10.1177/19386400251333477","url":null,"abstract":"<p><p>BackgroundLiterature suggests that patients view medical examination gloves as often overused and opportunities for cross-contamination. Little research focuses on the patient's perception of their surgeon when performing a physical examination in a clinic with or without medical examination gloves. The purpose of this project was to determine patient preference for glove use during foot and ankle examinations.MethodsA cross-sectional survey was conducted in a Foot and Ankle Orthopaedic Clinic, with 99 out of 100 patients participating (99% response rate). Participants, 53 patient's female (59.5%) and 36 male (40.4%) answered 8 questions on glove utilization, scored on a Likert scale (Appendix A). Descriptive statistics, data normalcy, and significance tests were used to analyze glove utilization (yes/no), gender, and age group, at P < .05 significance. The primary outcome examined patient preference for glove use during exams, while secondary outcomes assessed perceived thoroughness and provider approachability.ResultsAmong 89 patients (59.5% female, 40.4% male, mean age ~55), glove use was reported in 75 surveys and was more common with male patients (33.3% vs 9.43%, P = .059). Males were slightly more agreeable to preferring no gloves (2.86 vs 3.17, P = .134). Patients with physicians who wore gloves vs those without gloves during the encounter were more congenial to glove use for themselves (2.50 vs 3.24, P = .001) and for others (2.21 vs 3.00, P< .001), respectively. Patients preferred glove use for wound exams. Gender, glove use, or age did not influence perceptions of examination thoroughness (1.61) or provider approachability (3.32).ConclusionGlove use did not negatively impact patient perception of physical examination thoroughness or personability onto their physician. The results suggest that glove use may be up to the provider's discretion without concern for seeming less personable to patients or affecting patient perception of examination thoroughness.Levels of Evidence:Level IV.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400251333477"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008861","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":"Multidisciplinary Approach to Midfoot Charcot Neuro-Osteoarthropathy: A Case Series.","authors":"Marijn Stelwagen, Wilbert van Laar, Boudewijn Borger van der Burg, Menno Bénard, Wouter Brekelmans","doi":"10.1177/19386400251333038","DOIUrl":"https://doi.org/10.1177/19386400251333038","url":null,"abstract":"<p><p>BackgroundIn Charcot neuro-osteoarthropathy (CNO), deformity-induced ulcers significantly increase the risk of amputation. Reconstructive foot surgery (RFS) is essential to prevent this, but peripheral artery disease (PAD) and diabetes increase complication risks.MethodsAll patients from a single center treated with RFS for midfoot CNO between 2019 and 2023 were included. Treatment followed a multidisciplinary protocol aimed at optimizing 4 factors: hyperglycemia, infection, pressure, and arterial blood flow.ResultsSeventeen patients were included (mean follow-up 20 months). Sixteen patients (94%) achieved an ulcer-free, plantigrade foot. No amputations were performed. Fifteen patients (88%) were diabetic, 67% of whom had elevated HbA_1c levels, and 80% of these normalized after treatment. Four patients had PAD (24%), of whom 2 required revascularization. Deep infections occurred in 4 (24%) cases, and 6 (35%) required additional surgery.ConclusionsUlcer-free and good functional outcomes can be achieved, and amputation prevented, in patients with midfoot CNO provided they are treated by a multidisciplinary team.Level of Evidence:Level IV, case series.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400251333038"},"PeriodicalIF":0.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043098","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":"Comparison of an Opioid-Free Multimodal Pain Regimen to an Opioid-Containing Regimen in Elective, Outpatient, Bunion, and Forefoot Surgery.","authors":"Rachel Glenn, Daniel Ross, Chase Gauthier, Tyler Gonzalez, J Benjamin Jackson","doi":"10.1177/19386400251333042","DOIUrl":"https://doi.org/10.1177/19386400251333042","url":null,"abstract":"<p><p>BackgroundMultimodal, opioid-free regimens for postoperative pain have been increasing in popularity due to concerns regarding the current opioid crisis. Despite their increased popularity, there is limited evidence regarding the effectiveness of these regimens for outpatient forefoot procedures. This study looks to compare a multimodal, opioid-free pain control regimen to a historical opioid regimen in patients undergoing elective, outpatient forefoot procedures.MethodsData were collected prospectively in patients undergoing elective outpatient forefoot procedures, including bunion, bunionette, and lesser toe corrections, who were using a multimodal pain regimen, consisting of Acetaminophen, Meloxicam, Ketorolac, Cyclobenzaprine, and Pregabalin, from December 2020 to June 2022 and retrospectively for patient's undergoing similar procedures using an opioid-containing regimen, consisting of either oxycodone or hydrocodone, from October 2018 to February 2020 to at a single academic institution. Demographic information, VAS pain scores, satisfaction rating, and rescue opioid medication use were recorded. Continuous data were compared using the Wilcoxon Rank Sum test. A multivariable linear regression analysis was used to determine factors influencing a patient's VAS pain scores at 2 weeks postoperatively when controlling for confounding variables. All P < .05 were considered significant.ResultsA total of 41 patients were included in the opioid-free multimodal regimen group and 59 in the opioid-containing group. There was no significant difference between the multimodal group and opioid group in VAS pain score at 2 weeks postoperatively (1.4 vs 1.0, P = .26). Patients in the multimodal group had an 88% satisfaction rating. 17% required rescue opioid medications. Multivariable analysis demonstrated utilization of the multimodal pain regimen did not significantly influence VAS scores at 2 weeks postoperatively when controlling for confounding variables (P = .06).ConclusionOur multimodal, opioid-free pain control regimen demonstrated similar effectiveness, with high satisfaction and low rescue opioid use, as an opioid-containing regimen in patients undergoing elective outpatient foot and ankle procedures. These findings demonstrate this multimodal pain regimen is effective at controlling postoperative pain in patients undergoing elective outpatient forefoot procedures.Level of Evidence:II.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400251333042"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044272","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 Amputation Rates From 2016 to 2021 in People With and Without Diabetes Mellitus in the Netherlands: DUDE-9, a Retrospective, Observational Study.","authors":"Leonie Rosien, Rose Geurten, Henk Bilo, Dirk Ruwaard, Rijk Gans, Jacques Oskam, Chantal Tilburg, Arianne Elissen, Peter van Dijk","doi":"10.1177/19386400251333047","DOIUrl":"https://doi.org/10.1177/19386400251333047","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to determine recent lower extremity amputation (LEA) rates in individuals with and without diabetes mellitus (DM) in the Netherlands.</p><p><strong>Design: </strong>This is a retrospective, observational study of LEAs based on all-payer claims database (APCD) data from 2016 to 2021.</p><p><strong>Methods: </strong>This study analyzes LEAs using an APCD covering over 99% of the Dutch population. It assesses LEA rates in individuals with and without diabetes (types 1 and 2), focusing on 2016, when preventive diabetic foot care was fully implemented. All individuals aged ≥18 years detected with an LEA through reimbursement claims were included in the analysis.</p><p><strong>Results: </strong>The total number of individuals with reimbursed LEAs per year ranged from 5030 (35.7 per 100,000 individuals) to 5260 (38.1 per 100,000). In individuals with DM, this ranged from 2907 to 3081 (290.9 to 312.6 per 100,000). The highest LEA prevalence was found in individuals with type 1 DM (T1DM) (606.1-732.4 per 100,000). In individuals without DM, the yearly LEA rates ranged between 16.3 and 17.8 per 100,000. Approximately two thirds of all individuals with LEA were male (ratios 1.9-2.3).</p><p><strong>Conclusion: </strong>Compared to earlier Dutch studies, major LEA incidence appears to be slightly fluctuating over time, without an increase in minor amputations. This contrasts with other countries, where increased minor amputation rates are observed. These data provide valuable insights into LEA rates and emphasize that individuals most at risk are those with T1DM. More detailed studies, including longitudinal and clinical data, are needed to further specify groups and individuals at risk.<b>Levels of Evidence:</b> Level III: Retrospective cohort study.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400251333047"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060732","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":"Retrospective Comparison of Return to Sports and Physical Activity After Forefoot and Midfoot Arthrodesis Procedures in Foot and Ankle Surgery.","authors":"Seif El Masry, Grace M DiGiovanni, Allison L Boden, Aoife MacMahon, Scott J Ellis","doi":"10.1177/19386400251333045","DOIUrl":"https://doi.org/10.1177/19386400251333045","url":null,"abstract":"<p><p>BackgroundPhysical activity and returning to sports are vital for athletes after foot and ankle surgery. While joint preservation is preferred, joint arthrodesis becomes necessary in certain injuries or deformities. Common procedures include Lisfranc arthrodesis, modified Lapidus for hallux valgus (HV), and first metatarsophalangeal (MTP) arthrodesis for hallux rigidus (HR), addressing pain and deformities. Prior studies show promising outcomes individually, yet lack comparisons. Thus, this retrospective study aims to compare clinical outcomes and return to sports in the 3 procedure groups.MethodsBetween 2006 and 2014, a total of 48 modified Lapidus procedures for HV, 38 Lisfranc injuries, and 50 MTP fusion for HR cases were assessed regarding their physical activity and return to sport, utilizing sports-specific, patient-administered questionnaires. Clinical outcomes were evaluated through the Foot and Ankle Outcome Score (FAOS), encompassing pain, symptoms, stiffness, daily function, sports function, and quality of life. Comparisons between these groups were made based on these survey outcomes.ResultsRegarding FAOS scores, the 3 surgery groups revealed no significant differences in outcomes for the Pain subscale (P = .07). However, significant differences were observed among the 3 groups in each of the other domains (all P < .05). These differences were due to the MTP fusion having poorer FAOS scores as the Lisfranc and Lapidus groups had no differences in all domains (all P > .05). The MTP Fusion group showed comparable outcomes regarding return to sports and physical activity despite the lower FAOS scores.ConclusionMTP Fusion patients exhibited poorer FAOS scores compared with those undergoing modified Lapidus and Lisfranc procedures. However, despite this disparity they demonstrated a high rate of return to sports suggesting that alongside partial midfoot arthrodesis for Lisfranc injuries and modified Lapidus procedure for HV, first MTP joint arthrodesis for HR represents a reliable option for young athletes.Level of Evidence:Level III, comparative series.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400251333045"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001418","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":"Short-Term Clinical and Radiological Results of the Infinity Ankle Arthroplasty: A Prospective Study.","authors":"Karen Sandvik Gyllensten, Ulf Sundin, Inger Storrønning, Ivar Ervik Husby, Erik Haavardsholm, Hilde Berner Hammer, Siri Lillegraven, Marianne Lund Eriksen, Mads Sundet","doi":"10.1177/19386400251330086","DOIUrl":"https://doi.org/10.1177/19386400251330086","url":null,"abstract":"<p><p>BackgroundAnkle joint arthroplasty is increasingly used in primary or secondary end-stage osteoarthritis. Initial reports on the fourth-generation Infinity total ankle system showed a high failure rate due to component loosening. The objective of this study was to assess complications, reoperations, patient reported outcome measures (PROMs) and radiographic findings after 1 year.MethodsData were prospectively collected in a local ankle surgery registry between January 2018 and March 2023. All cases of primary ankle arthroplasty using the Infinity system with a 1-year follow-up were included (106 ankles in 101 patients). Complications, revisions, and reoperations were described after 1 and 2 years, and the 1-year postoperative PROMs (AOFAS Ankle-Hindfoot score, MOxFQ, EQ5D, and EQ5D-VAS) were compared to preoperative values. One-year postoperative radiographs were assessed for signs of loosening.ResultsThe mean age was 65 years (SD 11.7), 55% were female, and the mean BMI was 27 kg/m² (SD 4.2). Main indications for arthroplasty were chronic instability (27%), inflammatory joint disease (25%) and posttraumatic osteoarthritis (22%). After 1 year, there were 6 (5.5%) reoperations, of which 3 (2.7%) were prosthesis revisions, and 3 (2.7%) were outside the primary operative site. One (0.9%) reoperation was due to aseptic loosening of the tibia component. After 2 years, there was 1 additional reoperation with a tibial osteotomy and exchange of polyethylene insert. All PROMs improved significantly between the preoperative and the 1-year follow-up assessment, with mean change in AOFAS 35.9 (P < .01), MOxFQ 46.9 (P < .01), EQ5D 0.36 (P < .01), and EQ5D-VAS 13.2 (P < .01). There were findings of radiolucent lines and/or cysts on 1-year postoperative radiographs in 9 cases (9%).ConclusionsWe found an acceptable rate of early aseptic loosening. All PROMs demonstrated a significant improvement from preoperative to 1-year postoperative assessment.Level of Evidence:Prospective cohort study, level II.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400251330086"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051598","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":"Allograft Reconstruction of a Ruptured Flexor Hallucis Longus Tendon in a Professional Dancer: A Case Report.","authors":"Isabel Wolfe, Emilie R C Williamson, Katie Godwin, Lew C Schon, Donald J Rose","doi":"10.1177/19386400251330103","DOIUrl":"https://doi.org/10.1177/19386400251330103","url":null,"abstract":"<p><p>Stenosing tenosynovitis/tendinitis of the flexor hallucis longus (FHL) tendon is a relatively common occurrence in dancers. When nonoperative management fails, surgical tenolysis/tenosynovectomy has been shown to successfully reduce pain and restore function. In this study, we present the case of a professional contemporary dancer with FHL stenosing tenosynovitis/tendinitis who underwent a z-lengthening of the FHL proximal to the intact tendon sheath which resulted in a rupture of the FHL upon return to dance. He subsequently underwent a FHL reconstruction with tendon allograft. He returned to unrestricted professional dance at 11 months postoperative, which has been maintained at 4-year clinical and MRI follow-up.<b>Level of evidence:</b> V.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400251330103"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059231","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":"Late-Presenting Salter-Harris Type 2 Distal Tibial Physeal Fracture: Favorable Outcome Following Surgical Treatment.","authors":"Gauri A Oka, Ashish S Ranade","doi":"10.1177/19386400251330089","DOIUrl":"https://doi.org/10.1177/19386400251330089","url":null,"abstract":"<p><p>We report the case of an 11-year-old boy with a late-presenting distal tibial Salter-Harris type 2 injury. Before approaching us, he had undergone 2 failed attempts of treatment (closed reduction with plaster cast application and closed reduction and K-wire fixation with plaster cast application). On the 13th day after the injury, the fracture was treated with a closed reduction and metaphyseal canulated cancellous screw fixation and plate fixation of the fibular fracture. At skeletal maturity (4.5 years after the surgery), there was no physeal growth arrest or deformity. We report a favorable outcome in a late-presenting distal tibial Salter-Harris type 2 physeal injury after surgical intervention, which was effective despite the delayed presentation and prior treatment failures.<b>Level of Evidence:</b> <i>Level V</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400251330089"},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059734","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":"Retrocalcaneal Enthesophytes and Radiographic Predictors of Failing Nonoperative Management in Insertional Achilles Tendinopathy: A Retrospective Cohort Study.","authors":"Joseph A S McCahon, Adam Kohring, Matthew J Schultz, Joseph Massaglia, Harrison A Patrizio, Selene G Parekh, David I Pedowitz, Joseph N Daniel","doi":"10.1177/19386400251331642","DOIUrl":"https://doi.org/10.1177/19386400251331642","url":null,"abstract":"<p><p>BackgroundThe purpose of this study was to investigate the relationship between radiographic characteristics of retrocalcaneal enthesophytes in insertional Achilles tendinopathy (IAT) and likelihood of failing nonoperative management.MethodsA retrospective cohort study of 200 patients diagnosed IAT with symptomatic enthesophytes were identified and separated into operative and nonoperative cohorts. All patients had lateral weight-bearing radiographs which were used to measure the calcaneal spur-to-skin distance (CSK), calcaneal spur width (CSW), calcaneal spur height (CSH), and the Fowler-Philip angle (FPA). Demographic and radiographic parameters were compared between both groups. Multivariate regression analysis was performed to identify independent risk factors associated with failing nonoperative management.ResultsThe operative group had significantly smaller CSK (6.0 mm vs 6.6 mm; P = .02), larger CSW (7.9 mm vs 6.2 mm; P < .001), and larger CSH (14.1 mm vs 11.1 mm; P < .001) compared with the nonoperative group. There was no significant between-group difference in FPA (61.9° nonoperative vs 63.3° operative; P = .052). Multivariate logistic regression analysis demonstrated CSK, CSW, and CSH as independent risk factors for failing nonoperative management.ConclusionRadiographic measurements of retrocalcaneal enthesophytes are a simple and reliable method for predicting which patients have a higher likelihood of failing nonoperative management of IAT.Level of Evidence:<i>III, retrospective cohort study</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400251331642"},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031878","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":"Sustentaculum Tali Tunnel Placement for Tibiospring Ligament Reconstruction Augmented With Graft Material: Cadaveric Study.","authors":"John M Thompson, Cody J Togher, Vincent G Vacketta, Jacob M Perkins, Patrick E Bull","doi":"10.1177/19386400251324791","DOIUrl":"https://doi.org/10.1177/19386400251324791","url":null,"abstract":"<p><p>Progressive collapsing flatfoot deformities (PCFD) are commonly the result of the impairment of medial hindfoot soft tissue structures including the posterior tibial tendon, deltoid, and spring ligament. These deformities have been treated surgically via calcaneal osteotomies and tendon transfers; only recently has soft tissue reconstruction gained momentum. Advancements have now made available graft materials to help augment and stabilize ligament repairs to further improve results. Medial hindfoot ligament reconstruction procedures require surgeon familiarity with soft tissue and osseocartilaginous structures. We assessed 20 cadaveric specimens after a simulated medial hindfoot ligament reconstruction procedure focusing on the sustentaculum bone tunnel. Post-procedure anatomic and radiographic observations carefully detailed any damage to anatomic structures. The sustentaculum tunnel guidewire at the lateral calcaneal cortex was documented, including angular position in relation to the subtalar joint. We determined that the posterior-inferior aspect of the lateral calcaneal surface serves as the ideal target region for the placement of the guidewire and subsequent tunnel drilling. Complications increased when drilling tunnels at 7 mm in diameter. The results provide insight for medial-to-lateral drilling of the calcaneus when performing tunneling techniques and can be used to help optimize surgical results when for deltoid/spring ligament repair augmented with graft materials.<b>Level of Evidence:</b> Level V.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400251324791"},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032087","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}