Foot & ankle specialist最新文献

{"title":"Total Ankle Arthroplasty Polyethylene Wear Varies With Implant Type and Mode of Failure.","authors":"Jensen K Henry, Emily Teehan, Kira Lu, Mark Wishman, Isabel Shaffrey, Joaquin Palma Munita, Joseph Nguyen, Brett Steineman, Elexis Padgett, Constantine Demetracopoulos","doi":"10.1177/19386400261431158","DOIUrl":"https://doi.org/10.1177/19386400261431158","url":null,"abstract":"<p><p>BackgroundPolyethylene wear is a mode of failure of any joint replacement, including total ankle arthroplasty (TAA). This study aims to quantify the type and severity of polyethylene damage from retrieved TAA prostheses. We hypothesized that polyethylene wear will be more extensive in TAAs that underwent revision (polyethylene and tibial and/or talar component) rather than reoperation (polyethylene exchange alone), and that wear would vary between implants based on extent of constraint.MethodsThis is a retrospective study of TAA patients (2007-2021) who underwent revision or reoperation following primary TAA with a symmetric bicondylar (SB) implant with more constraint (n = 25, Inbone II/Infinity) or an asymmetric bicondylar (AB) implant with less constraint (n = 30, Salto Talaris). Retrieved polyethylene inserts were examined microscopically to characterize wear patterns according to a standardized protocol. Two independent raters graded articular and backside surfaces in quadrants for 7 damage modes. We assessed associations between polyethylene wear pattern and severity with implant type, revision, and reoperation.ResultsFifty-five TAAs underwent revision (n = 28) or reoperation (n = 27). The SB cohort had significantly greater overall polyethylene damage severity for one rater (P = .007), and greater damage severity in the medial anterior articular region (P = .019) than the AB for both raters. Revision TAAs had significantly greater overall damage severity than reoperations (P ≤ .036), with significantly greater damage severity in multiple articular-sided regions (P ≤ .048). Scratching (P ≤ .030) and pitting (P < .001) were also significantly greater in revision TAAsConclusionTotal ankle arthroplasties with primary SB implants exhibited greater overall polyethylene damage severity than AB implants. Thus, surgeons may want to consider polyethylene type when selecting an implant. In addition, revision was associated with greater polyethylene damage than reoperation. Clinical Relevance. This may suggest polyethylene damage severity increases with increased constraint. Furthermore, polyethylene damage severity is linked to TAA failure, indicating a more severe intraarticular process involving the polyethylene.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261431158"},"PeriodicalIF":2.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647744","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":"Development of Synostosis and Determination of the Risk Factors After Surgical Treatment of Ankle Fracture-Dislocations.","authors":"Ahmet Yigitbay, Cemal Kural, Bülent Tanrıverdi, Mustafa Gökhan Bilgili","doi":"10.1177/19386400261426837","DOIUrl":"10.1177/19386400261426837","url":null,"abstract":"<p><p>ObjectiveThis study aimed to identify the possible risk factors for the development of partial bridging and synostosis in the distal tibiofibular joint following surgically treated ankle fracture-dislocations and to examine the effects of these conditions on ankle function.Materials and MethodsThis retrospective cohort study included patients who presented to our hospital with a diagnosis of ankle fracture-dislocation and had a minimum follow-up duration of 1 year. A total of 37 patients (13 men, 35.1%; 24 women, 64.9%) were included in the study. Ankle radiographs and low-dose computed tomography were performed on the patients during their final check-ups to assess the ankle joint. The presence of partial bridging and synostosis in the distal tibiofibular joint was recorded. Postoperative ankle functions were evaluated using AOFAS and MOXFQ scores.ResultsThe ankle fracture-dislocations were on the right side in 23 patients (62.1%) and on the left in 14 patients (37.9%). The mean age of the patients was 46.5 years (range: 22-72), and the total follow-up duration was 46 months (range: 14-60). Partial bridging was detected in 9 patients 24.3%, and synostosis was detected in 7 patients 18.9%. It was found that the side of the fracture and the fracture classification had no significant effect on distal tibiofibular synostosis. The incidence of partial bridging was significantly higher in men than in women (P = .013). The use of syndesmosis screws was identified as a risk factor for the development of partial bridging and synostosis (P = .014). It was observed that synostosis restricted the ankle joint range of motion, but this was not statistically significant. Furthermore, no difference was found between the groups regarding AOFAS and MOXFQ scores.ConclusionMale sex and cortical syndesmotic screw fixation were associated with an increased risk of distal tibiofibular bridging and synostosis.Level of Clinical Evidence4.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261426837"},"PeriodicalIF":2.1,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610554","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":"Hexapod-Assisted Clubfoot Correction Strictly Following Ponseti Principles: A Purely Biomechanical Approach.","authors":"Farhan Ali, Mubashir M Wani, Abdelsalam Hegazy","doi":"10.1177/19386400261433301","DOIUrl":"10.1177/19386400261433301","url":null,"abstract":"<p><p>BackgroundResistant, syndromic, and neuropathic clubfoot deformities may not respond to repeat Ponseti casting, leaving limited options short of extensive soft-tissue release or osteotomies. Hexapod-assisted gradual correction offers a multiplanar alternative, but existing approaches often diverge from Ponseti biomechanics.PurposeTo evaluate the feasibility and early outcomes of a hexapod correction protocol intentionally modeled after Ponseti principles in children with resistant, syndromic, or neuropathic clubfoot deformities.MethodsA retrospective, IRB-exempt review included 5 boys (mean age 7.4 ± 1.1 years) treated using a staged hexapod protocol replicating the Ponseti CAVE sequence. Diagnoses included arthrogryposis (n = 2), Muscular dystrophy (n = 1), and neuropathic clubfoot associated with spina bifida (n = 2). International Clubfoot Study Group (ICFSG) numeric scores were reconstructed retrospectively from clinical documentation. Minimum follow-up was 24 months.ResultsMean pretreatment ICFSG score was 40.6 (range 36-45), improving to 8.0 (range 4-14). Three patients achieved excellent outcomes (0-5), and 2 achieved good outcomes (6-15). All patients attained durable plantigrade alignment, and both neuropathic ulcers healed. Complications included 2 superficial pin-site infections and one reducible first MTP dislocation.ConclusionA Ponseti-guided hexapod strategy appears feasible for correcting severe, resistant, or syndromic clubfoot when casting is no longer viable. Reconstructed ICFSG scores demonstrated consistent improvement, though these early findings should be interpreted cautiously. Larger prospective studies are needed to clarify long-term durability and indications.Level of evidenceIV.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261433301"},"PeriodicalIF":2.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610676","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":"Three-Dimensional Distance and Coverage Mapping of the First Ray in Hallux Valgus.","authors":"Sudheer C Reddy, Khue Tran, Xiaoxu Li, Qiuhong Ke, Cunjian Chen","doi":"10.1177/19386400261427165","DOIUrl":"10.1177/19386400261427165","url":null,"abstract":"<p><p>BackgroundThree-Dimensional Distance and Coverage Mapping (DM and CM) generated through weightbearing CT (WBCT) can aid in understanding the complex articular relationship in hallux valgus (HV). Prior studies have demonstrated that subluxation can occur at the hallux metatarsophalangeal (MTP) and metatarsosesamoid articulation with greater deformities. Little is known however about these parameters at the level of the tarsometatarsal (TMT) joint, particularly as it relates to the concept of TMT instability as a cause for HV. The purpose of this study is to evaluate DM and CM characteristics at the first TMT joint through WBCT in a cohort of HV patients relative to controls.MethodsTwenty-nine feet (14 left and 15 right) from 16 individuals (avg age of 56.6 ± 6.2 yrs) underwent WBCT. Twelve feet were clinically diagnosed with HV, without clinical evidence of TMT instability, and formed the experimental group, while the remaining 17 feet, absent of deformity, served as the control group. For distance maps, spatial relationship of the joint was assessed by sampling the surface of one bone and calculating the shortest distance to the opposing bone. A limit of 4 mm was set to ensure the analysis focuses on relevant anatomical gaps. For coverage maps, the region was defined along the longitudinal axis of the 1^st metatarsal, with 10% of each end defined to be in contact with the opposing bone. The nearest distance was calculated for this region, with regions of 5 mm or less defined as covered and >5 mm defined as uncovered. Sagittal TMT 1 angle was calculated as a marker of TMT instability. Welch's t-test and Mann-Whitney U were used for statistical analysis.ResultsHallux valgus patients demonstrated significantly increased coverage along the dorsal lateral and plantar lateral quadrant of the MTP joint relative to controls (28.59%, P=.002 and 14.47%, P=.007, respectively) and decreased coverage along the dorsal medial and plantar medial quadrant (-42.63%, P=.002 and -46.69%, P<.001, respectively). No differences in distance mapping at the MTP joint or contact and distance mapping at the TMT joint were observed between groups (Table 1). Sagittal TMT 1 angle was higher in the HV group (1.36° vs 0.6°, P=.02).DiscussionThere is notable discrepancy in coverage at the MTP joint in HV patients relative to those without HV, consistent with subluxation of the hallux MTP joint in HV. Contrary to our hypothesis, no discernable difference was noted at the TMT joint with respect to DM and CM. While sagittal plane angulation was higher in HV, it did not result in appreciable changes in contact and distance mapping at the TMT joint.Level of EvidenceIII: Retrospective case control.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261427165"},"PeriodicalIF":2.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610636","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":"Insurance Status and Patient Outcomes After Total Ankle Arthroplasty.","authors":"Nana F Amponsah, Joydeep Baidya, John Pignataro, Kush Mody, Darshan Reddy, Matthew Culkin, Grant M Thomas, David Pedowitz, Joseph Daniel, Selene Parekh","doi":"10.1177/19386400261428869","DOIUrl":"10.1177/19386400261428869","url":null,"abstract":"<p><p>BackgroundAs total ankle arthroplasty (TAA) becomes more prevalent compared with arthrodesis for treating ankle osteoarthritis, understanding the impact of insurance type on outcomes is crucial. This retrospective cohort study compares Medicare and Preferred Provider Organization (PPO)/Health Maintenance Organization (HMO) patients, assessing differences in clinical characteristics, complications, reoperations, and patient-reported outcomes. The goal is to identify disparities in TAA outcomes based on insurance type.MethodsWe conducted a retrospective cohort study of 830 patients who underwent TAA between May 2010 and June 2024. Patients were grouped by insurance type (Medicare vs PPO/HMO). The inclusion criteria were patients aged 18+ undergoing TAA; exclusions were for incomplete records. Patient-reported outcomes included preoperative and 1-year postoperative visual analog scale (VAS) pain scores and Foot and Ankle Ability Measure scores. Statistical analyses used T-tests, Mann-Whitney U tests, χ², and Fisher exact tests.ResultsThe study analyzed 830 participants, with 401 in the Medicare cohort and 429 in the PPO/HMO cohort. Medicare patients were older (mean 70.4 years vs 59.1 years, P < .001), had a higher Charlson Comorbidity Index (3.72 vs 2.51, P < .001), and experienced longer lengths of stay (1.73 vs 1.44 days, P < .001). Prior ankle surgery was more common in the PPO/HMO cohort (49.9% vs 41.4%, P = .017). Preoperative VAS pain scores were significantly higher in the PPO/HMO cohort (6.70 vs 5.91, P = .021), whereas postoperative VAS scores were similar between groups (P = .100). There were no significant differences in reoperation, readmission, or return to normal activities between the cohorts.ConclusionInsurance type is associated with differences in patient demographics and preoperative characteristics among patients undergoing TAA. Despite higher comorbidity burden and longer hospital stays among Medicare patients, postoperative clinical outcomes and functional recovery were comparable between Medicare and PPO/HMO cohorts.Level of EvidenceIII-Retrospective Comparative Study.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261428869"},"PeriodicalIF":2.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610685","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":"Biomechanical Performance of 4-Leg Sustained Dynamic Compression Staples in First Tarsometatarsal Arthrodesis.","authors":"Tian Wang, Matthew Pelletier, James Johnson, Courtney Kline, William Walsh, Craig Lareau, David Safranski","doi":"10.1177/19386400241281898","DOIUrl":"10.1177/19386400241281898","url":null,"abstract":"<p><p>Background<i>This study investigates the biomechanical efficacy of new 4-leg Sustained Dynamic Compression (SDC) NiTiNOL staples, hypothesized to offer superior stability and resilience to loading before fusion completion, compared with conventional hardware.</i>Methods<i>Twenty sawbones left full foot models were divided into 4 treatment groups: (1) 4-leg Inline Staple, (2) 4-leg Inline Staple + 2-leg Staple, (3) 4-leg Inline Staple + Screw, and (4) Plate + Screw. An osteotomy was performed to simulate a Lapidus procedure, and the respective fixation methods were applied. Mechanical testing was conducted using a servo-hydraulic testing machine to evaluate constructs' load, contact force, contact area, and plantar gap.</i>Results<i>The 4-leg Inline Staple + Screw group demonstrated significantly increased joint contact force, joint contact area, and decreased plantar gap compared with the Plate + Screw group, both before and after cyclic testing. All SDC-containing constructs exhibited post-cyclic joint contact areas that were 2.36</i>×, <i>3.87</i>×, <i>and 5.49</i>× <i>greater than the post-cyclic plate + screw group. Most notably, the 4-leg Inline Staple + Screw group maintained a plantar gap of less than 3 mm throughout the testing, unlike other groups.</i>Conclusions<i>The 4-leg Inline SDC Staple, particularly when combined with a static screw, demonstrated biomechanical superiority over traditional plate and screw constructs in Lapidus procedures. These findings suggest a promising avenue for enhanced post-operative stability, which could translate into quicker patient recovery, improved fusion rates, and potentially lower non-union rates. Further clinical trials are warranted to validate these biomechanical advantages in patient outcomes.</i>Level of Evidence:<i>Therapeutic, Level V: Bench Testing</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"211-218"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482287","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":"Addressing Barriers to Timely Orthopaedic Follow-up for Foot and Ankle Fractures After Emergency Department Visits.","authors":"Parimal Rana, Jane Brennan, Andrea Johnson, Caroline Donegan, Jake Gelfand, Adrienne Spirt, David Keblish, Justin Turcotte, Elizabeth Friedmann","doi":"10.1177/19386400241249807","DOIUrl":"10.1177/19386400241249807","url":null,"abstract":"<p><strong>Introduction: </strong>Foot and ankle fractures present common challenges in emergency departments, warranting careful follow-up protocols for optimal patient outcomes. This study investigates the predictors of orthopaedic follow-up for these injuries after an emergency department (ED) visit.</p><p><strong>Methods: </strong>A retrospective observational study of 1450 patients seen in the ED with foot or ankle fractures from July 2015 to February 2023 was conducted. All included patients were discharged with instructions to follow-up with an orthopaedic provider. Demographic data, fracture details, and follow-up patterns were extracted from medical records. Social vulnerability was assessed using the Centers for Disease Control (CDC) Social Vulnerability Index. Univariate and multivariate analyses were performed to identify predictors of follow-up. A subgroup analysis comparing patients who followed up >7 days from ED presentation (ie, delayed follow-up) to those who followed up within 7 days of presentation was then performed. Statistical significance was assessed at P < .05.</p><p><strong>Results: </strong>Overall, 974/1450 (67.2%) patients followed up with orthopaedics at an average time of 4.16 days. After risk adjustment, Medicaid coverage (odds ratio [OR] = 0.56, P = .018), increased overall social vulnerability (OR = 0.83, P = .032), and increased vulnerability across the dimensions of socioeconomic status (P = .002), household characteristics (P = .034), racial and ethnic minority status (P = .007), and household type and transportation (P = .032) were all associated with lower odds of follow-up. Phalangeal fractures were also associated with decreased odds of follow-up (OR = 0.039, P < .001), whereas ankle fractures were more likely to follow-up (OR = 1.52, P = .002). In the subgroup analysis, patients of older age (P = .008), non-white race (P = .024), motor vehicle accident (MVA) (P = .027) or non-private insurance (P = .027), those experiencing phalangeal fractures (P = .015), and those seen by an orthopaedic provider in the ED (P = .006) were more likely to present with delayed follow-up.</p><p><strong>Conclusion: </strong>Patients with increased social vulnerability and Medicaid insurance are less likely to seek follow-up care after presentation to the ED with foot and ankle fractures.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"175-186"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900723","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":"Variability in Surgical Case Volume Performed During ACGME-Accredited Orthopaedic Foot and Ankle Fellowship Training.","authors":"Jason Silvestre, Jared J Reid, Daniel J Scott, Amiethab A Aiyer, Christopher E Gross","doi":"10.1177/19386400241247256","DOIUrl":"10.1177/19386400241247256","url":null,"abstract":"<p><p>IntroductionPrevious studies have demonstrated a positive correlation between case volume and outcomes in foot and ankle surgery. This study elucidates surgical case volume benchmarks for Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic foot and ankle fellowship training in the United States.MethodsThe ACGME provided case logs for orthopaedic residents and foot and ankle fellows (2018-2021). Variabilities in reported fellowship case volumes were defined as the fold-difference between 90th and 10th percentiles. Reported case volumes were compared between training cohorts with parametric tests.ResultsCase logs from 65 orthopaedic foot and ankle fellows and 3146 orthopaedic residents were included. Fellows reported 1.3- to 1.5-fold more foot and ankle cases during fellowship training than during residency training (P < .001). On average, orthopaedic foot and ankle fellows reported 405.4 cases and most were arthrodesis (17%), forefoot reconstruction (17%), mid/hindfoot reconstruction (13%), tendon repair/transfer (12%), and trauma ankle hindfoot (11%). Case categories with the highest variabilities were amputation (14.8-fold difference), infection/tumor (11.6-fold difference), arthroscopy (9.2-fold difference), and calcaneus (8.7-fold difference).DiscussionCase volume benchmarks can assist trainees and faculty during orthopaedic foot and ankle training. More research is needed to determine case minimum requirements needed for autonomous practice in foot and ankle surgery.Level of Evidence:<i>Level III</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"147-154"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871493","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":"Pickleball and the Rising Incidence of Achilles Tendon Injuries in the Elderly.","authors":"Joseph A S McCahon, Mark Miller, Samantha Riebesell, David I Pedowitz, Selene G Parekh, Joseph N Daniel","doi":"10.1177/19386400241286591","DOIUrl":"10.1177/19386400241286591","url":null,"abstract":"<p><p>BackgroundWith its rising popularity of pickleball, particularly in the aging population, comes concern for potential injuries that previously rarely affected this patient cohort. The purpose of this study was to investigate the trends of pickleball-related Achilles tendon injuries.MethodsA retrospective case series was performed to determine the trends associated with pickleball-related Achilles tendon injuries over the last 10 years. A database search of all Achilles tendon ruptures (ICD-10 S86.0) presenting to a large, multistate, subspecialty referral orthopaedic clinic between January 2013 and June 2023 were identified and included in the study. Pickleball-related injuries were identified via query and confirmed with manual chart review. The incidence of pickleball-related injuries, as well as patient demographics and rate of surgery was determined and compared with the total population during that time period.ResultsA total of 2684 patients who suffered an Achilles tendon injury between January 2013 and June 2023 were identified, with 43 patients meeting the inclusion criteria for pickleball-related Achilles tendon ruptures. The number and overall incidence of pickleball-related Achilles tendon injuries has been increasing since 2016, excluding 2020 where there was a large decrease likely due to the COVID-19 epidemic. Pickleball was associated with older age at time of injury (64.5 vs 48.6, P < .001) as well as a lower BMI (26.6 vs 29.4, P < .001). In addition, patients who sustained a pickleball-related Achilles tendon injury were more likely to undergo surgery (67.4% vs 45.4%, P = .008).ConclusionThe rising popularity of pickleball and its associated injuries poses a significant risk to the aging population, with Achilles tendon injuries occurring in older individuals and resulting in a higher likelihood of undergoing surgery.Level of Evidence:<i>IV; retrospective case-series</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"206-210"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395723","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":"Navigating Ankle Fracture Surgery in the Shadow of COVID-19.","authors":"Justin P Chan, Henry Hoang, Amanda Anderson, Andrew R Hsu","doi":"10.1177/19386400241274539","DOIUrl":"10.1177/19386400241274539","url":null,"abstract":"<p><p>BackgroundThis case control study aimed to evaluate the impact of preoperative COVID-19 diagnosis on postoperative complications in patients undergoing ankle fracture surgery using the National COVID-19 Cohort Collaborative (N3C) database. The investigation focused on the interplay between COVID-19 diagnosis timing, patient characteristics, and clinical outcomes, particularly considering the potential mechanisms by which COVID-19 may contribute to increased complications.MethodsThis case control study included patients who underwent ankle fracture surgery using the N3C database. The cohort was divided into two groups: patients without COVID-19 diagnosis within 12 weeks of surgery (n = 16 806) and those with a positive COVID-19 diagnosis within 12 weeks of surgery (n = 369). Demographic factors were analyzed. Clinical outcomes encompassed deep vein thrombosis (DVT), sepsis, surgical site infection, bleeding, acute kidney injury, 30-day mortality, and 365-day mortality. Multivariate logistic regression analyses were conducted.ResultsThe COVID-19-positive cohort displayed a slightly higher mean age (52.95 ± 18.43 vs 51.62 ± 18.36, P = .169) and body mass index (34.88 ± 9.99 vs 33.86 ± 8.80, P = .028) compared to the negative cohort. Although some outcomes, such as DVT and sepsis, demonstrated slightly higher frequencies in the COVID-19-positive group, these differences were not statistically significant. Adjusted odds ratios (AORs) for various COVID-19 diagnosis periods were generally not significant, except for a heightened risk of 30-day all-cause mortality associated with COVID-19 positivity within 0 to 2 weeks of surgery (AOR = 6.29, P = .003).ConclusionsPreoperative COVID-19 diagnosis within 12 weeks did not exhibit a significant association with most postoperative complications. While this study did not unveil substantial COVID-19-related effects, acknowledging the broader context of the pandemic remains essential in guiding comprehensive patient care strategies.Level of Evidence:Level III.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"187-195"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302490","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}