Foot & ankle specialist最新文献

{"title":"Examining the Influence of Psychiatric Comorbidities on Postoperative Outcomes in Total Ankle Arthroplasty.","authors":"Weston E McDonald, Alexander S Guareschi, John Ryan Allen, Joshua L Morningstar, Richard J Friedman, Daniel J Scott, Christopher E Gross","doi":"10.1177/19386400261474566","DOIUrl":"https://doi.org/10.1177/19386400261474566","url":null,"abstract":"<p><p>IntroductionThis study aims to evaluate the effect of mental health disorders on the postoperative outcomes of patients undergoing primary total ankle arthroplasty (TAA).MethodsThe Nationwide Readmissions Database was queried to identify 29 705 patients undergoing primary TAA from 2015 to 2020. Patients were divided into cohorts based on concurrent mental health disorder (MHD) (MHD = 6041, no MHD = 23,664), with sub-analysis for depression, anxiety, psychosis, bipolar disorder, and posttraumatic stress disorder.ResultsPatients with any MHD were significantly younger (P < .001), more likely to be female (P < .001), lower income (P < .001), and had a higher Charlson-Deyo comorbidity index (P < .001). Multivariate regression analysis found any MHD to be predictive of increased risk of any complication (odds ratio [OR] = 1.108; 95% confidence interval [CI] = 1.001-1.227; P = .048), adverse discharge (OR = 1.552; 95% CI =1.450-1.660; P < .001), extended stay (OR = 1.339; 95% CI = 1.204-1.488; P < .001), and infection (OR = 1.762; 95% CI = 1.305-2.377; P < .001).ConclusionPatients with MHD are at a statistically significantly higher risk of complications, infections, protracted hospital stays, and adverse discharge outcomes following primary TAA.Level of Evidence:Level III, retrospective comparative database study.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261474566"},"PeriodicalIF":2.1,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809386","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":"Endoscopic Peroneus Longus Transfer for Chronic Achilles Tendon Rupture: A Novel Surgical Technique.","authors":"Ahmed Saleh, Ahmed Maher Hawila, Ayman Youssef Eltabbaa","doi":"10.1177/19386400261475902","DOIUrl":"https://doi.org/10.1177/19386400261475902","url":null,"abstract":"<p><p>BackgroundChronic Achilles tendon rupture (CATR) is a debilitating condition affecting activities such as walking and jumping. Surgical reconstruction remains preferred for larger defects, with local tendon transfers including the flexor hallucis longus (FHL) and peroneus brevis (PB). However, these techniques carry risks of donor-site morbidity and neurovascular injury, particularly in high-risk patients.ObjectivesThis article describes a novel minimally invasive endoscopic technique and reports 3 cases of CATR reconstruction using peroneus longus (PL) tendon transfer as an alternative.MethodsThis technique employs standard posterolateral and posteromedial hindfoot portals without requiring additional peroneal tendoscopy portals. A small incision is made near the calcaneocuboid joint to perform tenodesis between PB and PL tendons, with the foot in maximum eversion to maximize tendon harvest. The PL tendon is then pulled through the posterolateral portal with the aid of the tag sutures, then passed through a calcaneal tunnel, and secured using an interference screw under fluoroscopic guidance.ResultsThe procedure was performed in 3 patients with complete CATR (2 insertional, 1 noninsertional). At 1-year follow-up, all patients demonstrated clinical improvement in American Orthopaedic Foot & Ankle Society (AOFAS) and Achilles tendon Total Rupture Score (ATRS) measurements, with no gross clinical weakness in ankle eversion or lateral instability. One patient developed localized plantar heel hypoesthesia, while no major neurovascular complications or lateral ankle instability were observed.ConclusionEndoscopic PL transfer was feasible in 3 patients with CATR and was associated with improved short-term clinical scores. This technique may be considered a potential alternative or salvage option when FHL transfer is unsuitable. However, larger comparative studies are needed before definitive conclusions can be made regarding this technique.Levels of Evidence:<i>Therapeutic studies, Level IV: Case series</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261475902"},"PeriodicalIF":2.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802441","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":"Which Injectable Technology Is Best in the Non-surgical Management of Ankle Osteoarthritis: A Systematic Review.","authors":"Jacob Bertwistle, Abdul-Hadi Kafagi, Justin Mooteeram, Anand Pillai","doi":"10.1177/19386400261472524","DOIUrl":"https://doi.org/10.1177/19386400261472524","url":null,"abstract":"<p><p>ObjectiveTo compare the efficacy and safety of different intra-articular injections in the non-surgical management of ankle osteoarthritis (AOA) in adults.MethodsCINAHL, Medline, PubMed, Embase, and the Cochrane Library were used as our databases from conception to May 2025 using the following string ((Ankle joint) AND (osteoarthritis)) AND (injection OR injectable technology OR intraarticular injection OR stem cell OR MSC OR mesenchymal STEM cell OR PRP OR corticosteroid OR botulinum toxin A) searching for randomized control trials which were manually screened for eligibility and then risk of bias. Eight studies were included, 4 placebo trials (3 comparing hyaluronic acid (HA) with saline, 1 comparing platelet-rich plasma (PRP) with saline) and 4 randomized comparative trials (comparing differing HA regimens, HA with exercise, botulinum toxin type-A (BoNT-A) with exercise + HA and corticosteroids (CS) with CS + HA, respectively).ResultsHA seems to be an effective form of management for AOA, either alone as multiple small doses or combined with either CS or exercise therapy. BoNT-A also seems effective (compared with the current recommended treatment); however, PRP and CS alone do not have any evidence of being effective.ConclusionHA seems to be the most effective in managing AOA symptoms. However, this could not be very objective due to how little research there is on the other forms of injectable technologies.Level of Evidence:<i>Level II: Systematic review of all relevant RCTs (of varying quality).</i></p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261472524"},"PeriodicalIF":2.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801800","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":"Effect of Intravenous Methylprednisolone Versus NSAIDs on Early Soft Tissue Recovery in High-Energy Pilon and Foot Fractures: A Prospective Cohort Study.","authors":"Adriana C Bravo, Albert Baduell, Daniel Poggio, Carolina Montoya-delaTorre, Leticia Torres, Jenaro Fernández-Valencia, Héctor Aguado, Ruben Garcia-Elvira","doi":"10.1177/19386400261477786","DOIUrl":"https://doi.org/10.1177/19386400261477786","url":null,"abstract":"<p><p>BackgroundHigh-energy fractures of the tibial pilon, hindfoot, and midfoot are frequently associated with severe soft tissue injury, delaying definitive fixation. The \"wrinkle sign\" is a clinical marker of edema resolution and readiness for surgery. Corticosteroids may accelerate soft tissue recovery, but their role in orthopaedic trauma remains underexplored. We hypothesized that intravenous methylprednisolone would reduce the time to wrinkle sign appearance compared with intravenous nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with these types of fractures.MethodsThis prospective, multicenter cohort study included 40 patients treated at 2 hospitals between June 2022 and September 2024. Patients received either intravenous methylprednisolone (1 mg/kg/day, tapered every 3 days) or dexketoprofen (50 mg every 8 hours) starting at admission and based on the routine clinical practice of each hospital (treatment allocation was not randomized). The primary outcome was time to wrinkle sign appearance, and secondary outcomes included hospital length of stay and the incidence of soft tissue and infectious complications.ResultsThe median time to wrinkle sign was shorter in the corticosteroid group (CG) (4.5 days [interquartile range, IQR = 3.5-8.0]) than in the NSAID group (NG) (7.5 days [IQR = 3.5-8.0]), though not statistically significant (<i>P</i> = .192). However, patients receiving corticosteroids were significantly more likely to develop the wrinkle sign within 10 days (65% vs 30%; odds ratio = 4.33, 95% CI: 1.15-16.32; <i>P</i> = .03). No surgical site infections occurred in the CG, while 2 superficial infections were reported in the NG. Median hospital stay was shorter in the CG (11.5 vs 17.5 days), though not statistically significant (<i>P</i> = .277).ConclusionsIn our sample, intravenous methylprednisolone was associated with a higher probability of achieving surgical readiness within 10 days in high-energy tibial pilon, hindfoot, and midfoot fractures, while maintaining a comparable safety profile.Level of Evidence:<i>Level II</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261477786"},"PeriodicalIF":2.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802463","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":"Timing of Achilles Tendon Revision within 2 Months of Primary Repair Affects Incidence of Acute Complications.","authors":"Rachel E Cherelstein, Samhita Kotapati, Eslam Alkaramany, Solangel Rodriguez-Materon","doi":"10.1177/19386400261477510","DOIUrl":"https://doi.org/10.1177/19386400261477510","url":null,"abstract":"<p><strong>Background: </strong>Early revision of primary Achilles tendon repair is sometimes necessary, and the Achilles tendon's inherent hypovascularity creates a uniquely challenging biological environment for reoperation. However, the optimal timing for revision and its associated complication risks remain poorly characterized.</p><p><strong>Purpose: </strong>To evaluate the relationship between the timing of early Achilles tendon revision, performed within 8 weeks of primary repair, and the incidence of acute postoperative complications.</p><p><strong>Methods: </strong>Using the PearlDiver M91Ortho data set, patients who underwent Achilles tendon revision 0 to 8 weeks after primary Achilles tendon repair and did not have a diagnosis of diabetes mellitus were stratified into groups based on the interval between operations: 0 to 2 weeks, 2 to 4 weeks, 4 to 6 weeks, and 6 to 8 weeks. The rates of complications, including deep vein thrombosis, pulmonary embolism, superficial and deep surgical-site infection (SSI), wound dehiscence, debridement, and complex regional pain syndrome, were identified. Complication rates across timing groups were compared using chi-square tests and Fisher's exact tests with Bonferroni correction for pairwise analyses.</p><p><strong>Results: </strong>Among 759 patients, sex and age distributions did not differ significantly across timing groups. Overall complication rates varied significantly by revision interval, as did wound dehiscence and deep SSI. Superficial SSI occurred only in the 2-to 4-week group. The post hoc testing showed significantly higher overall complication rates for the 2- to 4-week and 4- to 6-week groups compared with the 0- to 2-week and 6- to 8-week groups. Wound dehiscence was more frequent in the 2- to 4-week and 4- to 6-week groups compared with the 0- to 2-week group. Deep SSI occurred more often in the 2- to 4-week and 4- to 6-week groups compared with the 6- to 8-week groupConclusion:Revision occurring at 2-6 weeks after primary Achilles tendon repair is associated with a significantly higher risk of complications compared with revisions within 0-2 weeks or at 6-8 weeks, thereby suggesting an optimal revision-timing window to mitigate adverse outcomes.</p><p><strong>Level of evidence: </strong>\u0000 <i>Retrospective cohort study (Level of Evidence III).</i>\u0000 </p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261477510"},"PeriodicalIF":2.1,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760561","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":"Influence of GLP-1 Receptor Agonists on Surgical and Nonsurgical Treatment of Ankle Osteoarthritis.","authors":"Ysa Le, Sydney Thai, Jessica Siragusa, Lilia Elsabbagh, Indeevar Beeram, Nigel Hsu, John Thompson, Amiethab Aiyer","doi":"10.1177/19386400261471652","DOIUrl":"https://doi.org/10.1177/19386400261471652","url":null,"abstract":"<p><p>BackgroundGlucagon-like peptide-1 (GLP-1) receptor agonists are widely used for the treatment of obesity and type 2 diabetes mellitus (T2DM), with established metabolic benefits. However, their influence on musculoskeletal outcomes, particularly in patients with ankle osteoarthritis (OA), remains unclear.MethodsWe conducted a retrospective cohort study using the TriNetX Analytics Network to evaluate the association between GLP-1 therapy and surgical or nonsurgical interventions for ankle OA. Adults with obesity (body mass index [BMI] ≥30 kg/m²) or T2DM (ICD-10: E11) were identified between 2016 and 2020. Patients were stratified by GLP-1 use, defined as ≥2 prescriptions separated by ≥6 months for semaglutide, liraglutide, dulaglutide, exenatide, or lixisenatide. Outcomes included ankle joint injection (CPT: 20605, 20606), ankle arthroscopy/debridement (CPT: 29891, 29898, 29897, 29895), and total ankle arthroplasty (TAA) or arthrodesis (CPT: 27700, 27702, 27870, 29899). Outcomes were analyzed beginning 6 months after index date. Hazard ratios (HRs) were estimated with 95% confidence intervals (CIs).ResultsAfter matching, 3089 obese and 8117 diabetic patients were included in each comparison group. In the obese cohort, GLP-1 users had a lower risk of ankle joint injection (HR = 0.8, 95% CI = 0.6-0.9) and TAA (HR = 0.5, 95% CI = 0.3-0.9), while risk of arthroscopy was not significantly different. In the diabetic cohort, GLP-1 use was associated with increased risk of arthroscopy (HR = 1.9, 95% CI = 1.2-3.2) but not joint injection or TAA. Over 5 years, GLP-1 users achieved greater reductions in BMI compared with non-users (obese cohort: -2.7 vs -1.6 kg/m²; diabetic cohort: -2.1 vs -1.7 kg/m²; both P < .01). HbA1c improved significantly in both diabetic groups, with slightly greater reduction in non-users (-6.0% vs -5.5%, P < .01)ConclusionObese GLP-1 users demonstrated lower rates of invasive ankle procedures, while diabetic GLP-1 users experienced higher arthroscopy utilization. These findings suggest that metabolic improvements may not uniformly translate to musculoskeletal benefit, warranting further investigation.Level of Evidence:<i>III</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261471652"},"PeriodicalIF":2.1,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801771","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":"Hyaluronic Acid in the Management of Foot and Ankle Pathologies.","authors":"Jared Rubin, Alexander Tham, Michael Allen, James J Butler, Samuel R Montgomery, Nathaniel P Mercer, Bradley A Lezak, Jay Zaifman, John G Kennedy","doi":"10.1177/19386400261477453","DOIUrl":"https://doi.org/10.1177/19386400261477453","url":null,"abstract":"<p><p>BackgroundHyaluronic acid (HA) has emerged as a potential biologic adjunct in the management of various foot and ankle pathologies due to its viscoelastic, anti-inflammatory, and chondroprotective properties.MethodsA scoping review of the currently available literature evaluating HA use in foot and ankle pathology was performed, with emphasis on osteoarthritis (OA), osteochondral lesions of the talus (OLTs), and soft tissue disorders.ResultsCurrent evidence suggests that HA injections may provide pain relief and functional improvement across multiple foot and ankle conditions. The most consistent evidence supports potential HA use in soft tissue disorders, including Achilles tendinopathy, plantar fasciitis, and acute lateral ankle injuries. HA may be used as an adjunct in OLT and selected OA applications, although outcomes remain heterogeneous across studies.ConclusionAlthough HA demonstrates a favorable safety profile and potential clinical benefit in selected foot and ankle conditions, currently available evidence remains limited by heterogeneous study designs, inconsistent treatment protocols, and short-term follow-up. Additional high-quality, comparative, and long-term studies are warranted to better define the role of HA in foot and ankle pathology.Level of Evidence:<i>Level V, Scoping Review</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261477453"},"PeriodicalIF":2.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763503","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":"Timing of Fracture Fixation in Ankle Fracture-Dislocations.","authors":"Diederick Penning, Jasper Tausendfreund, M Azad Naryapragi, Kostan W Reisinger, Pieter Joosse, Erik Tanis, Tim Schepers","doi":"10.1177/19386400241273105","DOIUrl":"10.1177/19386400241273105","url":null,"abstract":"<p><p>Ankle fracture-dislocations may require delayed internal fixation. Our aim was to compare acute open reduction and internal fixation (ORIF) with delayed ORIF, using external fixation or cast splint in ankle fracture-dislocations. Factors that affect the rates of re-operation and Surgical site infection (SSI) were identified. In this retrospective cohort study, patients were included with open and closed ankle fracture-dislocations treated with ORIF from two large peripheral hospitals and one academic center in the Netherlands. This study included 447 patients with an ankle fracture-dislocation. In the multivariate analysis, the difference between surgery <48 hours compared to bridging with cast or external fixation had no significant influence on unscheduled re-operation or SSI. Higher body mass index (BMI) and open fractures had a significant positive correlation with re-operation while diabetes mellitus (DM) and open fractures correlated with SSI. In patients with open fractures, there was also no significant difference in outcome between acute or delayed internal fixation. We suggest that it is safe to perform primary ORIF on all dislocated ankle fractures if the soft tissue injury allows surgery within 48 hours. When significant swelling is present, patients with well-reduced fractures and with no soft tissue injury could be treated safely with a cast until delayed ORIF is possible.<b>Level of Evidence</b>: <i>Therapeutic level 2B (retrospective cohort study)</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"368-382"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378665","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":"Cross-Cultural Adaptation and Validation of Foot and Ankle Ability Measure (FAAM) for Arabic-Speaking Patients.","authors":"Sulaiman A Almousa","doi":"10.1177/19386400241298797","DOIUrl":"10.1177/19386400241298797","url":null,"abstract":"<p><p>BackgroundThe original English Foot and Ankle Ability Measure (FAAM) is widely adopted to track changes in foot and ankle function. The aim of this study is to translate it to an Arabic version of FAAM (FAAM-A), and then to assess the validity and reliability of the FAAM-A version.MethodologyOne hundred five consecutive Arabic-speaking participants with different foot and ankle pathologies completed the FAAM-A. Fifty-six males and 49 females with a mean age of 39.8 years; 78.1% respondents have completed high school or higher. Convergent and divergent validities were assessed using correlation coefficients between the FAAM-A subscales and the short form-36 (SF-36), physical function (PF), physical component summary (PCS), mental health (MH), and mental component summary (MCS). Cronbach's alpha was calculated to assess internal consistency. A subgroup of 20 participants filled the FAAM-A twice to test for test-retest reliability, using intraclass correlation coefficients (ICCs) and minimal detectable changes (MDCs).ResultsThe average FAAM-A was 55.32 and 43.23 for the activity of daily life (ADL) and Sports subscales, respectively. FAAM-A ADL subscale had a moderate correlation with the PF, 0.565; PCS, 0.546; and MCS, 0.447; and a low correlation with MH, 0.34. The sports subscale had a moderate correlation with the PF (0.529), PCS (0.513), and a low correlation with MCS (0. 395) and MH (0. 297). Cronbach's alpha was 0.97 and 0.95 for ADL and sports subscales, respectively. Intraclass correlation coefficient was 0.99 for both subscales. Minimal detectable change at a 95% confidence level was 6.81 and 8.19 for the ADL and sports subscales, respectively.ConclusionThe FAAM-A is proven to be valid and reliable instrument for assessing foot and ankle disability. It is an effective tool for clinical assessment and research within Arabic-speaking populations.Level of Evidence:Level II, Prospective cohort study.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"383-389"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683669","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":"Deltoid All-Inside Repair in SER IV Bimalleolar-Equivalent Ankle Fractures.","authors":"Tiago Soares Baumfeld, Matheus Kuffner, Daniel Soares Baumfeld, Gustavo Araujo Nunes, Alexandre Leme Godoy Dos Santos, Stefan Rammelt","doi":"10.1177/19386400261427776","DOIUrl":"10.1177/19386400261427776","url":null,"abstract":"<p><p>BackgroundAnkle fractures are the second most common fractures of the lower limb. In supination-external rotation (SER) stage 4 injuries, the medial malleolus or the deltoid ligament is disrupted. The stability of the deltoid ligament is essential for the functionality, however, the need for surgical repair remains debated. The aim of this study is to assess deltoid stability in 12 ankle fractures treated with an all-inside repair technique.MethodsA prospective case series of 12 patients (8 men,4 women aged between 25 and 53 years who had a stage 4 LH SER ankle fracture with unstable deltoid ligament injury between September 2023 and February 2024. No patients in this study had an associated posterior malleolus fracture. All patients were treated with deltoid all-inside repair at the time of fracture fixation. Outcomes were measured using the VAS scales, radiographic and magnetic resonance imaging (MRI), and AOFAS scores are reported exclusively in the Supplementary Material for historical comparability, Stability was tested using stress and weight-bearing radiographs, measuring talar tilt (TT) and medial clear space (MCS).ResultsClinically, the patients had good results, with a mean VAS of 1.5 and AOFAS score of 87 at 6 months follow-up. There were no complications observed during the study period. MCS remained stable (P = .125), with means of 3.03 mm (postop), 2.87 mm (weight-bearing), and 3.38 mm (stress). Similarly, TT remained consistent (P = .597), with means of 1.17º (postop), 0.87º (weight-bearing), and 1.14º (stress). These findings confirm preserved joint alignment and ligament integrity postrepair.DiscussionTo the best of our knowledge, All-inside deltoid repair has been described; however, reports specifically within SER IV bimalleolar-equivalent fractures and short-term radiographic stability remain limited. The technique demonstrated favorable short-term functional outcomes and radiographic stability.ConclusionSER IV bimalleolar-equivalent ankle fractures, arthroscopic all-inside deltoid repair maintained radiographic reduction and yielded favorable short-term outcomes.Levels of EvidenceLevel IV, Case Series.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"435-442"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679143","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}