Foot & ankle surgery (New York, N.Y.)最新文献

{"title":"Knee-to-Talus osteochondral grafting for talar lesions: Mid-term outcomes of the OATS procedure","authors":"Shevanka Dias Abeyagunawardene ,&nbsp;Joseph Paul ,&nbsp;Dror Maor","doi":"10.1016/j.fastrc.2025.100544","DOIUrl":"10.1016/j.fastrc.2025.100544","url":null,"abstract":"<div><h3>Background</h3><div>Talar osteochondral lesions (OCLs), often resulting from ankle trauma, affect the cartilage and subchondral talus bone and frequently require surgical intervention when conservative measures fail. Arthroscopic debridement and microfracture are some of the surgical interventions, leaving many patients with ongoing pain even after extended rehabilitation. The osteochondral autograft transfer system (OATS) offers an alternative by restoring hyaline cartilage using grafts from non-weight-bearing knee regions.</div></div><div><h3>Purpose / Study Design</h3><div>This retrospective case series evaluated the effectiveness of OATS in improving patient-reported outcomes for patients with postero-medial talar OCL.</div></div><div><h3>Methods</h3><div>All procedures were performed by a single surgeon across three centres in Western Australia. The donor sites for all autografts were from a non-weight bearing region of the lateral femoral condyle on the ipsilateral side. Pre- and post-operative patient-reported outcome measures were collected.</div></div><div><h3>Results</h3><div>Thirteen patients underwent OATS for talar OCLs from 2020 to 2024, with mean follow-up of 1.99 years. All had failed prior non-operative management, and over half underwent previous arthroscopic debridement. The average lesion size was 169 mm², requiring 1–3 grafts. AOFAS scores improved significantly from 60.3 to 80.2 (p &lt; 0.0001), with no correlation between score change and age, lesion size, number of plugs, nor previous procedures. Donor site morbidity was low (15.4%), reported only as subjective weakness.</div></div><div><h3>Conclusion</h3><div>OATS is a safe and effective treatment for talar OCLs unresponsive to conservative or previous arthroscopic surgical management. Low donor site morbidity supports the use of ipsilateral knee harvest. Future studies should incorporate validated PROMs and explore predictive factors for surgical success.</div></div><div><h3>Level of Clinical Evidence</h3><div>Level 4 – Case Series</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100544"},"PeriodicalIF":0.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713409","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":"Atypical presentation of musculoskeletal tuberculosis in the ankle: A case report","authors":"Bassem Al Hariri ,&nbsp;Muhammad Faizan ,&nbsp;Mennatallah Lotfi ,&nbsp;Ahmed Alayadi M Salem ,&nbsp;Muhammad sharif ,&nbsp;Memon Noor Illahi","doi":"10.1016/j.fastrc.2025.100543","DOIUrl":"10.1016/j.fastrc.2025.100543","url":null,"abstract":"<div><div>Tuberculosis (TB) remains a significant global health challenge, with extrapulmonary TB making up about 10 % of all cases. Musculoskeletal TB is a minor component of these cases, with TB of the ankle and foot being exceptionally uncommon, accounting for just 0.1–0.3 % of extrapulmonary TB instances. We introduce a diagnostically challenging case involving a 30-year-old South Asian male who developed primary TB osteomyelitis of the left ankle, which initially presented as a non-healing ulcer resistant to conventional antibiotic treatment.</div><div>Characteristic features of osteomyelitis with associated soft tissue involvement were demonstrated by advanced imaging studies, including MRI. The definitive diagnosis was made through PCR and culture confirmation of Mycobacterium tuberculosis from surgical specimens. A thorough evaluation uncovered the presence of concomitant pulmonary TB, underscoring the significance of systemic assessment in cases of extrapulmonary presentations. The patient was effectively treated using a combination of surgical debridement and standard anti-tubercular therapy, showing a favorable early response.</div><div>This case demonstrates several vital clinical lessons: the importance of keeping a high suspicion for TB in persistent musculoskeletal lesions, especially in patients from endemic regions; the worth of state-of-the-art diagnostic methods in atypical presentations; and the significance of examining for concurrent pulmonary involvement even in cases of extrapulmonary disease that appear to be isolated. The report bolsters existing guidelines that advocate for a multidisciplinary strategy in TB management, integrating precise microbiological diagnosis, suitable imaging, and extended antimicrobial treatment to avert long-term consequences. Clinicians working in both endemic and non-endemic areas may find these findings especially relevant, as they may come across such atypical presentations.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100543"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687426","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":"Use of non metallic implant for medial malleolar prophylactic fixation in total ankle arthroplasty, a noninferiority study","authors":"Cameron Meyer ,&nbsp;Jae Yoon Kim ,&nbsp;Orlando Martinez ,&nbsp;Lauren M. Christie ,&nbsp;Gregory Berlet","doi":"10.1016/j.fastrc.2025.100542","DOIUrl":"10.1016/j.fastrc.2025.100542","url":null,"abstract":"<div><div>Metal screw fixation has been standard in orthopedic procedures but carries drawbacks including migration, breakage, and need for removal. New bio-integrative options have shown promise in fracture repair; but the use with prophylactic fixation in total ankle arthroplasty (TAA) is unclear. The purpose of this study was to compare outcomes of biointegrative implants versus no fixation in prophylactic medial malleolar fixation with TAA.</div><div>A retrospective review via surgeon operative database was performed including patients with primary total ankle arthroplasty by a single fellowship trained orthopedic foot and ankle surgeon between December 2018 and February 2024. Search was verified by billing documentation with a minimum of 1 year follow up. Objective patient data including age, comorbidities, smoking and social history were all recorded. Postoperative data was reviewed to assess perioperative complications specific to the two cohorts.</div><div>The authors reviewed 150 cases of a single surgeon performing total ankle replacement. When comparing postoperative complications between use of non metallic fixation to no fixation, this was 1.64% (n=1) to 5.65% (n=5) respectively. Intraoperative complications occurred in 60% (n=3/5) of patients without fixation while none were seen in the non metallic prophylactic cohort.</div><div>Non metallic implant designs continue to improve with bio-integrative benefits compared to no fixation of the medial malleolus in TAA. We found that intraoperative and postoperative complications are less likely with prophylactic fixation of the medial malleolus with a biointegrative implant. Further prospective studies are warranted to evaluate the long term benefit.</div><div><strong>Level Of Evidence:</strong> Level 3, Retrospective Cohort Study.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100542"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679960","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":"First case of calcaneal Brodie's abscess caused by Fusobacterium nucleatum in an immunocompetent adult","authors":"Jobin Jacob Job ,&nbsp;Zain Al Abdeen Al Zuabi ,&nbsp;Nisha De Souza ,&nbsp;Alauldeen Al Hussein ,&nbsp;Zhikai Li ,&nbsp;Chandra Pasapula","doi":"10.1016/j.fastrc.2025.100539","DOIUrl":"10.1016/j.fastrc.2025.100539","url":null,"abstract":"<div><div>Subacute calcaneal osteomyelitis is a challenging condition with a high relapse rate. This case report presents the first documented instance of subacute osteomyelitis of the calcaneus caused by <em>Fusobacterium nucleatum</em>, manifesting as post-traumatic heel pain in a 24-year-old male. The patient presented with heel pain following a fall, with no history of penetrating injury or immunosuppression. Imaging (Radiograph/CT/MRI) revealed a growing lytic lesion with surrounding bone marrow edema in the calcaneum. Surgical drainage and debridement were performed, and intraoperative cultures identified <em>Fusobacterium nucleatum</em>. The patient was treated with parenteral tazocin and oral metronidazole, followed by six weeks of oral doxycycline and metronidazole. Inflammatory markers normalized over three weeks, and the patient showed satisfactory recovery with follow-up radiographs and clinical reviews. This case highlights the importance of considering <em>Fusobacterium nucleatum</em> in subacute calcaneal osteomyelitis and demonstrates the effectiveness of combined surgical and antibiotic treatment.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100539"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687425","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":"Technique for all arthroscopic Brostrom repair using novel biocomposite scaffold ligament graft","authors":"Jay S. Badell","doi":"10.1016/j.fastrc.2025.100540","DOIUrl":"10.1016/j.fastrc.2025.100540","url":null,"abstract":"<div><div>Ankle sprains affect a large portion of the general population and are one of the most common reasons for emergency room visits in the United States and globally. In recent years the advent of synthetic ligament grafts has provided an option for repair of the diseased/injured ligament using an anatomic augmentation. Several of these ligament grafts exist, however long-term data is limited. There has been no report in literature of an all-arthroscopic technique with use of biocomposite scaffold ligament graft in repair of the lateral collateral ankle ligaments. Technique and case examples are described using an all-arthroscopic technique for anatomic lateral ankle ligament repair using a novel ligament graft. Five patients with refractory chronic ankle instability received all arthroscopic ATFL repair using the biocomposite scaffold ligament graft. Pre and post operative American orthopedic foot and ankle society score, foot function index score, visual analog pain scale scores were collected. Mean pre-operative American orthopedic foot and ankle society score, foot function index score, visual analog pain scale were 38.2 ± 22.7, 55.28 ± 29.8, 6.8 ± 2.2 respectively. Mean post-operative American orthopedic foot and ankle society score, foot function index score, visual analog pain scale were 88.0 ± 11.4, 16.4 ± 14.0, 1.6 ± 1.5 resp. This technique offers anatomic restoration of the lateral ankle ligamentous complex through a minimally invasive approach that can lead to quicker recovery and return to activity.</div><div><strong>Level of Clinical Evidence</strong>: 5, Technique</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100540"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623805","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":"Transverse tibial bone transport for treatment of calcaneal osteomyelitis: a case report","authors":"Ryan Stone DPM, FACFAS ,&nbsp;Mikhail Samchukov MD ,&nbsp;Byron Hutchison DPM, FACFAS","doi":"10.1016/j.fastrc.2025.100537","DOIUrl":"10.1016/j.fastrc.2025.100537","url":null,"abstract":"<div><div>Soft tissue defects of the posterior heel region with underlying osteomyelitis are challenging conditions to manage, particularly in the setting of concomitant peripheral arterial disease and diabetes mellitus. Such wounds are associated with high rates of amputation, loss of independence and high mortality. Transverse bone transport (TBT) is an evolving technique involving gradual distraction of the tibial cortex to promote angiogenesis of the lower extremity, improving extremity perfusion and overall wound healing potential. Recent applications of this technique demonstrate favorable healing in diabetic foot wounds with improved limb salvage rates. Herein, we describe a unique case where TBT was employed in conjunction with external fixation to successfully achieve wound healing and limb preservation in the setting of a posterior heel wound with calcaneal osteomyelitis.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100537"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670921","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":"Crossing screw fixation in first proximal phalanx fracture nonunion: A case report","authors":"Alec R. Wroblewski DPM,&nbsp;Brennan K. Reardon DPM, AACFAS,&nbsp;Nicholas S. Powers DPM, FACFAS","doi":"10.1016/j.fastrc.2025.100536","DOIUrl":"10.1016/j.fastrc.2025.100536","url":null,"abstract":"<div><div>Pedal phalangeal fractures are common, however, literature is lacking concerning reported treatment options for a hallux proximal phalanx nonunion. This case of a first proximal phalanx nonunion initially presented to the clinic following a traumatic injury and emergency room visit with radiographic analysis revealing a closed, mildly displaced first proximal phalanx fracture. After initial conservative treatment failed, the painful nonunion was treated operatively with open reduction and internal fixation. This report highlights the use of crossing screws as a method of surgical fixation with adjunctive use of bone allograft and bone stimulator, with immediate protected weightbearing included as part of the post-operative protocol. At 3 months following surgery, radiographic union was noted and the patient reported complete relief of pain. This supports utilizing the reported fixation method and weightbearing protocol, hopefully adding to the armamentarium available to practitioners when treating similar fractures and nonunions.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100536"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655461","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 hook test for rupture of tibialis anterior tendon","authors":"Om Lahoti","doi":"10.1016/j.fastrc.2025.100533","DOIUrl":"10.1016/j.fastrc.2025.100533","url":null,"abstract":"<div><h3>Background</h3><div>Chronic rupture of the tibialis anterior tendon is uncommon, and delays in diagnosis are common. The reasons are multifactorial, and incomplete physical examination is one of them.</div></div><div><h3>Methods</h3><div>The author describes a Tibialis Anterior Tendon (TAT) hook test to aid in diagnosis. The test is based on the normal anatomy of the TAT at the ankle, and a positive test confirms a normal intact tendon. A negative test confirms loss of continuity. This is a simple test that can be performed quickly and easily. This is easy to teach.</div></div><div><h3>Results</h3><div>The author has been using the test since 2021 and has diagnosed four cases of TAT chronic tear by the end of 2024.</div></div><div><h3>Conclusions</h3><div>The tibialis anterior hook test helps diagnosis of chronic ruptures. This test has not been previously described in the literature. The technique and experience of the author are presented in this paper.</div></div><div><h3>Levels of Evidence</h3><div>Level IV – Case series</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100533"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571318","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":"Clinical guidelines for the application of tibial cortex transverse transport for diabetic foot ulcers","authors":"Gan Golshteyn DPM, FACFAS ,&nbsp;Emmy Oji DPM, FACFAS ,&nbsp;Mikhail Samchukov MD, Co-Director","doi":"10.1016/j.fastrc.2025.100535","DOIUrl":"10.1016/j.fastrc.2025.100535","url":null,"abstract":"","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100535"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571319","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":"Unique finding of intravascular papillary endothelial hyperplasia in the foot: A case report","authors":"Callie Morlock DPM, AACFAS,&nbsp;Amanda Khoury DPM, AACFAS,&nbsp;Saloni Buch DPM, BS,&nbsp;Anna Hronek DPM, FACFAS, DABM, CWSP","doi":"10.1016/j.fastrc.2025.100530","DOIUrl":"10.1016/j.fastrc.2025.100530","url":null,"abstract":"<div><div>Intravascular papillary endothelial hyperplasia (IPEH), also known as a Masson’s tumor, is a benign soft tissue mass secondary to reactive endothelial cells induced by inflammation and thrombosis. The diagnosis of IPEH cannot be achieved by clinical evaluation or imaging modalities alone as it mimics benign and malignant tumors. In order to get a definitive diagnosis and rule out other pathologies, surgical resection and histopathology are necessary. Our case report highlights a patient who developed a lesion after increasing activity initially diagnosed as a ganglion cyst. After ultrasound and MRI findings, surgical resection was recommended to rule out malignancy. Histopathology concluded the diagnosis of IPEH demonstrating the importance of surgical excision for a definitive diagnosis along with the mixed clinical and imaging presentation faced for this type of pathology.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100530"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510891","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}