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

{"title":"Intramuscular corticosteroids combined with exercise for refractory midportion achilles tendinopathy: A case series","authors":"Jan MA Mens MD, PhD","doi":"10.1016/j.fastrc.2025.100573","DOIUrl":"10.1016/j.fastrc.2025.100573","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of Achilles tendinopathy (AT) typically consists of progressive exercise, load management, and patient education. The use of paratendinous administration is controversial. Improvement with conventional measures is often insufficient, creating a need for alternative solutions.</div></div><div><h3>Purpose</h3><div>Purpose is to describe the outcomes of patients treated with intramuscular corticosteroid-injections in combination with exercises.</div></div><div><h3>Study design</h3><div>retrospective analysis of a case series.</div></div><div><h3>Methods</h3><div>Baseline data and short-term outcomes were collected from patient records treated in our clinic. Follow-up results were gathered by means of structured telephonic interviews. AT was defined as pain in the Achilles tendon during activities with at least two of the following criteria: pain on tiptoe standing, swelling and/or tenderness 2–7 cm above the insertion, ultrasound signs of tendinopathy.</div></div><div><h3>Results</h3><div>Ten patients were included. The median duration of symptoms was 12 months (IQR 23). Patients reported improvement after 5.6 days (SD 4.8).The treatment reached its maximum effect at 6.2 weeks (SD 3.4). At the end of the 2–12 week intervention, six patients felt completely recovered and four reported feeling much better. At follow-up (23 months, SD 17), seven patients felt completely recovered and three much better. The median NRS pain score changed from 8 at baseline to 0 (<em>p</em> = 0.002), and the mean VISA-A score from 37 to 95 (<em>p</em> &lt; 0.0001). No major adverse events were observed.</div></div><div><h3>Conclusion</h3><div>one or two intramuscular corticosteroid injections combined with concentric–eccentric exercises may offer rapid and sustained relief for patients with midportion AT.</div></div><div><h3>Level of Clinical Evidence</h3><div>4</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100573"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158383","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":"Managing complex foot deformities in paraplegia: Outcomes of intramedullary hindfoot arthrodesis for spastic pes cavovarus; A case series review","authors":"Gil Genuth ,&nbsp;Martin Keith Ulrich ,&nbsp;Markus Damrau ,&nbsp;Lukas D Iselin","doi":"10.1016/j.fastrc.2025.100572","DOIUrl":"10.1016/j.fastrc.2025.100572","url":null,"abstract":"<div><h3>Background</h3><div>Patients with spinal cord injury (SCI), particularly those with paraplegia, often develop rigid foot deformities such as spastic pes cavovarus due to unopposed muscle activity and chronic spasticity. These deformities compromise seating alignment, hinder passive standing programs, and significantly increase the risk of pressure ulcers (PUs), especially at the heel, lateral border, first metatarsal head, and lateral malleolus. Conservative treatments often fail in severe, fixed deformities, necessitating surgical intervention.</div><div>This study aimed to evaluate the clinical and radiographic outcomes of hindfoot arthrodesis using intramedullary nail (IMN) fixation in paraplegic patients with spastic foot deformities, focusing on fusion rates, PU recurrence, and improvements in wheelchair positioning.</div></div><div><h3>Methods</h3><div>This retrospective case series included eight paraplegic patients (mean age: 34 years) with fixed pes cavovarus deformities treated between 2015 and 2019. All underwent percutaneous soft tissue release and open hindfoot joint preparation, followed by IMN fixation using a hindfoot nail. Radiographic fusion was assessed at 3, 6, and 9 months via standard radiographs and selected CT scans. Clinical follow-up lasted at least 12 months.</div></div><div><h3>Results</h3><div>Radiographic fusion was achieved in 75 % of cases. All patients showed clinical improvement in seating alignment and tolerance to gravity-loading protocols. Two patients had asymptomatic non-union. Postoperative complications included two superficial infections, one new PU, and two cases of symptomatic screw protrusion requiring hardware removal.</div></div><div><h3>Conclusion</h3><div>Hindfoot arthrodesis using IMN offers a promising surgical option for SCI patients with rigid foot deformities. It enables plantigrade alignment, supports pressure redistribution, and improves functional seating. Despite a small sample size, the outcomes justify further prospective studies to confirm its role in this complex, underserved population.</div></div><div><h3>Level of evidence</h3><div>4</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100572"},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gunshot wounds in the lower extremities: Treatment review","authors":"Michael A. Coyer DPM FACFAS ,&nbsp;James C. Connors DPM FACFAS ,&nbsp;Mark A. Hardy DPM FACFAS ,&nbsp;Victoria Suggs BS ,&nbsp;Kasra Karamlou DPM","doi":"10.1016/j.fastrc.2025.100571","DOIUrl":"10.1016/j.fastrc.2025.100571","url":null,"abstract":"<div><div>A high number of gunshot injuries occur in the lower extremities, making it likely that foot and ankle surgeons will encounter these wounds when involved in lower extremity trauma care. Understanding current thought processes and standards of care regarding high and low velocity wounds is imperative for surgeons to appropriately manage these unique and challenging traumatic injuries. Additionally, it is crucial to consider legal ramifications related to evidence collection, interaction with law enforcement, and witness testimony. This article discusses treatment guidelines that are crucial for patient care as well as preservation of evidence and appropriate documentation for law enforcement.</div></div><div><h3>Level of Evidence</h3><div>5</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100571"},"PeriodicalIF":0.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220585","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":"A rare presentation of an abductor hallucis soft tissue mass: A case report","authors":"Ksenja Llazar DPM ,&nbsp;Nayab Khan DPM ,&nbsp;Michael Loshigian DPM, FACFAS","doi":"10.1016/j.fastrc.2025.100570","DOIUrl":"10.1016/j.fastrc.2025.100570","url":null,"abstract":"<div><div>Schwannomas can present as soft tissue masses in the foot and ankle that mimic other conditions. This report presents a rare case of schwannoma arising within the abductor hallucis muscle belly in a 53-year-old female with past medical history of rheumatoid arthritis. The patient presented with a year-long history of left foot pain and a slowly enlarging, palpable mass on the plantar medial aspect of the foot. Initial evaluation and imaging revealed a well-circumscribed soft tissue mass with internal vascularity. However, due to medical history and overlapping clinical and imaging features, the differential diagnosis, among others, included rheumatoid nodules. Surgical excision of the mass was performed, and histopathology confirmed the diagnosis of traditional schwannoma. This report underlines the diagnostic challenge of distinguishing schwannomas from rheumatoid nodules and other types of soft tissue masses, specifically in patients with autoimmune disease. We discuss the clinical, radiological, and pathological aspects of this rare tumor. Definitive diagnosis requires histological analysis, as imaging alone may be inconclusive.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100570"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158384","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":"Lipofibromatosis-like neural tumor of the foot: A case study","authors":"Derek A. Swanson PMSIII ,&nbsp;Robert Lee PMSIII ,&nbsp;Annie Phan OMSIII, MA ,&nbsp;Janna Kroleski DPM, MS","doi":"10.1016/j.fastrc.2025.100568","DOIUrl":"10.1016/j.fastrc.2025.100568","url":null,"abstract":"<div><div>Lipofibromatosis-like neural tumors (LPF-NTs) are a rare form of mesenchymal tumors generally found in children and young adults¹. LPF-NTs are a novel tumor type, only recently identified and named with the first case being &lt;10 years ago². These tumors tend to occur in the distal extremities, presenting as slow-growing benign non-metastatic masses. They display a lipofibromatosis-like structure with an immunophenotype positive for CD34/S100 and NTRK1 gene abnormalities². Due to LPF-NTs rarity and a lack of pain until significant mass expansion, they are often challenging to diagnose making treatment options more challenging³. Conservative treatment will not stop tumor growth or pain long term, causing a need for surgical excision. LPF-NTs, if improperly excised, demonstrate a high rate of local recurrence². The rarity and diagnostic difficulty of LPF-NTs complicate patient care and increase the risk of misdiagnosis. This case report details a successful surgical removal of an LPF-NT and reviews the literature to improve recognition, diagnosis, and treatment by explicitly focusing on key characteristics, common diagnostic failures, and optimal treatment approaches for an LPF-NT located in the foot.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100568"},"PeriodicalIF":0.0,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096294","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":"Unexpected bony regrowth following partial hallux amputation in a diabetic neuropathic foot: A case report","authors":"Avvi Shabat DPM ,&nbsp;Vinay Hosuru Siddappa MD ,&nbsp;Sam Lai Huat Lo MD","doi":"10.1016/j.fastrc.2025.100569","DOIUrl":"10.1016/j.fastrc.2025.100569","url":null,"abstract":"<div><div>Bony regrowth following digital amputation in adult diabetic patients is rarely observed. This case report presents a 60-year-old man with diabetes and peripheral neuropathy who underwent partial distal phalanx amputation of the hallux due to osteomyelitis. Radiographic imaging 15 months later revealed unexpected regeneration of approximately 1 cm of bone at the amputation site. We hypothesize that preserved periosteal structures and the patient’s physically active lifestyle contributed to osteogenesis. This case highlights the potential for spontaneous bone regeneration in adults under specific biomechanical and surgical conditions.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100569"},"PeriodicalIF":0.0,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096293","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":"Rare presentation of synovial sarcoma in the foot: A case study","authors":"Drishti Dhawan ,&nbsp;Emily Pugh","doi":"10.1016/j.fastrc.2025.100566","DOIUrl":"10.1016/j.fastrc.2025.100566","url":null,"abstract":"<div><div>Synovial sarcoma is a rare, high-grade soft tissue malignancy that most commonly affects the extremities of adolescents and young adults, with a predilection for the foot and ankle. We present the case of a 47-year-old male with a 12-month history of progressive left foot dorsal swelling and pain. Initial imaging suggested a soft tissue hemangioma; however, surgical excision and subsequent histopathologic and molecular analysis revealed a monophasic synovial sarcoma with SS18-SSX gene fusion. The patient underwent wide re-excision of the tumor bed in coordination with orthopedic oncology. Final pathology confirmed negative margins, and no metastatic disease was identified on PET or chest CT. Given the complete resection and absence of residual disease, adjuvant radiation therapy was deferred. The patient remains disease-free on surveillance imaging at follow-up. This case highlights the diagnostic challenges of synovial sarcoma in the foot and ankle and emphasizes the importance of early biopsy, multidisciplinary coordination, and adherence to oncologic principles for optimal outcomes. Malignancy should remain a consideration in the differential diagnosis of persistent soft tissue masses.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100566"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109402","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":"Adjuvant hydrolyzed collagen powder in high-risk patients with large soft tissue defects undergoing orthoplastic limb preservation surgery","authors":"Christopher Bibbo ,&nbsp;Sara Mateen ,&nbsp;Suhail Masadeh","doi":"10.1016/j.fastrc.2025.100567","DOIUrl":"10.1016/j.fastrc.2025.100567","url":null,"abstract":"<div><div>Limb preservation in the multi-morbid patient remains a significant challenge. The combination of orthopedic and plastic reconstructive techniques (“Orthoplastics”) is well known to result in limb preservation (“limb salvage”) even in extremely high-risk patients. Despite advances, adjunctive healing techniques remain desirable.</div><div>In this case series, we examined the use of hydrolyzed collagen powder in limb salvage in multi-morbid patients undergoing limb preservation surgery. The medical records of ten high-risk patients with multiple co-morbidities undergoing limb preservation reconstruction, who would otherwise have required a major level amputation, were reviewed retrospectively. Of these patients, there was an average of nine varying risk factors, including the presence of infection, diabetes mellitus, renal impairment, vascular disease, smoking, illicit drug or alcohol abuse, or nicotine use. The case review data included patient demographics, risk factors, specific pathophysiology, Orthoplastic procedure, and the volume of adjunctive hydrolyzed collagen during the reconstructive procedures.</div><div>All patients achieved limb preservation or the prevention of an anticipated higher-level amputation. On average, two hydrolyzed collagen applications were used per patient with a mean volume of 1.8 g (range 2-4 g). Notably, the presence of an actively treated infection did not appear to diminish the efficacy of hydrolyzed collagen. Additionally, no adverse reactions were identified with the use of hydrolyzed collagen. These findings suggest that use of hydrolyzed collagen is a safe, valuable adjunct in Orthoplastic limb preservation surgery for patients at extreme risk for limb loss.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100567"},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220587","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":"About the Journal","authors":"","doi":"10.1016/S2667-3967(25)00098-9","DOIUrl":"10.1016/S2667-3967(25)00098-9","url":null,"abstract":"","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100563"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060081","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":"Right foot acute pediatric extensor hallucis longus end to end repair with semitendinosus graft application: A case report","authors":"Emanoil Shafik DPM, MPH, MS,&nbsp;Max Sanginario DPM,&nbsp;Stephen Trimnell DPM, MS,&nbsp;Joseph D. Cuomo DPM, MS,&nbsp;Abdelhafid El Akri MD, DPM,&nbsp;Sagar Shah DPM,&nbsp;Henry Habib DPM, DABPM","doi":"10.1016/j.fastrc.2025.100562","DOIUrl":"10.1016/j.fastrc.2025.100562","url":null,"abstract":"<div><div>A 11 year old female was referred to Podiatric Surgeon by Plastic Surgeon for right foot lacerations and lateral fibular fracture that had occurred one month prior. Patient had no known past medical history and states that she is a very active dancer. Patient states she was on vacation with her family on a Caribbean island where while rough housing with her sibling, she stepped on a broken glass bottle leading to inverting her ankle. Patient sustained multiple lacerations to her foot and ankle. A plastic surgeon on holiday at the same Caribbean resort was able to provide immediate medical attention to the patient. The right hallux upon physical examination was noted to be in fixed plantarflexion and lacked the ability to manually extend her right hallux upon command. Magnetic Resonance Imaging was done to evaluate the integrity of the long extensor tendon. Imaging of the right foot showing a 4 cm tear of the extensor hallucis longus tendon at the level of the proximal first metatarsal. Patient underwent a procedure for extensor hallucis longus repair with semitendinosus graft application.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100562"},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049163","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}