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

{"title":"Ultrasound grading of plantar plate injuries and correlation with surgical intervention","authors":"Mohammed Yusuf Aslam DPM ,&nbsp;Katherine Dux DPM, FACFAS ,&nbsp;Bryn Laubacher DPM, FACFAS ,&nbsp;Emad Allam MD","doi":"10.1016/j.fastrc.2025.100577","DOIUrl":"10.1016/j.fastrc.2025.100577","url":null,"abstract":"<div><h3>Background</h3><div>Plantar plate injuries are a common cause of forefoot pain and can lead to functional instability. These injuries may be classified as a low-grade (&lt;50 % thickness) or high-grade (&gt;50 % thickness) tear on ultrasound. This study evaluates plantar plate tear severity based on ultrasound and its correlation with surgical intervention.</div></div><div><h3>Methods</h3><div>A retrospective review was performed on patients with ultrasound-confirmed lesser metatarsophalangeal joint plantar plate tears between 2011 and 2024. Patients were categorized by ultrasound grade of tear and whether they underwent nonsurgical or surgical treatment. A Chi-square test assessed the association between grade of plantar plate tear (low and high) and treatment (nonsurgical and surgical).</div></div><div><h3>Results</h3><div>Fifty-four patients were included in the study. Of the 23 patients with low-grade tears, 4 required surgery. Of the 31 patients with high-grade tears, 11 required surgery. Statistical analysis revealed no statistically significant difference between plantar plate tear grade and treatment type (χ² = 1.35, <em>p</em> = 0.246).</div></div><div><h3>Conclusion</h3><div>The severity of plantar plate tear as determined by ultrasound does not independently predict the need for surgical treatment. Treatment strategies appear to be more strongly influenced by patient-reported pain, functional limitation, and patient preference rather than imaging findings alone.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100577"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790746","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":"Unusual posterior facet extrusion in a compound calcaneal fracture- a case report","authors":"Yogendra Gupta,&nbsp;Roshan Yadav","doi":"10.1016/j.fastrc.2026.100604","DOIUrl":"10.1016/j.fastrc.2026.100604","url":null,"abstract":"<div><div>Open calcaneal fractures rarely present with extrusion of posterior facet fragments. We report an unusual case of a 21-year-old male with an intra-articular calcaneal fracture and medial extrusion of a superolateral fragment of calcaneus posterior facet —an injury pattern scarcely described in the literature. The patient underwent delayed reconstruction on day 19 using an extensile lateral approach. The extruded fragment was retrieved laterally through blunt dissection, reduced anatomically into the defect, and fixed with a cannulated screw along with lateral wall plating. Despite early postoperative neuritic symptoms and later pain due to anterior process non-anatomical reduction, symptoms improved after implant removal and medical management. At 3-year follow-up, the patient had mild heel varus but maintained functional recovery and returned to work without analgesics. This case highlights the rarity of posterior facet fragment extrusion and demonstrates that anatomical reconstruction, even when delayed, can yield satisfactory outcomes.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100604"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187820","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":"Functional and radiographic outcomes following percutaneous fixation of intra-articular calcaneal fractures: a systematic review","authors":"Marcel Brzeszczyński ,&nbsp;Filip Brzeszczyński ,&nbsp;Oktawiusz Bończak","doi":"10.1016/j.fastrc.2026.100602","DOIUrl":"10.1016/j.fastrc.2026.100602","url":null,"abstract":"<div><div>The management of displaced intra-articular fractures of the calcaneus remains controversial due to the soft tissue complications associated with the traditional extensile lateral surgical approach. Minimally invasive percutaneous techniques have been developed with the aim of restoring calcaneal shape while reducing wound complications. This review evaluated functional and radiographic outcomes following percutaneous fixation of displaced intra-articular fractures of the calcaneus. A systematic search of MEDLINE and EMBASE databases identified studies that reported functional outcomes or radiographic measurements after percutaneous fixation. Data on patient demographics, fracture classification, operative technique, outcomes, complications, and study quality were extracted. Eight studies comprising 295 patients and 309 fractures met inclusion criteria. All studies included fractures of Sanders type three, seven included fractures of Sanders type two, and two reported fractures of Sanders type four. The average follow-up period across all studies was 29.2 months. Functional outcomes were favourable, with a pooled average score on the American Orthopaedic Foot and Ankle Society hindfoot scale of 85.6 across all studies and an average Maryland foot score of 88.9 across two studies. Radiographic correction was maintained at final follow-up, with improvements in both Böhler and Gissane angles reported in five studies. Five studies were assessed as high quality and three as low quality. Percutaneous fixation of displaced intra-articular fractures of the calcaneus provides reliable functional improvement, satisfactory restoration of radiographic parameters, and a lower rate of wound complications compared with open reduction and internal fixation. Larger, high-quality prospective studies are required to define the optimal minimally invasive method.</div><div>Level of clinical evidence: 2</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100602"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976973","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":"Medio-plantar forefoot approach for distal flexor hallucis longus exposure in checkrein syndrome: Case experience and literature review","authors":"Wen Po Jonathan Tan ,&nbsp;Omkar Mahadevan ,&nbsp;Muhammed Yaser Hasan","doi":"10.1016/j.fastrc.2025.100583","DOIUrl":"10.1016/j.fastrc.2025.100583","url":null,"abstract":"<div><h3>Background</h3><div>Checkrein syndrome is a rare condition characterized by dynamic flexion contracture of the hallux interphalangeal joint (IPJ) and extension contracture of the metatarsophalangeal joint (MTPJ) during ankle dorsiflexion. It most often arises secondary to trauma or iatrogenic injury along the course of the flexor hallucis longus (FHL) tendon. Multiple surgical approaches have been described but no consensus exists regarding the optimal technique</div></div><div><h3>Methods</h3><div>We report the case of a 36-year-old male who developed a painful Checkrein deformity of the hallux following fibular free flap harvest. Conservative measures were unsuccessful. Surgical management consisted of FHL tendon lengthening performed via a medio-plantar forefoot approach. A review of the literature was also performed to summarize available surgical strategies, approaches, and outcomes.</div></div><div><h3>Results</h3><div>The medio-plantar forefoot approach provided direct access to the FHL tendon proximal to the sesamoid sulcus, enabling precise Z-lengthening under intraoperative dynamic assessment. Postoperative recovery was uneventful, with resolution of big toe deformity and motion. Review of published cases demonstrated that Checkrein deformity most frequently follows post-traumatic and iatrogenic causes involving the leg, ankle, or hindfoot. The predominant surgical technique was FHL Z-lengthening<strong>,</strong> most often performed through a retro-malleolar approach<strong>,</strong> followed by midfoot and fracture-site–specific exposures. Overall, outcomes across all techniques were favorable, with high rates of deformity correction, motion restoration, and low recurrence.</div></div><div><h3>Conclusion</h3><div>The medio-plantar forefoot approach is a safe and effective surgical option in the management of Checkrein deformity. Its advantage is the targeted exposure and avoidance of extensive dissection but does limit associated lesser toe correction. A review of reported cases indicates that favorable outcomes can be achieved across all surgical techniques when appropriately selected.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100583"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790673","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":"Surgical management of functional hallux limitus using cotton osteotomy/posterior muscle group lengthening and its effect on cuneiform articular angle, Medial Arch Sag Angle, and Meary's angle","authors":"William Stallings DPM ,&nbsp;Julia Reczek DPM ,&nbsp;Léthicia K. Paul DPM, MPH, MS ,&nbsp;Holly Zucchero DPM ,&nbsp;Samuel Adegboyega DPM","doi":"10.1016/j.fastrc.2025.100594","DOIUrl":"10.1016/j.fastrc.2025.100594","url":null,"abstract":"<div><h3>Introduction</h3><div>Functional hallux limitus (FnHL) can arise from medial column instability caused by pathological compensation within the closed kinetic chain. This report presents a surgical case of FnHL attributed to instability at the naviculocuneiform joint (NCJ) following failed conservative management.</div></div><div><h3>Methods</h3><div>Medial column stability was addressed with a Cotton osteotomy, using the cuneiform articular angle (CAA) to determine appropriate graft size. An Austin osteotomy and proximal Akin were performed to correct a bunion deformity, while posterior muscle group lengthening was added to reduce rearfoot-driven strain on the medial column. Medial column integrity was evaluated preoperatively and at one year postoperatively via weight-bearing lateral radiographs, assessing the medial arch sag angle (MASA), CAA, medial cuneiform height (MCH), and Meary’s angle. Confirmation bias was reduced by using radiographic angles to support subjective outcomes of procedure.</div></div><div><h3>Results</h3><div>Postoperative imaging demonstrated notable improvement in CAA, Meary’s angle, and MCH, confirming correction of medial column instability. MASA remained unchanged. The bunion deformity was also corrected radiographically. Clinically, the patient showed improved 1st metatarsophalangeal joint (MPJ) function, with the metatarsophalangeal-interphalangeal (MTP-IP) score increasing from 62 to 90 at one year.</div></div><div><h3>Conclusion</h3><div>This appears to be the first report describing the combined use of a first metatarsal distal shaft osteotomy, Cotton osteotomy, and posterior muscle group lengthening to improve both 1st MPJ function and medial column stability during gait. A novel NC fault classification system is introduced to guide preoperative planning for medial column instability.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100594"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925805","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":"Second metatarsal reconstruction after segmental bone loss using a custom 3D-printed implant: A case report","authors":"Mustafa Al-Tameemi ,&nbsp;Lawrence M. Fallat","doi":"10.1016/j.fastrc.2025.100595","DOIUrl":"10.1016/j.fastrc.2025.100595","url":null,"abstract":"<div><div>Reconstructing extensive bone loss in the foot after trauma poses a significant surgical challenge. The challenge becomes even greater when the injury involves weight-bearing structures. This case report presents the use of a custom 3D-printed implant to reconstruct the second metatarsal following loss of its distal portion. This injury was further complicated by dislocations of the third to fifth metatarsophalangeal joints with plantar protrusion of the third and fourth metatarsal heads through the foot. Additionally, a dislocation of the first tarsometatarsal joint was also present. A staged surgical approach was employed consisting of (1) irrigation and debridement of the open wound, reduction of the dislocated joints and placement of a temporary antibiotic spacer into the distal second metatarsal space (2) insertion of a fibular strut allograft into the distal second metatarsal space while the custom 3D implant was being designed and internal fixation of the first tarsometatarsal joint using a bridge plate and (3) definitive reconstruction of the second metatarsal using a patient-specific 3D-printed implant.</div><div>Our surgical procedure restored foot anatomy and enabled our patient to return to full weight bearing. Postoperative radiographs confirmed excellent alignment, stability, and integration of the implant. This case highlights the transformative potential of 3D printing technology in addressing critical bone loss and restoring function in complex foot trauma. Custom implants offer significant advantages over traditional bone grafting techniques providing a promising solution for complex orthopedic reconstructions.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100595"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839981","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":"Glomus tumor of foot: A report of two cases","authors":"Muskaan Nagpal,&nbsp;Anirban Chatterjee,&nbsp;Kaustav Debnath,&nbsp;Sanhita Chatterjee,&nbsp;Vikash Kapoor","doi":"10.1016/j.fastrc.2025.100576","DOIUrl":"10.1016/j.fastrc.2025.100576","url":null,"abstract":"<div><div>Glomus tumors are benign lesions similar in structure to a normal glomus body with thermoregulatory action. These are mostly found in extremities with 75% in the hand and rarely in the foot. Though presence of glomus tumors in the foot is documented in literature, most have been in the medial three toes. In our study, though one was in the second toe, one was found in the fourth toe, which is even rarer. This report describes two female patients in their second decade of life who presented with gradually progressive painful swelling over the fourth toe since 10 years and second toe with associated nail deformation since 2 years, respectively. Clinically both revealed point tenderness over the swelling and cold intolerance relieved on taking non-steroidal anti-inflammatories(NSAIDs). Love test and Hildreth test were positive. Radiographs revealed no intralesional mineralization or osseous erosion. MRI revealed hypointense mass on T1 with hyperintensity on T2/STIR imaging. Clinically and radiologically the diagnosis of glomus tumor was confirmed. En masse excision was performed in both and histopathological examination confirmed the diagnosis. Patients were pain free on subsequent follow-ups. Glomus tumors of the foot are often misdiagnosed and need high clinical suspicion to avoid high morbidity associated with it.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100576"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147395447","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":"Bilateral total calcanectomy for chronic calcaneal osteomyelitis: A case report","authors":"Stumpner Thomas ,&nbsp;Pöchgraber Paul ,&nbsp;Oberluggauer Patricia ,&nbsp;Ortmaier Reinhold","doi":"10.1016/j.fastrc.2026.100609","DOIUrl":"10.1016/j.fastrc.2026.100609","url":null,"abstract":"<div><div>Chronic calcaneal osteomyelitis represents a complex surgical challenge due to poor soft-tissue coverage, limited vascularity, and the weight-bearing function of the heel. While below-knee amputation has traditionally been considered the definitive treatment, calcanectomy offers a limb-salvage alternative in selected patients. Bilateral total calcanectomy is exceedingly rare, and functional outcomes remain uncertain. We report a case of bilateral total calcanectomy performed for chronic polymicrobial calcaneal osteomyelitis in a 66-year-old woman. At 24-month follow-up, infection eradication, complete pain relief, and independent ambulation with custom orthopedic footwear were achieved. Our case highlights that bilateral total calcanectomy may result in satisfactory functional outcomes in selected patients.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100609"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187819","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":"Dynamic syndesmotic stabilization with non-metallic bio-integrative fixation: A novel technique guide","authors":"Anthony Schwab DPM, MS, AACFAS ,&nbsp;Garrett Wireman DPM, ATC, AACFAS ,&nbsp;Jason Nowak DPM, FACFAS ,&nbsp;Garret Strand DPM, FACFAS","doi":"10.1016/j.fastrc.2025.100587","DOIUrl":"10.1016/j.fastrc.2025.100587","url":null,"abstract":"<div><div>Syndesmotic instability occurs in up to 20 % of ankle fractures and may lead to asymmetric tibiotalar loading and early arthrosis if inadequately reduced. Traditional metallic fixation techniques, though effective, are associated with hardware removal rates exceeding 40 % and malreduction rates approaching 35 %. Bio-integrative fixation composed of continuous mineral fibers within a PLDLA matrix provides strength retention during healing while eliminating permanent hardware. We describe a reproducible technique utilizing OSSIOfiber® bio-integrative suture anchors for dynamic syndesmotic fixation. Under fluoroscopic guidance, a 2.5 mm tibial anchor is deployed through a 4.75 mm fibular tunnel, tensioned, and secured with a second anchor to achieve physiologic syndesmotic stabilization. Technical pearls, reduction verification, and postoperative assessment are outlined. This technique provides a minimally invasive, dynamic alternative for syndesmotic stabilization with the potential to reduce implant removal and malreduction risk. Early results and comparative evidence suggest equivalent fixation strength and radiographic outcomes to metallic devices, supporting bio-integrative fixation as a viable option for surgeons seeking a non-metallic solution.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100587"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737979","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":"Cotton osteotomy with a guide pin: A technique tip","authors":"R. Todd Hockenbury MD ,&nbsp;Blake E. Pritchett DPM, AACFAS ,&nbsp;Mark J. Capuzzi DPM, FACFAS","doi":"10.1016/j.fastrc.2025.100552","DOIUrl":"10.1016/j.fastrc.2025.100552","url":null,"abstract":"<div><div>The Cotton osteotomy is a mainstay procedure in the foot and ankle surgeon's repertoire during correction of progressive collapsing foot deformity (PCFD). The procedure involves a dorsal opening wedge osteotomy of the medial cuneiform followed by insertion of a bone wedge for recreation of the medial longitudinal arch. This addresses the forefoot varus component of a flatfoot, and is typically used in conjunction with other procedures to achieve correction in all planes. The osteotomy provides a supinatory moment around the triple joint complex. However, some pitfalls have been reported which have negative impact on reproducibility. These include lateral column overloading due to over-correction, sesamoid pain due to under-correction, breach of the plantar hinge, and even joint violation. Due to intricate local anatomy, proper identification of the location and trajectory of osteotomy placement is vital to ensuring avoidance of injury to adjacent joints. The purpose of this paper is to report on a simple technique utilizing a Kirschner wire guide pin for osteotomy guidance, resulting in improved patient outcomes and reproducibility.</div></div><div><h3>Level of evidence</h3><div>Level V</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100552"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187823","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}