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

{"title":"Acute simultaneous correction of 4th and 5th brachymetatarsia: A case report","authors":"Taimur Hasan DPM,&nbsp;Kasandra Trott DPM,&nbsp;Meghan Susek DPM","doi":"10.1016/j.fastrc.2025.100538","DOIUrl":"10.1016/j.fastrc.2025.100538","url":null,"abstract":"<div><div>Brachymetatarsia results from the premature closure of growth plates, leading to the development of an abnormally short metatarsal. This is typically congenital. The incidence is estimated to be between 0.02 % to 0.05 %. When evaluating cases involving more than one metatarsal, the combination of the first and fourth metatarsals is more common. The presentation of fourth and fifth brachymetatarsia is extremely rare. This case report serves as the first to discuss the acute correction of the fourth and fifth brachymetatarsia simultaneously.</div><div>A 15-year-old male patient presented with bilateral pain in the fourth sub-metatarsal region, accompanied by shortening and dorsal lateral aspect involvement of bilateral fourth digits. Sport activities worsened his symptoms, especially to the right fifth digit. Clinical, biomechanical, and radiographic evaluations were conducted. A plantar crease was observed bilaterally at the fourth sub-metatarsal region, along with varus deformity of the fifth digit and an elevated fourth digit.</div><div>Radiographically, a notable shortening of the fourth and fifth rays was observed in the metatarsal parabola, measuring 16.5 mm and 18.5 mm, respectively. The joint space appeared congruent, and a moderate plantar bowing of the fifth metatarsal was evident on lateral view. The patient underwent acute correction of the fourth and fifth metatarsals. Additionally, the patient underwent tendon lengthening and capsulotomies utilizing two separate incisions.</div><div>The patient experienced a successful recovery without complications, achieving complete relief of symptoms within a year. Two commonly utilized correction techniques include gradual lengthening with an external fixator and single-stage lengthening using a graft. In this case, the patient underwent single-stage lengthening, and post-operative serial radiographs demonstrated the full incorporation of the grafts.</div><div>Level of clinical evidence: IV</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100538"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049164","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}

{"title":"The role of intrinsic muscle flaps in the treatment of calcaneal osteomyelitis associated with heel ulceration in high-risk patients: proximally based abductor hallucis and abductor digiti minimi muscle flaps: Case report and a systematic review","authors":"Efthymios Gkotsoulias DPM, FACFAS ,&nbsp;David Kuten MD, FACC","doi":"10.1016/j.fastrc.2025.100534","DOIUrl":"10.1016/j.fastrc.2025.100534","url":null,"abstract":"<div><div>The purpose of this study is to demonstrate the use of the abductor hallucis and abductor digiti minimi muscle flaps in high-risk patients with diabetes and peripheral vascular disease for limb salvage involving extensive nonhealing ulcerations of the heel with concomitant osteomyelitis. The second objective is to assess the outcomes and safety of these intrinsic muscles in the surgical reconstruction of foot and ankle wounds. The two patients in this study exemplify the use of intrinsic muscle flaps as a last resort for complex foot pathology. A systematic literature review was conducted using several databases and search engines. A total of twenty-six studies met the inclusion criteria and were used for data extraction. One hundred fifty-two patients, with a total of one hundred fifty-three limbs treated, underwent either abductor hallucis or abductor digiti minimi intrinsic muscle flap for coverage of various foot and ankle pathology. Successful wound healing occurred in all patients, attesting to procedural efficacy and reliability. A major complication occurred in one patient (0.6 %), experiencing complete loss of the flap that was successfully managed with a local fasciocutaneous flap. Despite existing evidence, larger comparative studies are needed to investigate the efficacy of abductor hallucis and abductor digiti minimi muscle flaps in foot and ankle reconstruction.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100534"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514012","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":"Pseudobunion: A new unfortunate result after new minimally invasive bunion surgery. A retrospective radiographic review and case series of 17 feet","authors":"Bogdan Grecea DPM, AACFAS ,&nbsp;Neal M. Blitz DPM, FACFAS","doi":"10.1016/j.fastrc.2025.100521","DOIUrl":"10.1016/j.fastrc.2025.100521","url":null,"abstract":"<div><div>Minimally invasive bunion surgery (MIBS) techniques may produce a new painful, bunion-like complication caused by the residual medial ledge of bone. This “pseudobunion” has not been previously studied and the focus was on patients requiring revision surgery for hardware removal and/or metatarsal exostectomy.</div><div>A 7-year case review was performed between January 2018 to December 2024 and we identified 17 feet (16 patients) with pseudobunion requiring surgery. Data collected included age, sex, laterality, intermetatarsal angle (IMA), hallux valgus angle (HVA), bunion severity, first metatarsal regeneration (FMR) type and number of screws used during the index surgery. Radiographic evaluation included a newly defined metatarsal ledge resection angle (MLRA).</div><div>The mean age was 46.6 years and 100 % were females. One patient had bilateral pseudobunion. The mean interval between the index surgery and revision was 366.7 ± 132.2 days. A 2-screw construct was used in 10 feet (58.8 %) and a 1-screw construct in 7 feet (41.2 %). Index MIBS had a mean preoperative IMA of 17.1° ± 2.4° and postoperative 4.3° ± 1.4° (<em>p</em> &lt; 0.0001), and mean preoperative HVA of 33.5° ± 8.4° and postoperative of 4.3° ± 4.3° (<em>p</em> &lt; 0.0001). Pseudobunion did not occur in mild bunions. At revision, the mean MLRA improved from 56.0° ± 15.9° at the index to 24.4° ± 3.2° post-revision, reaching statistical significance (<em>p</em> &lt; 0.0001).</div><div>Two-screw constructs were associated with a higher incidence of Type I FMR (80 %), whereas one-screw constructs demonstrated predominantly Type II/III FMR (85.7 %), demonstrating a statistically significant association between number of screws and FMR healing type (<em>p</em> = 0.015). Year-over-year analysis, demonstrated a statistically significant downward trend in pseudobunion revisions (R² = 0.86, <em>p</em> = 0.008). While the relative distribution of number of screws did not significantly differ by year (<em>p</em> = 0.176), no pseudobunion revisions with 1-screw constructs have occurred since 2021, coinciding with the development of a 1-screw construct and resection technique allowing for full ledge removal.</div><div>Pseudobunion is a new complication that can be effectively addressed with revision surgery. However, it may be preventable during the index bunion procedure through careful selection MIBS generation, screw construct choice and adequately resecting the medial ledge.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100521"},"PeriodicalIF":0.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297522","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 excision of symptomatic nonunions of the fifth metatarsal base fractures: A systematic review of outcomes and complications","authors":"Zack Hill DPM, AACFAS ,&nbsp;Ceclina Cao PMS-3 ,&nbsp;Patcharathorn Pookun PMS-2 ,&nbsp;Fely Jhae D. Ebanculla PMS-2 ,&nbsp;Guanjin Chen PMS-3","doi":"10.1016/j.fastrc.2025.100514","DOIUrl":"10.1016/j.fastrc.2025.100514","url":null,"abstract":"<div><h3>Background</h3><div>Symptomatic non-unions of the fifth metatarsal base, particularly in Zones 1 and 2, pose significant treatment challenges. Surgical management includes open reduction internal fixation (ORIF) or excision of the non-union fragment. Though less technically demanding, excision procedures risk disrupting important tendon and ligamentous attachments, potentially affecting foot function.</div></div><div><h3>Methods</h3><div>This review synthesizes available data on surgical excision as a definitive treatment, addressing outcomes and complications. A systematic review of PubMed, Embase, Cochrane Library, and Google Scholar was performed to identify studies reporting on the excision of nonunion fragments at the proximal fifth metatarsal. Inclusion criteria required studies to present functional outcomes and complications following excision in Zones 1 and 2. Of 156 studies reviewed, 4 met the criteria, encompassing 18 patient cases.</div></div><div><h3>Results</h3><div>All 18 patients underwent excision of the proximal fragment, with various techniques used to preserve peroneal tendon function. Twelve patients were high-level athletes, and all returned to sport without pain or functional limitations. One study reported a significant improvement in AOFAS forefoot scores (from 58.6 to 95; <em>p</em> = 0.024) and VAS scores (from 8.0 to 1.6; <em>p</em> = 0.023). At an average follow-up of 18.3 months, 100 % of patients were pain-free, and no complications were reported.</div></div><div><h3>Conclusion</h3><div>Excision of symptomatic non-unions of the fifth metatarsal base, particularly in Zone 1 and selective cases for Zone 2, appears to be a safe and effective treatment option, allowing for significant pain relief and return to activity in high-level athletes. Further research is needed to validate long-term outcomes and optimal surgical techniques.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100514"},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470806","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":"Can AI outperform professional writers in summarizing foot and ankle literature?","authors":"Seth L. Warren DPM ,&nbsp;Steven R. Cooperman DPM, MBA, AACFAS","doi":"10.1016/j.fastrc.2025.100522","DOIUrl":"10.1016/j.fastrc.2025.100522","url":null,"abstract":"<div><div>This study evaluates the performance of an advanced large language model in summarizing scientific literature within the specialized field of foot and ankle surgery. Building upon prior work that demonstrated ChatGPT-3.5′s comparability to podiatric residents, this investigation compares ChatGPT-4.5 directly against paid, professionally written summaries sourced from Foot and Ankle Quarterly. Ten original research articles were summarized by ChatGPT-4.5 and matched with corresponding professionally written summaries. Quantitative analysis using BLEU and ROUGE metrics assessed textual similarity, while Flesch Reading Ease and Flesch-Kincaid Grade Level scores evaluated readability. A qualitative preference survey was conducted among three blinded, fellowship-trained foot and ankle surgeons. Results showed that AI-generated summaries were preferred in 73.33 % of comparisons and demonstrated no factual inaccuracies. Although professionally written summaries were quantitatively more readable, AI-generated summaries maintained higher consistency in language complexity. ROUGE scores suggested substantial content overlap between AI-generated and reference summaries, whereas BLEU scores reflected differences, which may be attributable to shorter AI summary lengths. These findings suggest ChatGPT-4.5 can reliably and efficiently produce accurate, high-quality summaries, potentially surpassing paid academic writers in certain domains. Broader implications include improved efficiency in academic research and literature review. Continued investigation and oversight are necessary to guide the responsible integration of AI tools into clinical and scholarly workflows.</div></div><div><h3>Level of evidence</h3><div>III, comparative study</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100522"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321833","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}