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

{"title":"Tibial cortex transverse transport: Historical evolution, clinical applications, and future directions","authors":"Quinn M. Schroeder DPM, AACFAS ,&nbsp;Dalon U. Paredes DPM ,&nbsp;Miranda Montion BS, MA ,&nbsp;Elizabeth R. Powell BS ,&nbsp;Dakota R.C. Topp BS ,&nbsp;Gan Golshteyn MS, DPM, FACFAS ,&nbsp;Emmy Oji DPM, FACFAS ,&nbsp;Khase A. Wilkinson DPM, FACFAS ,&nbsp;David V. Tran DPM, FACFAS ,&nbsp;Kyle M. Smith DPM, FACFAS","doi":"10.1016/j.fastrc.2025.100513","DOIUrl":"10.1016/j.fastrc.2025.100513","url":null,"abstract":"<div><div>Diabetic foot ulcers are among the most severe complications of diabetes mellitus, often leading to high morbidity, major amputations, and premature mortality. Despite advancements in wound care and limb salvage techniques, treatment failures remain prevalent. Tibial cortex transverse transport (TCT), leveraging principles of distraction osteogenesis, offers a unique approach by directly stimulating microvascular perfusion and tissue regeneration in ischemic limbs, addressing limitations of conventional therapies. Despite its potential and documented use elsewhere, TCT remains underutilized and less studied within Western healthcare systems, representing a significant knowledge gap. This paper provides a comprehensive review of the historical evolution of tibial cortex transverse transport, its underlying biomechanics, surgical methodology, and clinical applications. By tracing the origins of this procedure, detailing its mechanism of action, and discussing modern adaptations and future utilities, we aim to provide a foundation for wide adoption and refinement of this technique, particularly in Western medicine.</div><div>Level of clinical evidence: V</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100513"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270814","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":"2025-09-01","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":"Non-metal locking construct for hindfoot and ankle arthrodesis using intramedullary fibular allograft strut in cases with prior infection","authors":"Akshay Jain ,&nbsp;Garrett B. Nguyen ,&nbsp;Andrew K. Lamm ,&nbsp;Bradley M. Lamm","doi":"10.1016/j.fastrc.2025.100545","DOIUrl":"10.1016/j.fastrc.2025.100545","url":null,"abstract":"<div><div>Few reports have been published regarding septic ankle or charcot neuroarthropathy deformities with a fibular strut allograft construct. A retrospective review was conducted to examine the radiographic and clinical outcomes of using fibular allograft struts as intramedullary fixation to assist in hindfoot and ankle arthrodesis for limb salvage in patients with prior infections. 6 patients were identified, 5 patients met the inclusion and exclusion criteria. Three (60 %) patients had an initial diagnosis of Charcot neuroarthropathy with two (20 %) patients having an initial diagnosis of septic arthritis. All the patients (100 %) had various stages of wounds prior to surgery. Four patients had multiplanar external fixator devices applied prior to hindfoot arthrodesis with fibular strut allograft (Index procedure). One patient had an external fixator applied at the same time as the index procedure. External fixator devices were applied on average of 4.5 months (range, 3.97–5.33), were applied an average of 27 days before surgery (range, 4–60), and removed 3.9 months after surgery (range, 3.3–4.7). After external fixators were removed patients were placed into a fiberglass short leg cast for an average of 2.5 months (range, 1.4–4.2). At a 6 month postoperative CT scan, 80 % of patients achieved osseous union. This complex patient population has been shown to have poor union rates. Overall, the microvascular and macrovascular disease secondary to the uncontrolled hyperglycemia in diabetic patients, poor blood flow in patients with peripheral vascular disease, and suboptimal outcomes in cases of infection contributes to increased nonunion rates. This technique demonstrates a novel and viable approach in prior ankle and hindfoot infection cases. A locking, nonmetal construct in combination with fibular strut autograft needs to be considered routinely in this patient population as many of these patients either are faced with nonsurgical options or face amputation.</div></div><div><h3>Level of evidence</h3><div>3.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100545"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771353","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":"Ankle arthritis in the setting of distal tibial and calcaneal cysts: A case report of a novel staged treatment with bone graft substitute and total ankle arthroplasty","authors":"Michael A. Thomas DPM, MS, FACFAS ,&nbsp;Priya D. Patel DPM, AACFAS ,&nbsp;Hinal K. Patel DPM, AACFAS ,&nbsp;Mansi N. Patel DPM, AACFAS ,&nbsp;Aryan N. Bhagat ,&nbsp;Nitesh N. Bhagat MD ,&nbsp;Matthew K. Brant DPM, FACFAS","doi":"10.1016/j.fastrc.2025.100556","DOIUrl":"10.1016/j.fastrc.2025.100556","url":null,"abstract":"<div><div>Total ankle arthroplasty is a selective procedure that can be highly advantageous for the appropriate candidate. A primary indicator for a positive outcome of the procedure is adequate bone stock, and there is limited literature regarding total ankle arthroplasty in the setting of inadequate bone stock. Most literature refers to periprosthetic bone cysts after a total ankle replacement. This case study documents a 52-year-old male with long-standing ankle arthritis and distal tibial (2.5 × 2.5 × 1.3 cm, volume: 8.13 cm³) and calcaneal (3.8 × 3.5 × 3.0 cm, volume: 39.9 cm³) cysts. Here, a novel treatment was performed utilizing a staged procedure of bone graft substitute in the setting of distal tibial and calcaneal cysts before a total ankle arthroplasty. Preoperative CT imaging was used to evaluate the severity and size of the cysts prior to bone graft substitute implementation. CT imaging was also used postoperatively to confirm consolidation of the cysts. The patient was subsequently followed for two years after the final procedure and was noted to have a stable distal tibial plafond with sufficient ankle joint range of motion with the Wright Medical Inbone Total Ankle Replacement system® (Memphis, Tennessee, USA) by primarily using bone graft substitute for the tibial and calcaneal cysts and later performing a total ankle replacement. The patient had a follow-up period of 24 months after the final procedure with a preoperative AOFAS score of 34, which progressed to 79 postoperatively. As total ankle replacements are increasing in popularity, this novel staged treatment appears to be a safe and viable option to prevent ankle arthrodesis in patients with tibial and calcaneal cysts.</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 3","pages":"Article 100556"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864407","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":"Digital arthroplasty using double K-wire technique for hammertoe correction","authors":"Dr. Kwanoo Lee DPM, AACFAS (Fellow) ,&nbsp;Dr. McKayla Seymour DPM, AACFAS (Fellow) ,&nbsp;Dr. Jonathon Srour DPM, AACFAS (Physician) ,&nbsp;Dr. Israel Santander DPM, AACFAS (Physician) ,&nbsp;Dr. Scott T. Vantre DPM, FACFAS (Director of Research) ,&nbsp;Dr. Laurence G. Rubin DPM, FACFAS (Fellowship Director)","doi":"10.1016/j.fastrc.2025.100558","DOIUrl":"10.1016/j.fastrc.2025.100558","url":null,"abstract":"<div><div>Digital arthroplasty is a standard surgical treatment for hammertoe correction. To date, no study has been performed to evaluate a double K-wire technique for digital arthroplasty. This study examined radiographic correction for digital arthroplasty using a double K-wire technique. A retrospective chart review was performed on consecutive patients undergoing digital arthroplasty through a foot and ankle surgery private practice between December of 2020 to September 2022. A total of 30 patients with 53 hammertoe corrections were included in the study with a minimum of a 1-year follow up. The average transverse and sagittal plane angle improvement postoperatively was 5.2° and 27.2°, respectively with a statistically significant difference. Based on our study, arthroplasty with double K-wire fixation corrects hammertoe deformity as confirmed by radiographic measurements.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100558"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895744","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 novel treatment of talar neck fractures with significant bone voids using cervical spine allograft","authors":"Anthony Wing DO,&nbsp;Tung Dao DPM,&nbsp;Ryan Stone DPM,&nbsp;Daniel Degenova DO,&nbsp;Trent Davis DO,&nbsp;Benjamin Taylor MD","doi":"10.1016/j.fastrc.2025.100485","DOIUrl":"10.1016/j.fastrc.2025.100485","url":null,"abstract":"<div><div>Talar neck fractures are rare and challenging injuries often associated with severe complications, including malunion, nonunion, and osteonecrosis. This case report highlights a novel surgical approach for managing a severely comminuted and displaced talar neck fracture with a substantial medial bone void using a tricorticocancellous cervical spine allograft. A 19-year-old male presented with a Hawkins IIA talar neck fracture, successfully treated through dual incision primary osteosynthesis, grafting, and stable internal fixation. Postoperative outcomes revealed radiographic union by four months, near-normal function at 17 months, and no evidence of avascular necrosis or malunion. This is the first reported case using a cervical spine allograft to address acute bone voids in talar neck fractures, demonstrating its viability as an alternative to autograft, with excellent functional and radiographic outcomes. The findings underscore the importance of innovative grafting techniques for managing complex talar injuries.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100485"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501800","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":"Acute limb ischemia after posterior ankle dislocation with impingement and vasospasm of the anterior tibial artery: a case report and inpatient clinical algorithm","authors":"Kayla Curlis DPM ,&nbsp;Quinn Schroeder DPM AACFAS ,&nbsp;Bailey Lervick DO ,&nbsp;Miranda Montion B.S. ,&nbsp;Kyle McKray Smith DPM, FACFAS","doi":"10.1016/j.fastrc.2025.100511","DOIUrl":"10.1016/j.fastrc.2025.100511","url":null,"abstract":"<div><h3>Introduction</h3><div>Arterial vasospasms occurring from foot and ankle trauma, such as severe fracture dislocations, are under-reported throughout the foot and ankle literature. The tunica media of blood vessels is highly sensitive to external stimuli, such as trauma, compression, or traction, which can induce vasospasm.</div></div><div><h3>Body</h3><div>Here we describe a 25-year-old male who sustained a traumatic injury to the left ankle eliciting a posterior dislocation with associated fractures who subsequently had absent pedal pulses and unobtainable signal on a handheld doppler. CT-angiography revealed reduced vessel caliber along the course of the anterior tibial artery. Following bedside reduction and prior to scheduled surgical intervention, the patient spontaneously regained vascular flow to the lower extremity.</div></div><div><h3>Conclusion</h3><div>There are very limited reports of posterior ankle fracture dislocation creating an acute limb ischemia from vasospasms in the anterior tibial artery. This case report stands to portray the need for further reporting, follow up, and peri-operative management of patients with vascular compromise to the foot and ankle. A guideline was developed to assist clinicians in the inpatient setting with selecting appropriate imaging modalities to assess vascular status and identify potential compromise.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100511"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241813","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":"2025-09-01","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":"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":"2025-09-01","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":"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":"2025-09-01","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}