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

{"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":"2025-09-01","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":"Corrigendum to “The management of non-union following minimally invasive bunion surgery” [Foot & Ankle Surgery: Techniques, Reports & Cases 5 (2025) 100455]","authors":"Gil Genuth M.D. ,&nbsp;Rachel Thompson B.A. ,&nbsp;Amanda Zeng B.A. ,&nbsp;Nick Cullen M.D. ,&nbsp;Andrew Goldberg M.D. ,&nbsp;A. Holly Johnson M.D.","doi":"10.1016/j.fastrc.2025.100547","DOIUrl":"10.1016/j.fastrc.2025.100547","url":null,"abstract":"","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100547"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809439","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":"Outcomes of lower extremity peripheral nerve decompressions in the setting of radiculopathy","authors":"Victoria M. Nolte DPM, MS,&nbsp;Ashley L. Bowles DPM, FACFAS,&nbsp;Kyle J. Kinmon DPM, MS, FACFAS","doi":"10.1016/j.fastrc.2025.100550","DOIUrl":"10.1016/j.fastrc.2025.100550","url":null,"abstract":"<div><div>There have been volumes of literature published evaluating “Double Crush Syndrome” (DCS) and nerve pain treatment options, with little data centered on neuropathy specifically of the lower extremity. “Double Crush Syndrome” references a compression at two or more locations across a peripheral nerve that can synergize symptoms. Many surgeons will not attempt procedural treatment of this patient population due to the belief of a high risk-reward ratio. The objective of this case series is to evaluate patients suffering from lower extremity peripheral nerve entrapment and the impact of lower extremity nerve decompressions in the setting of radiculopathy. Twenty-seven patients treated with lower extremity nerve decompressions were followed for a minimum of 3 years. Outcomes were measured by subjective overall improvement in neuropathic pain. Twenty-five patients experienced pain relief post-operatively, including two patients who underwent a subsequent soleal sling tibial nerve decompression which improved their outcome. Two patients experienced no pain relief, though did not report an increase in their pain.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100550"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895743","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":"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":"2025-09-01","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":"A novel technique for surgical treatment of diabetic calcaneal osteomyelitis: Trabecular calcaneal instillation technique","authors":"Alper Erkin ,&nbsp;Hande Cengiz Açıl ,&nbsp;Taner Demirci ,&nbsp;Dilek Aygin ,&nbsp;Thomas Eberlein","doi":"10.1016/j.fastrc.2025.100517","DOIUrl":"10.1016/j.fastrc.2025.100517","url":null,"abstract":"<div><div>Negative Pressure Wound Therapy with instillation (NPWTi) is widely used for managing various wound types, including acute and chronic infections, soft tissue injuries and surgical wounds. However, there is a lack of large-scale, controlled studies specifically assessing the efficacy and safety of NPWTi in diabetic calcaneal osteomyelitis. This study aims to evaluate the effectiveness of the Trabecular Calcaneal Instillation technique, a novel surgical approach utilizing NPWTi for the management of diabetic calcaneal osteomyelitis. We implemented the Trabecular Calcaneal Instillation technique, which involves creating deep tubular cavities within the calcaneus and applying NPWTi. This approach was assessed in a cohort of 15 patients with diabetic calcaneal osteomyelitis. Key outcomes measured included wound healing rates, patient comfort and incidence of amputation. Preliminary findings indicate that the Trabecular Calcaneal Instillation technique significantly improved wound healing rates and patient comfort compared to traditional methods. It further allowed for the avoidance of amputation in 13 patients. The Trabecular Calcaneal Instillation technique shows advantages over traditional treatments for diabetic calcaneal osteomyelitis. Further research is necessary to confirm these findings and establish the technique's efficacy and safety in broader clinical practice.</div></div><div><h3>Level of evidence</h3><div>Level 4</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100517"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665800","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":"2025-09-01","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":"The pull-through technique: Surgical augmentation for debriding diabetic infections of the mid- and forefoot","authors":"Dolfi Herscovici Jr DO, FAAOS ,&nbsp;Alexander D. Selsky DO","doi":"10.1016/j.fastrc.2025.100555","DOIUrl":"10.1016/j.fastrc.2025.100555","url":null,"abstract":"<div><div>Aggressive, mechanical debridement is the preferred treatment for the management of chronic infected diabetic foot ulcers. The Pull-Through technique is a low-tech approach that does not require specialized equipment. What makes this approach attractive is that, combined with standard irrigation and debridement, this approach is low-cost, produces a smaller dorsal incision, allows for adequate debridement of the plantar wound, and may help debride biofilms present in the dorsum of the chronic plantar-based wound that could not be addressed by simply debriding the plantar wounds.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100555"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809514","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":"Corrigendum to “From Theory to Practice: Integrating AI Dictation” [Foot and Ankle Surgery: Techniques, Reports & Cases 5 (2025) 100497]","authors":"Steven R. Cooperman DPM, MBA, AACFAS","doi":"10.1016/j.fastrc.2025.100549","DOIUrl":"10.1016/j.fastrc.2025.100549","url":null,"abstract":"","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100549"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809515","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 50 % rule technique for guidewire placement in minimally invasive bunion surgery","authors":"Michael L. Sganga ,&nbsp;Keith A. Crenshaw","doi":"10.1016/j.fastrc.2025.100546","DOIUrl":"10.1016/j.fastrc.2025.100546","url":null,"abstract":"<div><div>Minimally Invasive Bunion Surgery (MIBS) continues to gain popularity with advancements in fixation systems, although there continues to be a steep learning curve associated with this procedure. This study aims to provide an additional technique to facilitate the placement of accurate and reproducible guidewires for screw fixation. As achieving the desired alignment with the proximal guidewire can be challenging, this study focuses on a reproducible technique that adheres to the important stability principles of MIBS.</div><div>This technique describes pre-operative planning for guidewire placement referred to as establishing the “cross-hairs and gunsights”. This provides external visualization to aid in guidewire placement. The 50% rule provides a landmark on lateral x-ray that allows for initial wire placement along the lateral cortex for efficient and accurate positioning that correlates with the expected capital fragment translation.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100546"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829170","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":"2025-09-01","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}