Tyson Compton, Kade Wagers, Emma H Braun, Angela P Presson, Devon Nixon
{"title":"The Impact of Social Deprivation on Outcomes in Forefoot Surgery.","authors":"Tyson Compton, Kade Wagers, Emma H Braun, Angela P Presson, Devon Nixon","doi":"10.1177/10711007251322443","DOIUrl":"https://doi.org/10.1177/10711007251322443","url":null,"abstract":"<p><strong>Background: </strong>The impact of social deprivation (SD) on health outcomes is a topic of increasing interest in orthopaedics. There are limited studies and no clear consensus, though, on the impact of SD on outcomes in foot and ankle surgery. Area deprivation index (ADI) is a well-studied and validated surrogate metric for SD. We hypothesized that patients with greater SD would have worse patient-reported pain and physical function at baseline and at 6 weeks and 6 months following elective forefoot surgery.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 477 forefoot surgeries between January 2015 and December 2022 to determine if SD was associated with patient-reported outcomes (PROs) related to pain and physical function. Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) and pain interference (PI) assessments administered preoperatively and at 6 weeks and 6 months postoperatively. SD was quantified using the ADI. Patients were divided into high- and low-deprivation groups using the national median ADI of 50.</p><p><strong>Results: </strong>At baseline before surgery, PROMIS-PF and PROMIS-PI scores were similar between high and low social deprivation groups. At 6 weeks and 6 months after surgery, there were no significant differences between high- and low-deprivation groups for either PROMIS-PF or PROMIS-PI. Both groups (high and low social deprivation) demonstrated similar improvements in pain and function at 6 months after surgery. The only variable associated with outcomes was employment status, with disabled and unemployed patients exhibiting greater pain and less function before surgery. Disabled patients also had greater pain after surgery.</p><p><strong>Conclusion: </strong>Based on our data, social deprivation did not appear to be associated with patient-reported pain or physical function prior to forefoot surgery or at 6 weeks or 6 months following surgery.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251322443"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618106","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}
Joaquin Palma, Grace DiGiovanni, Seif El Masry, Ricardo Villar, Agnes Jones, Allison Boden, Jensen Henry, Constantine A Demetracopoulos, Scott J Ellis
{"title":"Postoperative Medial Gutter Impingement Following Primary Total Ankle Arthroplasty: A Retrospective Case-Control Study.","authors":"Joaquin Palma, Grace DiGiovanni, Seif El Masry, Ricardo Villar, Agnes Jones, Allison Boden, Jensen Henry, Constantine A Demetracopoulos, Scott J Ellis","doi":"10.1177/10711007251321493","DOIUrl":"https://doi.org/10.1177/10711007251321493","url":null,"abstract":"<p><strong>Background: </strong>Medial gutter impingement may compromise the results of an otherwise well-fixed total ankle arthroplasty (TAA), but no previous study has assessed predisposing factors. This case-control study sought to investigate potential risk factors and the role of talar component downsizing in decreasing medial impingement.</p><p><strong>Methods: </strong>A retrospective case-control study with 149 patients was performed. Thirty-four patients reoperated for medial impingement were identified and matched to a control group of 115 patients. Radiographic parameters included pre- and post-TAA coronal alignment, talar center of migration ratio (TCMr), joint line height ratio (JLHR), and absolute talar component rotation (aTR). Demographic and radiographic data were compared. A logistic regression model assessed the correlation between medial gutter impingement with radiographic parameters and talar component downsizing.</p><p><strong>Results: </strong>Talar component downsizing was more frequent in the control group (70.4% vs 29.4%, <i>P</i> < .001). Postoperative varus alignment (91.17 vs 90.45 degrees, <i>P</i> = .012), a more elevated joint line (JLHR = 1.64 vs 1.5, <i>P</i> = .037), increased medial talar translation (TCMr = 10.66% vs 6.65%, <i>P</i> = .018), and internal talar rotation (aTR = 3.58 vs 0.24 degrees, <i>P</i> < .001) were observed in the medial impingement cohort. Regression analysis showed a negative correlation between talar downsize and the probability of medial impingement (OR = 0.18, 95% CI 0.07, 0.44, <i>P</i> < .001). A positive correlation was observed between medial impingement and a medially translated talar component (OR = 1.07, 95% CI 1.01, 1.15, <i>P</i> = .03) and a higher joint line level (OR = 1.23, 95% CI 0.99, 1.51, <i>P</i> = .051).</p><p><strong>Conclusion: </strong>Talar component downsizing correlated with an 82% reduction in the probability of medial gutter impingement. Postoperative varus alignment, an elevated joint line level, and medially translated and internally rotated talar component were more prevalent in patients reoperated for medial impingement.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251321493"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618102","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}
Guilherme Honda Saito, Danilo Ryuko Cândido Nishikawa, Adilson Sanches de Oliveira, Paula Jardim Fairbanks, Alberto Abussamra Moreira Mendes, Marcelo Pires Prado
{"title":"Results of Lisfranc Injuries Treated With Interosseous Suture Button Fixation With a Minimum 5-Year Follow-Up.","authors":"Guilherme Honda Saito, Danilo Ryuko Cândido Nishikawa, Adilson Sanches de Oliveira, Paula Jardim Fairbanks, Alberto Abussamra Moreira Mendes, Marcelo Pires Prado","doi":"10.1177/10711007251322166","DOIUrl":"https://doi.org/10.1177/10711007251322166","url":null,"abstract":"<p><strong>Background: </strong>Open reduction and internal fixation or primary arthrodesis are considered gold standards for treating Lisfranc injuries. However, several drawbacks are associated with these procedures, such as joint motion loss and potential cartilage damage. More recently, the suture button emerged as an alternative treatment for ligamentous Lisfranc injuries, which can be used either alone or in combination with traditional techniques, with the potential to mitigate some of these potential disadvantages. The primary outcome of the present study was to evaluate the functional outcomes of 20 patients treated with the suture button technique for Lisfranc injuries over a medium- to long-term follow-up period. The secondary outcome was to assess and describe the complications associated with this procedure.</p><p><strong>Methods: </strong>A retrospective review was conducted on 20 patients who underwent operation for acute Lisfranc injuries using the interosseous suture button technique between 2013 and 2019. The mean follow-up was 83 months (range 60-126). Clinical evaluation involved the assessment of complications, reoperations, visual analog scale (VAS) scores, American Orthopaedic Foot & Ankle Society (AOFAS) midfoot scores, patient satisfaction, and ability to return to previous activities. Radiographic analysis was performed aiming to evaluate reduction maintenance and osteoarthritis development.</p><p><strong>Results: </strong>Patients demonstrated excellent outcomes with an average VAS of 0.50 and a mean AOFAS midfoot score of 95.5. Incomplete reduction was the only factor we identified influencing lower VAS and AOFAS scores. Most complications were minor and solved with conservative treatment. More serious complications, such as loss of reduction and posttraumatic arthritis were observed in 2 patients each.</p><p><strong>Conclusion: </strong>In this small series with a relatively long follow-up, we found that the use of an interosseous suture button technique was a reliable method to treat acute Lisfranc injuries, resulting in satisfactory clinical and functional outcomes. However, outcomes including posttraumatic arthritis and loss of reduction raise remain of concern.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251322166"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618104","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}
Wolfram Grün, Emily Luo, Enrico Pozzessere, Erik Jesus Huanuco Casas, Antoine Acker, Pierre-Henri Vermorel, François Lintz, Cesar de Cesar Netto
{"title":"Foot Malalignment and Proximal Fifth Metatarsal Fractures.","authors":"Wolfram Grün, Emily Luo, Enrico Pozzessere, Erik Jesus Huanuco Casas, Antoine Acker, Pierre-Henri Vermorel, François Lintz, Cesar de Cesar Netto","doi":"10.1177/10711007251322141","DOIUrl":"https://doi.org/10.1177/10711007251322141","url":null,"abstract":"<p><strong>Background: </strong>Proximal fifth metatarsal fractures are common injuries that are classified into 3 zones according to their anatomical localization. While zone 1 and 2 fractures typically are traumatic, zone 3 fractures may be linked to foot alignment abnormalities, such as hindfoot varus and metatarsus adductus. The aim of the study was to explore the association between hindfoot alignment and different fracture zones, as well as the relationship between traumatic and atraumatic fracture origin and foot alignment.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with proximal fifth metatarsal fractures who had received a weightbearing computed tomography (WBCT) scan. Feet with zone 1 and 2 fractures were compared to zone 3 fractures and a healthy control group. Additionally, we compared feet with a traumatic fracture origin with those without. Foot alignment parameters, including the foot and ankle offset (FAO) and the forefoot arch angle (FAA), were analyzed alongside data from semiautomated segmentation reports. <i>P</i> <.05 was considered significant.</p><p><strong>Results: </strong>The study included 45 fractures (23 zone 1 and 2, 22 zone 3) and 19 controls. Zone 3 fractures showed a significant association with higher body mass index (<i>P</i> < .01), hindfoot varus (<i>P</i> < .01), and metatarsus adductus (<i>P</i> < .01) compared with zone 1 and 2 fractures, and they more frequently had a nontraumatic origin (<i>P</i> < .01). Zone 3 fractures also showed a significantly higher transverse arch (<i>P</i> < .01). No differences have been observed between zone 1 and 2 fractures and the controls. Fractures with atraumatic origin were significantly associated with hindfoot varus (<i>P</i> < .01), metatarsus adductus (<i>P</i> < .01), hindfoot varus (<i>P</i> < .01), and metatarsus adductus (<i>P</i> < .01).</p><p><strong>Conclusion: </strong>Hindfoot varus, metatarsus adductus, and a high transverse arch were significantly associated with zone 3 fractures as well as fractures with atraumatic origin.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251322141"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618099","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}
Jan S El Barbari, Matthias Meyer, Paul A Grützner, Benedict J Swartman, Sven Y Vetter, Jochen Franke
{"title":"Complication and Revision Rate in Complex Intraarticular Calcaneal Fractures: Extended Lateral vs Sinus Tarsi Approach.","authors":"Jan S El Barbari, Matthias Meyer, Paul A Grützner, Benedict J Swartman, Sven Y Vetter, Jochen Franke","doi":"10.1177/10711007251322466","DOIUrl":"https://doi.org/10.1177/10711007251322466","url":null,"abstract":"<p><strong>Background: </strong>Adequate surgical treatment of intra-articular calcaneal fractures is challenging. Current clinical evidence on the superiority of either the extended lateral approach (ELA) or the sinus tarsi approach (STA) and their impact on radiologic and functional outcome remains inconclusive, and studies are characterized by low case numbers and short follow-up periods. We hypothesized that using STA would lead to fewer complications and revisions, without impairing fracture reduction or short- to midterm outcome.</p><p><strong>Methods: </strong>This retrospective cohort study included 241 patients with intra-articular calcaneal fractures receiving surgical therapy by ELA or STA from 2014 to 2020. A propensity score matching was performed to adjust for covariates distribution after which 140 complete data sets were available for analysis. The primary endpoint was the time to surgical revision. Secondary endpoints were time to complication, complication, as well as revision rate, operating room time, length of stay, and the radiologic and functional outcome (12-Item Short Form Health Survey [SF-12], Visual Analogue Scale for Foot and Ankle [VAS-FA]).</p><p><strong>Results: </strong>The hazard ratio for surgical revision was 1.74 (95% CI 0.82-3.68) and for complications 1.66 (95% CI 0.82-3.33), both indicating no difference. Radiologic outcome, assessed by remaining step (<i>P</i> = .437) and gap (<i>P</i> = .911) and the reduction grading (<i>P</i> = .564), as well as the functional outcome assessed by the SF-12 (<i>P</i> <i>=</i> .827) and the VAS-FA (<i>P</i> <i>=</i> .930) was comparable in both groups.</p><p><strong>Conclusion: </strong>Compared with conventional ELA, the less invasive surgical technique via STA has similar short- to midterm complications and is associated with comparable anatomical reductions and functional outcomes. The propensity matching of the fracture severity gives us confidence to consider STA a suitable surgical approach in moderate and severe Sanders 3 and 4 type fractures.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251322466"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618096","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}
Laura E Sokil, Liam Wong, Elizabeth Roti, Graham J DeKeyser, Zachary M Working, Darin M Friess, James E Meeker
{"title":"The Direct Anterior Approach for AO/OTA43B and 43C Pilon Injuries.","authors":"Laura E Sokil, Liam Wong, Elizabeth Roti, Graham J DeKeyser, Zachary M Working, Darin M Friess, James E Meeker","doi":"10.1177/10711007251315095","DOIUrl":"https://doi.org/10.1177/10711007251315095","url":null,"abstract":"<p><strong>Background: </strong>Pilon fractures carry high rates of early wound healing, infectious complications, and late posttraumatic arthrosis. When reconstructive procedures are indicated, these patients are at further risk for early complications. Perhaps using the same direct anterior (DA) approach for initial repair and later reconstruction might mitigate these risks, but the DA approach has not been explored for initial repair. This study aimed to evaluate the performance of the DA approach for internal fixation of pilon fractures. We hypothesized that the reoperation rate for fractures treated with the DA approach would not differ from other surgical approaches in our series.</p><p><strong>Methods: </strong>A retrospective chart and radiographic review of operative Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 43B and C fractures from 2013 to 2022 were undertaken. Using Kaplan-Meier estimations, the likelihood of reoperation within 1 year of index surgery was analyzed. Reoperation risk factors were determined using multivariable logistic regression analyses created using a backward stepwise process.</p><p><strong>Results: </strong>A total of 135 fractures in 130 patients were eligible for review. The overall reoperation rate was 40.7%. There was no significant difference between DA and all other approaches for rate of reoperation for infection (2.3% vs 10%, <i>P</i> = .21), nonunion (15.9% vs 16.5%, <i>P</i> > .99), posttraumatic osteoarthritis (PTOA) (9.1% vs 7.8%, <i>P</i> > .99), and removal of symptomatic hardware (25% vs 36.3%, <i>P</i> = .27). In multivariate regression analysis, DA approach was associated with a lower rate of reoperation within 1 year (odds ratio 0.25, 95% CI 0.07-0.71, <i>P</i> = .015).</p><p><strong>Conclusion: </strong>The direct anterior approach can perform well for fixation of AO/OTA 43B and C fractures. Our retrospective series showed a favorable risk of reoperation at 1 year and a similar overall reoperation rate compared with all other combinations of approaches. Many factors determine the surgical approach to pilon fractures. This study has shown that the DA approach merits consideration as an option for open reduction and internal fixation.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251315095"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485147","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}
Maria Felsberg, Martha Adamik, Sebastian Schilde, Heike Kielstein, Karl-Stefan Delank, Alexander Zeh, Dariusch Arbab, Natalia Gutteck
{"title":"Anatomical Study of Nerve Injuries With Minimally Invasive Calcaneus Osteotomies.","authors":"Maria Felsberg, Martha Adamik, Sebastian Schilde, Heike Kielstein, Karl-Stefan Delank, Alexander Zeh, Dariusch Arbab, Natalia Gutteck","doi":"10.1177/10711007251319248","DOIUrl":"https://doi.org/10.1177/10711007251319248","url":null,"abstract":"<p><strong>Background: </strong>Calcaneal osteotomy is frequently used in correcting various foot deformities. Minimally invasive procedures such as minimally invasive calcaneus osteotomy (MICO) have become established because of their more favorable risk profile. The literature describes a safe zone for performing the osteotomy to protect the nerve structures. Overall, the existence of a \"safe zone\" remains controversial. The aim of this anatomical study was to determine the risk of nerve injury in the context of MICO.</p><p><strong>Methods: </strong>Twenty fresh frozen specimens were randomized to a V-shaped and oblique MICO groups. Following the skin incision, the osteotomies were performed with a Shannon burr. The nerve structures were then investigated both medially and laterally. After visualization of the osteotomy plane, standardized distance measurements were taken from the plane to the nerve and injuries were detected. Radiographs were then taken of all specimens, and the safe zone on each was measured and outlined.</p><p><strong>Results: </strong>The evaluation of the safe zone showed that in 17 of 20 cases the osteotomies we performed were located within the safe zone. We found 10 nerve injuries on 8 of 20 specimens. The medial calcaneal nerve was most vulnerable Overall, we found no significant correlation between the frequency of injured nerves and the type of osteotomy (<i>P</i> <i>=</i> .361).</p><p><strong>Conclusion: </strong>MICO is a procedure with a low-risk profile. We found that nerve injuries can occur despite compliance with surgical standards and the relative \"safe zone\" previously described. Other options for protecting the nerve structures and further investigations into the type of osteotomies should be carried out. The clinical relevance of these findings remains to be investigated.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251319248"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485191","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":"Association of Factors Related to the Size and Hepple Classification of Medial Osteochondral Lesions of the Talus.","authors":"Changjun Guo, Yongxing Cao, Chonglin Yang, SooMay Lim, Xingchen Li, Yang Xu, Jianping Huang, Liying Yang, Xiangyang Xu","doi":"10.1177/10711007251314975","DOIUrl":"https://doi.org/10.1177/10711007251314975","url":null,"abstract":"<p><strong>Background: </strong>Few studies have analyzed the association of factors contributing to the morphologic changes of medial osteochondral lesions of the talus (OLTs).</p><p><strong>Methods: </strong>Two hundred eighty consecutive patients who underwent surgery for OLTs from January 2010 to December 2022 were enrolled. The potential association of factors were age, gender, side of injury, duration of symptoms, body mass index, history of ankle sprain, chronic lateral ankle instability (CLAI), and ankle varus. Multivariate logistic regression analysis was performed to evaluate the association between these factors and both the size and Hepple classification of OLTs.</p><p><strong>Results: </strong>Size of OLTs was associated with age 40-60 years (OR 2.14, 95% CI 1.08-4.25; <i>P</i> = .029), age >60 years (OR 3.78, 95% CI 1.61-8.89; <i>P</i> = .002), duration of symptom 1-3 years (OR 2.06, 95% CI 1.03-4.15; <i>P</i> = .042), and duration of symptoms ≥3 years (OR 2.27, 95% CI 1.09-4.71; <i>P</i> = .028). CLAI was negatively correlated with the size of OLTs (OR 0.30, 95% CI 0.17-0.54; <i>P</i> < .001). Age >60 years was associated with Hepple V classification (OR 3.65, 95% CI 1.50-8.89; <i>P</i> = .004).</p><p><strong>Conclusion: </strong>In our cohort we found older age positively correlated with Hepple V classification. Increasing age and duration of symptom are positively associated with increasing size of medial OLTs, whereas CLAI was negatively correlated with the lesion size.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251314975"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416636","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":"Utility of 3D Wound Assessment in Monitoring Granulation Tissue Velocity Following Negative-Pressure Wound Therapy in Diabetic Foot Ulcers.","authors":"Jiyong Ahn, Alexandra Flaherty","doi":"10.1177/10711007251314805","DOIUrl":"https://doi.org/10.1177/10711007251314805","url":null,"abstract":"<p><strong>Background: </strong>Wound healing in diabetic foot ulcers (DFUs) is challenging and often requires extensive debridement and in some cases leads to amputation. Negative-pressure wound therapy (NPWT) can be utilized for DFUs. The optimal time frame for successful NPWT lacks consensus. Advanced wound scanning with a three-dimensional (3D) camera can enhance accuracy of DFU area and volume calculations. This study aimed to investigate the utility of 3D wound assessment in monitoring granulation tissue filling velocity with NPWT in DFUs.</p><p><strong>Methods: </strong>A retrospective case series study was performed for 101 DFUs (Wagner classification 3 or 4 lesions with significant necrotic tissue debridement failing to achieve primary closure, leading to open amputation) undergoing NPWT from September 2018 to June 2019. Demographic data and wound characteristics were recorded. Before application of NPWT, wounds were irrigated after extensive procedures, and digital photographs of the wound were captured using an infrared 3D camera. Wound area and volume were measured weekly from before the application of NPWT to 1 month after. Risk factors associated with wound healing in DFUs were also evaluated.</p><p><strong>Results: </strong>NPWT resulted in significant area improvements for open DFUs. Postoperative 1-week area change velocity was 1.35 cm<sup>2</sup>/d, peaking at 2 weeks (1.84 cm<sup>2</sup>/d). Volume also showed significant improvement over time (<i>P</i> = .001), with a 1-week peak velocity of 1.20 cm<sup>3</sup>/d. All peak area and volume changes occurred within 2 weeks after NPWT application. Compared to the midfoot and hindfoot, the forefoot exhibited a lower velocity of volume (<i>P</i> = .001).</p><p><strong>Conclusion: </strong>3D wound assessment for the velocity of granulation tissue filled in an open DFU after NPWT can be useful for monitoring healing progression. Most wound healing following NPWT in DFUs was completed within the first 2 weeks.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251314805"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416640","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}
Andrew C Peterson, Melissa R Requist, Jacob C Benna, Jayson R Nelson, Shireen Elhabian, Cesar de Cesar Netto, Timothy C Beals, Amy L Lenz
{"title":"Talar Morphology of Charcot-Marie-Tooth Patients With Cavovarus Feet.","authors":"Andrew C Peterson, Melissa R Requist, Jacob C Benna, Jayson R Nelson, Shireen Elhabian, Cesar de Cesar Netto, Timothy C Beals, Amy L Lenz","doi":"10.1177/10711007241309915","DOIUrl":"https://doi.org/10.1177/10711007241309915","url":null,"abstract":"<p><strong>Background: </strong>Charcot-Marie-Tooth disease (CMT), a common inherited neurologic disorder, significantly impacts the morphology of foot bones, particularly the talus. The disease has been classified into types based on specific mutations, with the most common being CMT type 1 (CMT1; demyelinating) and CMT type 2 (CMT2; axonal). However, the specific osseous morphologic variations in CMT patients and their major genetic subgroups remain insufficiently understood, posing challenges in clinical management and surgical intervention.</p><p><strong>Methods: </strong>This study analyzed talar morphology in individuals with CMT compared with a healthy control group, employing a single-bone statistical shape model and talar neck offset angle measurements. Participants included 18 CMT individuals (yielding 29 tali) and 43 healthy controls. For individuals with CMT, the average age at diagnosis was 36.5 ± 19.8 years, with a mean interval of 8.6 years between diagnosis and imaging. Talar morphology was evaluated using weightbearing computed tomography and subsequent morphologic and angular analysis.</p><p><strong>Results: </strong>Differences were observed in talar morphology between CMT and healthy individuals. Notably, CMT1 and CMT2 tali exhibited a flatter talar dome and more medial talar head and neck compared with controls. Additionally, the CMT1 and CMT2 subgroups both had a more medially oriented talar neck based on the talar neck offset angle compared with the controls.</p><p><strong>Conclusion: </strong>The findings illustrate significant morphologic variations in the talus of CMT patients, indicating the need for type-specific clinical approaches in treating CMT-related foot deformities. Understanding these talar variations is crucial for tailoring surgical techniques and orthotic designs, and developing effective rehabilitation protocols for individuals with CMT, potentially improving patient care and outcomes.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007241309915"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400956","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}