Foot & ankle international最新文献

{"title":"Response to \"Letter Regarding: Change in Talar Axial Rotation and Pain Intensity Following Correction of Progressive Collapsing Foot Deformity\".","authors":"Matthew S Conti, Grace M DiGiovanni, Seif El Masry, Agnes Jones, Jaeyoung Kim, Jonathan T Deland, Scott J Ellis","doi":"10.1177/10711007251317183","DOIUrl":"https://doi.org/10.1177/10711007251317183","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"46 4","pages":"465-466"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004066","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 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":"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":"389-398"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","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}

{"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":"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":"429-434"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","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":"Why I Want Bunion Surgery-the Patient's Preoperative and Postoperative Perspective.","authors":"Michael de Buys, Nikiforos P Saragas, Paulo N F Ferrao","doi":"10.1177/10711007251321475","DOIUrl":"10.1177/10711007251321475","url":null,"abstract":"<p><strong>Background: </strong>Hallux valgus is the most common pathology afflicting the hallux. Surgery is generally offered to symptomatic patients who fail conservative treatment. The aim of this study is to evaluate patient-reported reasons for undergoing hallux valgus corrective surgery in a preoperative and postoperative cohort.</p><p><strong>Methods: </strong>We performed a prospective and retrospective cross-sectional study. Our study included all patients aged >18 years who were planning to or have had hallux valgus surgery during the study period. An information sheet including 14 possible reasons for having hallux valgus surgery and a questionnaire to rank each reason (1-10) was sent to all patients. Patients were divided into a preoperative group and a postoperative group to eliminate bias. In our study we had 101 patients, 5 males and 96 females, at an average age of 50.6 years.</p><p><strong>Results: </strong>The preoperative cohort included 51 patients and the postoperative cohort 50 patients. The 3 most important reasons for having surgery, in both cohorts, were the ability to move pain free, eliminate pain over bunion, and to be able to walk long distance and over uneven terrain without pain. The 3 least important factors were to reduce the need for an orthotic, narrower foot, and to wear high heels. Indications were divided into one of 4 categories. Pain was the highest-rated category in both pre and postoperative groups, followed by function. In the preoperative group, appearance was the next most important group and shoe wear the least. In comparison, in the postoperative group, shoe wear was more important than appearance.</p><p><strong>Conclusion: </strong>Pain and function are the most important reasons patients have for surgery in both the preoperative and postoperative patient cohorts. Patients were more likely to list cosmesis as a reason to undergo surgery in the preoperative than the postoperative group.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"410-414"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Evaluation of Tunnel Positions for Anatomic Lateral Ankle Ligament Reconstruction: Based on a Cadaveric and Radiographic Study.","authors":"Anhong Wang, Chenyu Lian, Lizhong Jing, Shikai Xiong, Shuai Yang, Weili Shi, Linxin Chen, Xing Xie, Dong Jiang, Qinwei Guo","doi":"10.1177/10711007251315474","DOIUrl":"10.1177/10711007251315474","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Previous studies reported the ligament attachments with regard to anatomic landmarks. However, these absolute distances may differ in size and anatomic variability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To develop radiologic methods for assessing the tunnel placements of anatomic lateral ankle ligament reconstruction with a single common fibular tunnel and provide quantitative data on radiography and 3-dimensional computed tomography (3D CT).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Sixteen ankle specimens were used to identify the attachment centers of the anterior talofibular ligament and calcaneofibular ligament. Subsequently, bone tunnels were created at these sites, with their positions evaluated via lateral radiographs and CT scans. Reference lines such as the anterior distal fibular line from the inferior tip of the fibula to the anterior tubercle on the fibula and the anterior lateral malleolar line from the apex of the lateral talar process to the anterolateral corner of the trochlea on the talus were employed for accurate tunnel positioning. For the calcaneal tunnel, the posterior subtalar line and its orthogonal line form the basis for a structured square measurement frame. The tunnel entries were orthogonally projected onto these references, enabling a percentage-based description of their locations. The interobserver and intraobserver reliability of the radiographic measurements were assessed using intraclass correlation coefficients (ICCs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The fibular tunnel was projected at 35.9% on lateral radiography and 35.0% via 3D CT along the anterior distal fibular line. The talar tunnel was recorded at 62.4% on radiography and 63.5% on 3D CT along the anterior lateral malleolar line. There were no significant differences in the length of the posterior subtalar line (34.6 vs 31.4 mm, &lt;i&gt;P&lt;/i&gt; = .140), distance &lt;i&gt;a&lt;/i&gt; to the calcaneal tunnel (16.1 vs 14.7 mm, &lt;i&gt;P&lt;/i&gt; = .100), and distance &lt;i&gt;b&lt;/i&gt; to the calcaneal tunnel (27.9 vs 25.1 mm, &lt;i&gt;P&lt;/i&gt; = .233) between the lateral roentgenogram and 3D CT. The calcaneal tunnel was observed at 80.6% on lateral radiography and 79.7% on 3D CT along the posterior subtalar line and at 46.4% on radiography and 46.3% on 3D CT along the orthogonal line. No significant differences were observed in the locations of the fibular, talar, and calcaneal tunnels between lateral radiography and 3D CT. Good interobserver agreement and intraobserver reproducibility were achieved, as indicated by ICCs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study describes reproducible radiographic measuring techniques and provides quantitative data for intraoperative positioning and postoperative assessment of tunnel locations for anatomic lateral ankle ligament reconstruction. Both lateral radiography and 3D CT were effective modalities for evaluating the bone tunnels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;By offering reproducible measurement strategies and critical quantitat","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"378-385"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756939","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":"Education Calendar.","authors":"","doi":"10.1177/10711007251332702","DOIUrl":"https://doi.org/10.1177/10711007251332702","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"46 4","pages":"467"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055723","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":"Optimal Target Angle in Oblique Diaphyseal Osteotomy of the Fifth Metatarsal for Symptomatic Bunionette: A Retrospective Analysis.","authors":"Yasunari Ikuta, Tomoyuki Nakasa, Shingo Kawabata, Saori Ishibashi, Satoru Sakurai, Dan Moriwaki, Nobuo Adachi","doi":"10.1177/10711007251315112","DOIUrl":"10.1177/10711007251315112","url":null,"abstract":"<p><strong>Background: </strong>The effects of the osteotomy angle during oblique diaphyseal osteotomy of the fifth metatarsal on the clinical outcomes remain unclear. This study aimed to clarify the clinical and radiographic outcomes of this procedure, with a focus on the intraoperative osteotomy angle.</p><p><strong>Methods: </strong>This retrospective study included 30 female patients who underwent oblique diaphyseal osteotomy of the fifth metatarsal with single-screw fixation for symptomatic bunionette (36 feet, mean age, 68.3 years; mean follow-up, 22.5 months). The angles between the osteotomy line and the fifth metatarsal and screw insertion axes were measured as the osteotomy and screw insertion angles, respectively. Receiver operating characteristic curve analysis was performed to determine the cutoff value for the osteotomy angle. The metatarsophalangeal angle (MTPA) and intermetatarsal angle (IMA) between the fourth and fifth metatarsals were measured on dorsoplantar images. The Japanese Society for Surgery of the Foot (JSSF) scale was scored at the preoperative and final follow-up visits.</p><p><strong>Results: </strong>Screw backout was identified in 14 feet (38.9 %). The osteotomy and screw insertion angles were 35.9 and 62.2 degrees in the screw backout group and 24.6 and 71.2 degrees in the control group, respectively (<i>P</i> < .05). The osteotomy angle >31.1 degrees was a cutoff value of postoperative screw backout (sensitivity, 0.79; specificity, 0.96; area under the curve, 0.92). The mean MTPA and IMA were 21.0 and 12.3 degrees preoperatively and 9.3 and 8.2 degrees at the final follow-up, respectively. The mean JSSF scale score improved significantly from 59.9 to 95.3.</p><p><strong>Conclusion: </strong>The osteotomy angle was greater and the screw was inserted more shallowly against the osteotomy line in the screw backout group compared with the control group. The optimal target angle of the osteotomy line to the fifth metatarsal axis should be <30 degrees intraoperatively for single-screw fixation.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"415-421"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392782","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":"Could MIS Lateral Ligament Reconstruction Be the Future?","authors":"Jonathon D Backus, Thomas O Clanton","doi":"10.1177/10711007251323894","DOIUrl":"10.1177/10711007251323894","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"386-388"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756916","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":"Education Calendar.","authors":"","doi":"10.1177/10711007251332702","DOIUrl":"https://doi.org/10.1177/10711007251332702","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"46 4","pages":"467"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059162","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":"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":"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":"268-274"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}