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Flexor Tendon Injury Risk With Percutaneous Intramedullary Screw Fixation for Lesser Metatarsal Fractures: A Cadaveric Study. 经皮髓内螺钉固定治疗小跖骨骨折的屈肌腱损伤风险:一项尸体研究。
Foot & ankle international Pub Date : 2025-07-10 DOI: 10.1177/10711007251351300
James D Baker, Joseph S Burke, Jantz Arbon, Arsh Patel, Kelly Hynes, Jeannie Huh
{"title":"Flexor Tendon Injury Risk With Percutaneous Intramedullary Screw Fixation for Lesser Metatarsal Fractures: A Cadaveric Study.","authors":"James D Baker, Joseph S Burke, Jantz Arbon, Arsh Patel, Kelly Hynes, Jeannie Huh","doi":"10.1177/10711007251351300","DOIUrl":"https://doi.org/10.1177/10711007251351300","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous intramedullary screws have recently become a fixation option for the surgical management of lesser metatarsal fractures. Their advantages over Kirschner (K)-wire fixation include avoidance of pin site complications, fixation stability, and need for removal. To date, there has been limited literature published on their use and safety profile. The purpose of this study is to determine the frequency and extent of flexor tendon disruption associated with percutaneous intramedullary screw fixation for lesser metatarsal fractures.</p><p><strong>Methods: </strong>Seven left and right lower extremity cadaver specimens were procured. A cannulated 3.6-mm screw was placed percutaneously in the second through fifth metatarsals (MTs) in a retrograde fashion. The plantar surface of each specimen was then exposed to visualize the flexor tendons. The tendon location relative to the drill hole, incidence of tendon disruption, percentage of tendon disruption, and the distance between the tendon and the drill hole were measured.</p><p><strong>Results: </strong>Overall, 21 of 56 (37.5%) flexor tendons were damaged, 5 (35.7%) in the second MT, 7 (50%) in the third MT, 9 (64.3%) in the fourth MT, and 0 (0%) in the fifth MT. The percentage of tendon disruption for each metatarsal was 15%, 11%, 11%, and 0%, respectively. The mean distance from uninjured tendons to the drill hole was 1.07 mm, 0.94 mm, 0.9 mm, and 2.03 mm, respectively. Across all metatarsals, the majority of flexor tendons were located medial to the drill hole, with the greatest clearance seen in the fifth metatarsal.</p><p><strong>Conclusion: </strong>Percutaneous insertion of intramedullary screws for lesser metatarsal fixation resulted in a 37.5% rate of flexor tendon injury, primarily affecting the fourth metatarsal. Although these disruptions involved 10% to 20% of tendon width, their clinical impact remains uncertain. Adjusting the starting point to a slightly more lateral position, if possible, may minimize the risk of flexor tendon injury. Future studies should assess functional outcomes, plantar plate involvement, and biomechanical consequences of partial tendon injury.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251351300"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602612","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}
引用次数: 0
Minimally Invasive Distal Chevron With Supination Corrects First Metatarsal Pronation in Hallux Valgus: A Retrospective Weightbearing Computed Tomography Study. 微创远端弓形旋后矫正拇外翻第一跖骨前旋:回顾性负重计算机断层扫描研究。
Foot & ankle international Pub Date : 2025-07-10 DOI: 10.1177/10711007251351301
Barbara Piclet-Legre, Eva Schenkels, Delphine Amsellem, Matthieu Lalevée, Lolita Micicoi
{"title":"Minimally Invasive Distal Chevron With Supination Corrects First Metatarsal Pronation in Hallux Valgus: A Retrospective Weightbearing Computed Tomography Study.","authors":"Barbara Piclet-Legre, Eva Schenkels, Delphine Amsellem, Matthieu Lalevée, Lolita Micicoi","doi":"10.1177/10711007251351301","DOIUrl":"https://doi.org/10.1177/10711007251351301","url":null,"abstract":"<p><strong>Background: </strong>Hallux valgus (HV) significantly impacts patients' quality of life. The coronal plane deformity is often not captured by traditional 2-dimensional radiographs, yet its correction may be important. This study explores the efficacy of distal chevron osteotomies with supination in correcting first metatarsal (M1) pronation in HV.</p><p><strong>Methods: </strong>A retrospective analysis of 58 weightbearing CT scans from HV patients undergoing distal chevron with supination was conducted (29 patients had pre- and postoperative CT scans).Functional scores (European Foot and Ankle Society [EFAS], EuroQoL-5 levels, 5 dimensions [EQ5L-5D], EuroQoL-visual analog scale [EQ-VAS]) and angular measurements (hallux valgus angle, intermetatarsal angle, metatarsal pronation angle, alpha angle) were assessed pre- and postoperatively. Inter- and intraobserver reproducibility were evaluated using intraclass correlation coefficients.</p><p><strong>Results: </strong>Postoperative outcomes demonstrated significant improvement in functional scores for all patients, including an increase in EFAS score (Δ = 6.7, <i>P</i> < .001). Angular measurements, including metatarsal pronation angle (MPA), intermetatarsal angle, hallux valgus angle, and alpha angles, improved postoperatively. Preoperative MPA and alpha angle were 14.7 ± 4.9 and 16.6 ± 5.2 (<i>P</i> < .05). Postoperative MPA and alpha angles were 7.9 ± 3.4 and 7.4 ± 4.8 (<i>P</i> < .05). Intraclass correlation coefficient showed moderate to excellent correlations for angular measurements.</p><p><strong>Conclusion: </strong>Distal chevron technique with supination allowed pronational realignment of the M1 head relative to the ground in hallux valgus. Postoperative pronation values were close to the normative ones previously defined in the literature. Although statistically significant improvements were observed, the lack of validated minimal clinically important difference values for EFAS, EQ5L-5D, and EQ-VAS limits confident interpretation of their clinical relevance.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251351301"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602614","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}
引用次数: 0
Radiographic Changes in Central Tarsometatarsal Arthritis Following Flatfoot Reconstruction. 平足重建后中央跗跖关节炎的影像学变化。
Foot & ankle international Pub Date : 2025-07-07 DOI: 10.1177/10711007251346471
Hansol Moon, InHwa Baek, ChanIn Seo, Woo-Chun Lee
{"title":"Radiographic Changes in Central Tarsometatarsal Arthritis Following Flatfoot Reconstruction.","authors":"Hansol Moon, InHwa Baek, ChanIn Seo, Woo-Chun Lee","doi":"10.1177/10711007251346471","DOIUrl":"https://doi.org/10.1177/10711007251346471","url":null,"abstract":"<p><strong>Background: </strong>Progressive collapsing flatfoot deformity (PCFD) has been reported as a common cause of the nontraumatic degenerative arthritis of the midfoot, and arthrodesis has been used for symptomatic arthritis unresponsive to nonoperative measures. The hypothesis of this study was that nontraumatic central tarsometatarsal (TMT) arthritis associated with PCFD would be improved without arthrodesis by restoration of medial longitudinal arch. The aim of this study was to investigate the clinical and radiologic results of central TMT arthritis with medial longitudinal arch restoration in PCFD.</p><p><strong>Methods: </strong>From April 2017 to December 2022, 18 patients (21 feet) with nontraumatic central TMT arthritis and PCFD who underwent medial longitudinal arch reconstruction with flexor hallucis longus (FHL) transfer were included. Mean follow-up was 30.2 (range, 12-67) months. Clinical findings were evaluated with visual analog scale (VAS) and Foot Function Index (FFI). Radiologic staging of second TMT joint was done based on CT scans because it was the most common and severely involved joint. Changes in radiographic parameters for PCFD were assessed.</p><p><strong>Results: </strong>Clinical results were improved. VAS changed from 7.1 ± 1.3 to 1.6 ± 0.5, FFI changed from 53.3 ± 0.5 to 12.2 ± 7.0 at the preoperative and postoperative periods, respectively (<i>P</i> < .001). Radiologic stage of the second TMT joint was improved (<i>P</i> < .001) from 3.4 (range 2-4) to 1.2 (range 1-2). Lateral talo-first metatarsal angle was improved from 33.3. ± 7.4 to 16.8 ± 5.4 degrees (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>Nontraumatic central tarsometatarsal arthritis associated with progressive collapsing flatfoot deformity showed radiographic improvement without central TMT joint arthrodesis following medial longitudinal arch reconstruction. However, clinical outcome improvement after surgery cannot be specifically attributed to the TMT joint changes.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251346471"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577419","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}
引用次数: 0
Surgeon Preferences, Surgical Location, and Timing of Repair Drive Achilles Tendon Rupture Repair Cost. 外科医生的偏好,手术位置和修复时间驱动跟腱断裂修复成本。
Foot & ankle international Pub Date : 2025-07-06 DOI: 10.1177/10711007251347278
Emily B Parker, Suhas Rao Velichala, Varun Nukala, Soheil Ashkani-Esfahani, Gregory R Waryasz, Jeremy T Smith, Daniel Guss, Christopher P Chiodo, Christopher W DiGiovanni, David N Bernstein
{"title":"Surgeon Preferences, Surgical Location, and Timing of Repair Drive Achilles Tendon Rupture Repair Cost.","authors":"Emily B Parker, Suhas Rao Velichala, Varun Nukala, Soheil Ashkani-Esfahani, Gregory R Waryasz, Jeremy T Smith, Daniel Guss, Christopher P Chiodo, Christopher W DiGiovanni, David N Bernstein","doi":"10.1177/10711007251347278","DOIUrl":"https://doi.org/10.1177/10711007251347278","url":null,"abstract":"<p><strong>Background: </strong>Midsubstance Achilles tendon repair is a common procedure, yet the factors influencing its cost have been underexamined and often imprecisely understood. Using time-driven activity-based costing (TDABC), we examined variation in total cost, compared patient-, surgeon-, and surgery-specific characteristics between high- and non-high-cost repairs, and assessed factors associated with total cost to identify specific cost drivers that might reduce expenses without compromising clinical outcomes.</p><p><strong>Methods: </strong>Patients undergoing midsubstance Achilles tendon rupture repair between January 3, 2022 and December 28, 2023 at 2 academic medical centers and their affiliated community hospitals and ambulatory surgical centers were identified. Exclusion criteria included revision procedures and those with concurrent procedures besides fasciotomy. TDABC methodology was used to determine total cost across 3 clinical phases: preoperative, intraoperative, and postoperative. Cost was normalized per institution requirements. Bivariate analysis was performed across all characteristics between high-cost (top decile) procedures and all others. Spearman correlation between operative time and total cost was assessed. Multivariable linear regression was used to identify key cost drivers.</p><p><strong>Results: </strong>Among 341 primary midsubstance Achilles rupture repairs performed by 8 surgeons, the most expensive procedure was 6 times costlier than the least expensive one. Eighty-five percent of the cost, on average, was incurred intraoperatively. A \"good\" correlation was found between operative time and total cost (<i>P</i> < .05). When accounting for covariates, increasing time between rupture and repair was associated with higher cost (<i>P</i> < .05). Surgical location, surgical approach, and repair suture were also associated with total cost (<i>P</i> < .05).</p><p><strong>Conclusion: </strong>Substantial variability in the cost of primary midsubstance Achilles rupture repair is driven by factors including timing of surgical repair, intraoperative surgeon-specific characteristics (ie, surgical approach and suture choice), and surgical location. Further standardization of treatment approach and decreasing time to the operating room could lower cost variability and improve the value of care for patients with midsubstance Achilles tendon rupture undergoing surgery.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251347278"},"PeriodicalIF":0.0,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568176","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}
引用次数: 0
PROMIS Outcomes After Operative vs Nonoperative Treatment of Achilles Rupture. 手术与非手术治疗跟腱断裂的预后对比。
Foot & ankle international Pub Date : 2025-07-01 Epub Date: 2025-05-26 DOI: 10.1177/10711007251336756
Philomena Burger, Mina Botros, Zein El-Zein, Amanda Holleran, John Ketz, A Sam Flemister, David Ciufo
{"title":"PROMIS Outcomes After Operative vs Nonoperative Treatment of Achilles Rupture.","authors":"Philomena Burger, Mina Botros, Zein El-Zein, Amanda Holleran, John Ketz, A Sam Flemister, David Ciufo","doi":"10.1177/10711007251336756","DOIUrl":"10.1177/10711007251336756","url":null,"abstract":"<p><strong>Background: </strong>Achilles tendon rupture is a common injury in the adult population. The role of operative and nonoperative management remains controversial. The purpose of this study is to evaluate and compare patient-reported outcomes using Patient-Reported Outcomes Measurement Information System (PROMIS) after operative and nonoperative treatment of acute Achilles rupture.</p><p><strong>Methods: </strong>Patients with Achilles ruptures were identified as either undergoing surgical repair or nonoperative functional rehabilitation. The primary outcomes were PROMIS physical function (PF), pain interference (PI), and depression scores. These were routinely collected prospectively during the initial office visit and follow-up appointments. A distribution-based method was used to determine the minimal clinically important difference (MCID), which was ½ SD of each PROMIS domain. These values were further used to calculate the percentage of patients who returned to population mean PROMIS scores at final follow-up. Secondary outcomes included deep vein thrombosis (DVT), wound healing, infections, and reruptures.</p><p><strong>Results: </strong>A total of 216 patients were included (115 nonoperative, 101 operative). Patients treated operatively were younger (35.6 vs 45.1 years, <i>P</i> < .001), with slightly lower BMI (<i>P</i> = .011). Sex distribution among the groups were similar (<i>P</i> = .933). Both treatments improved PROMIS PF, PI, and depression scores. Although there was a trend toward achieving population means in PF earlier in the operative group, the groups equalized over time, with no statistically significant difference between treatment groups for the percentage of patients who were below, at, or above population mean PROMIS values at 6 months and final follow-up. There was no difference in rerupture rates or identified DVTs. However, there were increased wound issues in the operative group (<i>P</i> = .035), with 12.8% symptomatic scarring, 6% infections, 3% delayed healing, and 3% with palpable nodules, compared with 1 case of cellulitis in a nonoperative patient.</p><p><strong>Conclusion: </strong>In our patients with an Achilles tendon rupture, on average, operative management was not associated with statistically meaningful differences in patient-reported physical function compared with nonoperative treatment. Surgery also comes at the cost of increased wound/complication rates and was associated with modestly slower improvement in pain and depression scores.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"715-722"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145116","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}
引用次数: 0
Ankle Fractures and Deltoid Ligament Repair: A Generational Tale. 踝关节骨折和三角韧带修复:一代人的故事。
Foot & ankle international Pub Date : 2025-07-01 Epub Date: 2025-06-21 DOI: 10.1177/10711007251340689
John Y Kwon
{"title":"Ankle Fractures and Deltoid Ligament Repair: A Generational Tale.","authors":"John Y Kwon","doi":"10.1177/10711007251340689","DOIUrl":"10.1177/10711007251340689","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"697-698"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340781","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}
引用次数: 0
Evaluating Large Language Models for Patient Information: What Is Worth Publishing? 评估患者信息的大型语言模型:什么值得发表?
Foot & ankle international Pub Date : 2025-07-01 Epub Date: 2025-07-08 DOI: 10.1177/10711007251356034
Charles L Saltzman, Robert B Anderson, Brad D Blankenhorn, John T Campbell, Christopher P Chiodo, Timothy R Daniels, George B Holmes, Ellie Pinsker, Stefan Rammelt, Robert A Vander Griend
{"title":"Evaluating Large Language Models for Patient Information: What Is Worth Publishing?","authors":"Charles L Saltzman, Robert B Anderson, Brad D Blankenhorn, John T Campbell, Christopher P Chiodo, Timothy R Daniels, George B Holmes, Ellie Pinsker, Stefan Rammelt, Robert A Vander Griend","doi":"10.1177/10711007251356034","DOIUrl":"https://doi.org/10.1177/10711007251356034","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"46 7","pages":"677-678"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585964","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}
引用次数: 0
Porous Titanium Wedges Associated With High Rates of Osseointegration and Radiologic Correction in Progressive Collapsing Foot Deformity. 多孔钛楔与进行性塌陷足畸形的高骨整合率和放射学矫正相关。
IF 2.2
Foot & ankle international Pub Date : 2025-07-01 Epub Date: 2025-05-20 DOI: 10.1177/10711007251334061
Carolina Montoya-delaTorre, María José Ilabaca, Eva García-Jarabo, Rubén García-Elvira, Jesús VilayRico, Daniel Poggio-Cano
{"title":"Porous Titanium Wedges Associated With High Rates of Osseointegration and Radiologic Correction in Progressive Collapsing Foot Deformity.","authors":"Carolina Montoya-delaTorre, María José Ilabaca, Eva García-Jarabo, Rubén García-Elvira, Jesús VilayRico, Daniel Poggio-Cano","doi":"10.1177/10711007251334061","DOIUrl":"10.1177/10711007251334061","url":null,"abstract":"<p><strong>Background: </strong>The main purpose of this study is to assess the radiologic correction outcomes following surgical treatment of flexible progressive collapsing foot deformity using porous titanium implants.</p><p><strong>Methods: </strong>Multicenter, retrospective, descriptive, radiologic study. All patients with painful flexible progressive collapsing foot deformity (between 18 and 80 years old) who underwent surgical correction using porous titanium wedges for Cotton and Evans osteotomies between January 2019 and December 2021 were included. Patients with active infection or soft tissue anomalies in the surgical area were excluded. Pediatric patients were not included. Radiographs in weightbearing anteroposterior and lateral views were taken before the surgery and by the end of the 2-year follow-up period. The following were measured and compared: Meary angle and calcaneal pitch angle, Kite angle, and talonavicular coverage percentage. Radiologic osseointegration was assessed through Worth's classification.</p><p><strong>Results: </strong>Forty-one patients (43 feet: 26 right feet and 17 left feet) were included. The mean differential preoperative/postoperative angle measurements were as follows: Meary 14.7 degrees (<i>P</i> = .001), calcaneal inclination 4.3 degrees (<i>P</i> = .001), Kite 11 degrees (<i>P</i> = .03), talonavicular coverage 42.5 degrees (<i>P</i> = .01), and percentage of talonavicular coverage 15% (<i>P</i> = .03). Thirty-eight patients (88%) showed complete osseointegration of the wedges by the end of the follow-up period (grade 4). The remaining 5 patients presented partial integration (grade 3).</p><p><strong>Discussion: </strong>Regardless of the initial deformity severity, all patients consistently recovered and maintained a normal to class BI (Consensus Group classification) radiologic aspect by the end of the follow-up period.</p><p><strong>Conclusion: </strong>In this retrospective series, we found that titanium Cotton and Evan wedges offered reliable radiologic correction, and high osseointegration levels.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"732-739"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113055","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}
引用次数: 0
Response to "Letter Regarding: Incidence of Complications With Precontoured Allograft Wedges in Foot and Ankle Surgery". 对“关于:在足踝手术中预整形异体移植楔的并发症发生率”的回复。
Foot & ankle international Pub Date : 2025-07-01 Epub Date: 2025-07-08 DOI: 10.1177/10711007251341898
Allison L Boden, Seif El Masry, Grace M DiGiovanni, Constantine A Demetracopoulos, Elizabeth A Cody
{"title":"Response to \"Letter Regarding: Incidence of Complications With Precontoured Allograft Wedges in Foot and Ankle Surgery\".","authors":"Allison L Boden, Seif El Masry, Grace M DiGiovanni, Constantine A Demetracopoulos, Elizabeth A Cody","doi":"10.1177/10711007251341898","DOIUrl":"https://doi.org/10.1177/10711007251341898","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"46 7","pages":"807"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585966","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}
引用次数: 0
Does Use of Allograft Affect Union Rates in Minimal Invasive Hallux Valgus Surgery? 同种异体移植物对微创外翻手术愈合率有影响吗?
Foot & ankle international Pub Date : 2025-07-01 Epub Date: 2025-05-20 DOI: 10.1177/10711007251337459
Christian G Guevara, Dino Fanfan, Taylor Schnepp, Daniel Murray, Christopher Hodgkins, Thomas San Giovanni, Cary Chapman
{"title":"Does Use of Allograft Affect Union Rates in Minimal Invasive Hallux Valgus Surgery?","authors":"Christian G Guevara, Dino Fanfan, Taylor Schnepp, Daniel Murray, Christopher Hodgkins, Thomas San Giovanni, Cary Chapman","doi":"10.1177/10711007251337459","DOIUrl":"10.1177/10711007251337459","url":null,"abstract":"<p><strong>Background: </strong>Hallux valgus (HV) is a common foot deformity that can cause significant discomfort. Surgical correction of hallux with minimally invasive surgery (MIS) has been gaining popularity in recent years among surgeons. The use of allograft in traditional open approaches has been proposed to improve the outcomes of foot and ankle procedures by expediting time to union. We performed a retrospective analysis of patients undergoing MIS HV correction with and without the allograft at the time of surgery. The primary aim of our study was to determine if use of allograft in HV MIS correction led to different time to union as well as rate of unions.</p><p><strong>Methods: </strong>A retrospective cohort study was designed to compare the radiographic outcomes of patients who underwent hallux valgus correction with or without allograft. Patients included in the analysis underwent primary HV correction using fourth-generation minimally invasive techniques and had postoperative weightbearing radiographs. Exclusion criteria included revision HV surgery, open surgery for HV correction, and patients lost to follow-up. All surgeries were performed by 3 fellowship-trained foot and ankle orthopaedic surgeons at a single center in Miami, Florida, from September 2019 to December 2022, with only 1 surgeon using allograft. All patients had similar postoperative protocols. The allograft group received 2 mL of a demineralized bone matrix (DBM) gel (Allosync; Arthrex). Radiographs were evaluated by 2 independent orthopaedic surgeons who were anonymized to the patient's group allocation. The primary outcome of this study was time to radiographic union, defined as formation of 2 neocortices on postoperative radiographs, as well as overall rate of union. The secondary outcomes included a comparison of traditional radiographic measurements and the incidence of complications.</p><p><strong>Results: </strong>Sixty-eight patients (68 feet) met inclusion criteria: allograft group (n = 26) and a control group (n = 42). Demographics between both groups were similar. In our study, all 68 feet obtained complete union and no malunions or nonunions were observed in either group. The average time to complete union for the allograft group was 5.69 ± 3.16 months (95% CI 4.45-6.93) and the control group was 6.0 ± 3.95 months (95% CI 4.80-7.19); union times between groups did not reach statistical significance (<i>P</i> = .731). Maintenance of surgical correction was observed in all patients.</p><p><strong>Conclusion: </strong>In this study, the use of demineralized bone matrix allograft during MIS HV correction did not result in a statistically significant difference in time to union or overall union rates. Although the allograft group showed a slightly shorter average union time, this difference was not clinically or statistically significant. These findings suggest that the routine use of allograft in MIS HV correction may not provide a meaningful benefit.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"740-746"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113054","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}
引用次数: 0
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