Foot & ankle international最新文献

{"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":"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 cm²/d, peaking at 2 weeks (1.84 cm²/d). Volume also showed significant improvement over time (<i>P</i> = .001), with a 1-week peak velocity of 1.20 cm³/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":"287-294"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","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}

{"title":"A Comprehensive Weightbearing Computed Tomography Study on Patients With Hallux Valgus: Exploring Multiplanar Deformity Interrelationships.","authors":"Chien-Shun Wang, Erik Jesús Huánuco Casas, Emily J Luo, Antoine S Acker, Mark E Easley, Cesar de Cesar Netto","doi":"10.1177/10711007241309912","DOIUrl":"10.1177/10711007241309912","url":null,"abstract":"<p><strong>Background: </strong>Hallux valgus (HV) is a complex, multiplanar deformity. In this study, we examined the interrelationships between various components of this deformity using weightbearing computed tomography (WBCT). We hypothesized that the severity of traditional axial plane deformities would correlate with malpositioning of the metatarsosesamoid complex, first-ray coronal rotational deformity, and malalignment of the hindfoot and midfoot. The findings may offer valuable insights for guiding the correction of HV deformities.</p><p><strong>Methods: </strong>Patients with an HV angle greater than 15 degrees who underwent WBCT were included. Traditional 2-dimensional parameters were semiautomatically assessed. Manual measurements included hindfoot and midfoot WBCT parameters, for example, foot and ankle offset, talar posterior and middle facet morphology, and forefoot arch angle. First-ray parameters, including first metatarsal rotation, sesamoid rotation angle, hallucal pronation angle, and sesamoid position, were measured using established methods. Patients were categorized by hindfoot moment arm values to evaluate hindfoot-forefoot relationships.</p><p><strong>Results: </strong>Sixty-eight feet (53 patients) were included. Manual measurements exhibited excellent interobserver reliability, with ICCs of 0.845 to 0.987 and a kappa coefficient of 0.899 for the sesamoid position. The mean HV angle was 27.4 ± 7.8 degrees, whereas the mean IM angle was 15.8 ± 3.5 degrees. Significant correlations were observed between the HV and intermetatarsal (IM) angles, with all metatarsosesamoid complex parameters and first-ray coronal plane rotational parameters distal to the metatarsal head. The axial and sagittal talar-first metatarsal angles correlated with the HV angle but not with the IM angle. Significant differences in the HV angle, sagittal first tarsal-metatarsal joint angle, and first metatarsal head rotation were observed between the hindfoot moment arm groups, as confirmed by post hoc analysis.</p><p><strong>Conclusion: </strong>The findings support our hypothesis, identifying significant correlations between metatarsosesamoid complex malposition, distal first-ray coronal pronation, and traditional axial plane deformities in HV. Some hindfoot-midfoot alignments correlated with the HV angle but not with the IM angle.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"343-356"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043869","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 Osteosynthesis of Os Subfibulare for Chronic Lateral Ankle Instability With Large Os Subfibulare.","authors":"Yeo Kwon Yoon, Kwang Hwan Park, Dong Woo Shim, Wonwoo Lee, Yong Hyun Yoon, Seung Hwan Han, Jin Woo Lee","doi":"10.1177/10711007241309914","DOIUrl":"10.1177/10711007241309914","url":null,"abstract":"<p><strong>Background: </strong>Os subfibulare (OS) is commonly found in patients with chronic lateral ankle instability (CLAI). When performing lateral ligament reconstruction for CLAI, excision of a large OS can cause substantial lateral ligament defects making anatomic repair challenging. This study analyzed clinical and radiologic outcomes among patients who underwent osteosynthesis of the OS for chronic lateral ankle instability and a large OS.</p><p><strong>Methods: </strong>28 ankles with CLAI and a large OS (≥10 mm) that underwent osteosynthesis of the OS between June 2007 and July 2021 were included in the study and followed for ≥24 months. Visual analog scale (VAS) for pain, Karlsson-Peterson ankle score, and Medical Outcomes Study Short Form Health Survey-36 physical component summary (SF-36 PCS), talar tilt angle, and anterior displacement of the talus were used to assess clinical and radiologic outcomes. All reoperations and complications were also evaluated.</p><p><strong>Results: </strong>The mean OS size was 15.4 mm (range, 12.2-21.0 mm). The mean follow-up period was 78.9 months (range, 24.0-177.0 months). Mean VAS score, Karlsson-Peterson ankle score, SF-36 PCS, talar tilt angle, and anterior displacement of the talus all improved significantly, from preoperative values of 5.3 ± 1.8, 38.4 ± 10.6, 45.6 ± 10.8 points, 11.1 ± 5.7 degrees, and 7.3 ± 1.9 mm, to 0.9 ± 1.4, 88.7 ± 12.6, 80.2 ± 12.3 points, 3.9 ± 2.0 degrees, and 4.8 ± 1.3 mm, respectively, by the last follow-up. The overall complication rate was 10.7% (3 ankles); the reoperation rate was 7.1% (2 ankles).</p><p><strong>Conclusion: </strong>Osteosynthesis of the OS produced satisfactory outcomes in patients with CLAI and a large OS. This method may be a viable surgical option for patients with this condition.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"324-331"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018882","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":"Three-Plane Calcaneal Osteotomy With Joint Preservation vs Subtalar Arthrodesis to Treat Painful Calcaneal Fracture Malunions.","authors":"Hui Feng, Dong-Dong Ji, Xin-Quan Yang, Yang Yue, Zhe Wang, Yan Zhang, Pei-Long Liu, Jing-Qi Liang, Hong-Mou Zhao","doi":"10.1177/10711007241310228","DOIUrl":"10.1177/10711007241310228","url":null,"abstract":"<p><strong>Background: </strong>Calcaneal fracture malunion (CFM) commonly occurs with multiple pathologic changes and progressive pain and difficulty walking. The purpose of this study was to propose a modified 3-plane joint-preserving osteotomy for the treatment of CFM with subtalar joint incongruence, and to compare its efficacy to subtalar arthrodesis.</p><p><strong>Methods: </strong>A retrospective comparative analysis of the data of 56 patients with CFM admitted from January 2017 to December 2022 was performed. Twenty-six patients were in the osteotomy group and 30 in the arthrodesis group. Computed tomographic (CT) scans were used for measurement of the intraarticular steps. Radiologic parameters, visual analog scale (VAS) score for pain, 12-Item Short Form Health Survey (SF-12) mental component summary (MCS) and physical component summary (PCS) scores were compared between the 2 groups of patients to assess the outcome preoperatively and at last follow-up, which averaged 22.6 ± 3.6 months and 27.6 ± 3.6 months for the osteotomy and arthrodesis groups, respectively.</p><p><strong>Results: </strong>Improvements in pain, function, and overall quality of life were obtained in both groups compared with the preoperative values at last follow-up. The VAS and SF-12 scores were similar between the groups at the last follow-up. In the osteotomy group, the average CT scan-measured intraarticular step-offs were significantly reduced from 3.7 ± 1.2 mm to 0.9 ± 0.3 mm. The osteotomy group showed improvement in pronation and supination range of motion (ROM) of the feet (<i>P</i> < .01). The correction of the ankle height and Meary angle were slightly better in the osteotomy group.</p><p><strong>Conclusion: </strong>In this short-term follow-up study, good results were achieved in both joint-preserving osteotomy and subtalar arthrodesis groups for the treatment of CFM with subtalar joint incongruence. The osteotomy group preserved the subtalar joint and achieved improvements in pronation and supination ROM.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"295-302"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043870","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 Shape of Things to Come.","authors":"Max P Michalski, Glenn B Pfeffer","doi":"10.1177/10711007251315471","DOIUrl":"10.1177/10711007251315471","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"275-276"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400915","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":"Bosworth fracture: Pathoanatomy, Complications, and Medium-term Results of Treatment.","authors":"Jan Bartoníček Md PhD, Stefan Rammelt, Michal Tuček, Pavel Douša Md PhD, Caroline Stöckigt Md","doi":"10.1177/10711007241311925","DOIUrl":"10.1177/10711007241311925","url":null,"abstract":"<p><strong>Background: </strong>Bosworth fractures (BFs) with entrapment of a fibular fragment behind the posterior malleolus (PM) are rare but potentially serious injuries to the ankle. Despite an increased awareness through a more regular use of computed tomography (CT) scanning, there is still a scarcity of clinical outcome studies.</p><p><strong>Methods: </strong>Over a course of 25 years, data on 23 patients treated for BF at our institutions (mean age 44 years) were collected prospectively. Of those, 16 patients had a Weber type B fracture with displacement of the proximal fibular fragment and 7 patients Weber type C fractures with displacement of the distal fibular fragment behind PM. All but 1 patient, who refused operative treatment, were treated with open reduction and internal fixation. A total of 21 patients were followed up for an average of 66 (range, 18-204) months.</p><p><strong>Results: </strong>The PM was fractured in 96% and the Tillaux-Chaput tubercle in 13% of cases. In 80% of patients with preoperative CT scans, the fibular fragment was entrapped between the posterior aspect of the distal tibia and the displaced PM fragment. An initial attempt at closed reduction was successful in 4 of 7 Weber type C fractures and in none of 16 Weber type B fractures. The overall complication rate was 22%. Eighty-one percent of patients rated their results as good or excellent. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score at the final follow-up averaged 84.1 (range, 45-100). Risk factors for postoperative osteoarthritis and poor functional results included unsuccessful closed reduction, inadequate open reduction, and avascular necrosis of the talus. Clinical and radiographic results were correlated.</p><p><strong>Conclusion: </strong>Unsuccessful initial reduction and failure to achieve anatomic open reduction were associated with posttraumatic arthritis whereas open anatomic reduction and internal fixation resulted in favorable functional and radiographic results in the medium to long term.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"332-342"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034879","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":"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}

{"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":"In Vivo Kinematics of the Distal Tibiofibular Syndesmosis With Different Loading Weights.","authors":"Ye Luo, Feng Li, Xiaofan Huang, Danni Wu, Yaqi Zhao, Shaobai Wang","doi":"10.1177/10711007251315163","DOIUrl":"https://doi.org/10.1177/10711007251315163","url":null,"abstract":"<p><strong>Background: </strong>The distal tibiofibular syndesmosis (DTS) is crucial for maintaining ankle stability and distributing stress in the ankle joint. However, the in vivo kinematics of the DTS during high-impact activities remain unknown. This study aims to explore these kinematics and investigate the influence of additional trunk load using a high-speed dual fluoroscopy imaging system (DFIS). It was hypothesized that the maximum lateral translation of the DTS would not exceed the diagnostic threshold, and the range of motion (ROM) would increase with the addition of load.</p><p><strong>Methods: </strong>This study included 14 healthy participants. Magnetic resonance imaging (MRI) was used to create 3-dimensional models of the distal tibia and fibula. High-speed DFIS was employed to capture continuous fluoroscopic images of the DTS while participants performed single-leg landing jumps. A weighted vest was used to introduce additional load. DFIS data and 3D models were imported into virtual environment software to obtain kinematic data. A 1-way analysis of variance was conducted to compare 3-dimensional 6 degree-of-freedom kinematics and the joint's ROM before and after adding trunk load.</p><p><strong>Results: </strong>The primary rotational movements of the DTS after ground contact were eversion and external rotation, whereas translational movements included lateral and downward translation. After adding additional load, the DTS showed a significantly greater maximum extension angle (2.70 ± 0.56 degrees vs 3.17 ± 0.59 degrees, <i>P</i> = .038) and flexion-extension ROM (2.74 ± 0.61 degrees vs 3.32 ± 0.83 degrees, <i>P</i> = .044) compared to preload conditions. The maximum internal rotation angle (0.25 ± 0.73 degrees vs 1.51 ± 0.86 degrees, <i>P</i> < .001) and internal-external rotation ROM (-2.09 ± 1.39 degrees vs 3.88 ± 1.10 degrees, <i>P</i> = .004) of the DTS were significantly greater after adding load.</p><p><strong>Conclusion: </strong>During single-leg landing, the primary movements of the DTS involve eversion and external rotation. With additional loading, the rotational angles of the DTS increase.</p><p><strong>Clinical relevance: </strong>The distal tibiofibular syndesmosis increases its rotational motion angle to accommodate higher loads.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251315163"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392778","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}