Foot & ankle international最新文献

{"title":"Mid- to Long-Term In Vivo Polyethylene Wear Rates in Salto Talaris Total Ankle Arthroplasty.","authors":"Joseph A S McCahon, Tyler Radack, Hope Thalody, Adam Lencer, Tiffany Bridges, Tara G Moncman, David I Pedowitz, Selene G Parekh, Joseph N Daniel","doi":"10.1177/10711007251336752","DOIUrl":"10.1177/10711007251336752","url":null,"abstract":"<p><strong>Background: </strong>Polyethylene wear particles have been shown to be a contributing factor of osteolysis and aseptic loosening. To date, no clinical study has investigated the in vivo wear rates of Salto Talaris total ankle arthroplasty (TAA). Therefore, the purpose of our study was to evaluate mid- and long-term outcomes and in vivo wear rates in primary total ankle arthroplasty and their association with peri-implant osteolysis, complications, and implant survivorship.</p><p><strong>Methods: </strong>A retrospective review was performed to determine the mid- and long-term in vivo polyethylene wear rates in primary TAA. Patients with a minimum of 5-year clinical and radiographic data from a primary TAA with a fixed-bearing, semiconstrained, ultrahigh-molecular-weight polyethylene (UHMWPE) system were identified and included in this study. Polyethylene wear rates at final follow-up were analyzed using anteroposterior ankle radiographs and a validated computer-assisted Roman software. In addition, demographic data, peri-implant osteolysis, complications, reoperations, and revisions were recorded.</p><p><strong>Results: </strong>Fifty-four patients with a mean follow-up of 8.1 years (range, 5.2-13.0) were included in this study. The median polyethylene wear rate for the entire cohort was 0.06 mm/y (95% CI 0.04-0.08). Linear wear rate was found to have no true correlation relationship with patient age, BMI, or polyethylene size. More than half of patients (57%) demonstrated some radiographic signs of peri-implant osteolysis or cysts at final follow-up; however, comparative analysis investigating the relationship between wear rate and peri-implant osteolysis found no significant difference in wear rates for patients with tibial or talar osteolysis compared with those without (<i>P</i> = .451 and <i>P</i> = .434, respectively).</p><p><strong>Conclusion: </strong>UHMWPE in this primary TAA demonstrated low in vivo wear rates. Rates of peri-implant osteolysis remain high with no clear association between wear rates and osteolysis.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"757-764"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129750","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":"Severity of Bone Marrow Edema on MRI Predicts the Diagnostic Potential of Foot Joint Injections.","authors":"Matthäus Cieciera, Reto Sutter, Stephan H Wirth, Tobias Götschi, Nadja A Farshad-Amacker","doi":"10.1177/10711007251334097","DOIUrl":"10.1177/10711007251334097","url":null,"abstract":"<p><strong>Background: </strong>Intraarticular steroid and local anesthetic injections are often performed for foot pain. Localizing the exact joint acting as a pain generator in foot pain is eminent for optimal and cost-effective treatment. Because of the complex anatomy of the foot with multiple small articulations side by side, this can be challenging. This study's purpose was to determine magnetic resonance imaging (MRI) findings as possible predictive factors for the immediate outcome of intraarticular injections of the foot.</p><p><strong>Methods: </strong>All single joint foot injections at our institution from January 2019 to May 2020 with prior MRI scans were included in this retrospective study. Visual analog scale (VAS) pain assessments before and after injection, relative change in pain scores and indication were recorded. All MRIs were retrospectively analyzed by 2 blinded radiologists regarding the presence and severity of subchondral bone marrow edema (BME), subchondral cysts, cartilage defects, osteophytes, joint effusion, and soft tissue edema. Spearman analysis was used to assess correlation between MRI findings and pain relief. Interrater variability was assessed using weighted Cohen κ analysis.</p><p><strong>Results: </strong>A total of 164 injections from 162 patients were included (mean age, 53 years ± 15.5, 99 females). Relative pain reduction correlated significantly with BME severity (<i>P</i> < .05). Interrater reliability assessing BME was excellent (weighted Cohen κ 0.863).</p><p><strong>Conclusion: </strong>The degree of pain reduction after intraarticular foot injections correlates significantly with the severity of subchondral bone marrow edema-like signal on MRI before injection.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"747-756"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058465","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":"Increased Lateral Calcaneal Body and Subtalar Joint Visualization Utilizing a Modified Sinus Tarsi Approach.","authors":"Rohan Bhimani, Andrew M Hresko, Kevin Y Wang, John Y Kwon","doi":"10.1177/10711007251343530","DOIUrl":"10.1177/10711007251343530","url":null,"abstract":"<p><strong>Background: </strong>The traditional sinus tarsi approach (TST) for open reduction and internal fixation (ORIF) of calcaneus fractures has gained popularity because of adequate fracture exposure with lower wound complication rates. Visualization, as compared with more extensile approaches, can be limited, however. This study introduces a modified sinus tarsi approach (MST) that extends the TST incision approximately 2 cm posterodorsally as well as 2 cm anteroplantarly, to enhance exposure. The aim of this study is to quantify the amount of exposure obtained with the traditional sinus tarsi approach and the modified sinus tarsi approach.</p><p><strong>Methods: </strong>Twelve unpaired fresh frozen cadaveric specimens underwent sequential dissection starting with the TST followed by the MST. Standardized tension was applied to the incisions during both surgical exposures. Exposed surface areas, including the lateral calcaneal wall, posterior facet, and dorsal surface were marked. Digital images of the exposed calcaneal surfaces were analyzed using digital imaging software. The distance of the sural nerve from the incision was recorded for the MST.</p><p><strong>Results: </strong>The MST provided significantly greater exposure of the lateral calcaneal wall, posterior facet and dorsal surface compared to the TST (865 ± 77.8 mm², 39% of total lateral wall area, vs 322 ± 71.9 mm², 14.9% of total lateral wall area; 204 ± 69.8 mm², 43.3% of posterior facet area, vs 66.9 ± 27.9 mm², 13.7% of posterior facet area; and 549 ± 124 mm², 45.1% of dorsal surface area, vs 199 ± 61.8 mm², 16.3% of dorsal surface area, all <i>P</i> < .0001). The sural nerve was found an average of 1.8 ± 6.1 mm dorsal to the plantar extent of the MST incision.</p><p><strong>Conclusion: </strong>In noninjured cadaver specimens, the modified sinus tarsi approach, which extends the incision by 4 cm, was found to substantially increase visualization of calcaneal surfaces compared with the traditional sinus tarsi approach. Care must be taken with the sural nerve, which is often in or near the MST distal extension. This enhanced exposure may allow for improved fracture reduction and fixation while retaining the soft tissue and angiosomal benefits of the traditional sinus tarsi approach.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"765-773"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499922","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":"Letter Regarding: Incidence of Complications with Precontoured Allograft Wedges in Foot and Ankle Surgery.","authors":"Solangel Rodriguez-Materon, Megan Miles, Nigel Hsu, Brian Gallagher, Gregory P Guyton","doi":"10.1177/10711007251341899","DOIUrl":"https://doi.org/10.1177/10711007251341899","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"46 7","pages":"806"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585965","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":"Effects of Fibular Plate Fixation and Deep Posterior Tibiotalar Ligament Repair on Ankle Stability in a Weber B Fracture Model with Complete Deltoid Ligament Sectioning.","authors":"Andreas F Dalen, Martin G Gregersen, Aleksander L Skrede, Øystein Bjelland, Alf Inge Hellevik, Tor Åge Myklebust, Fredrik A Nilsen, Marius Molund","doi":"10.1177/10711007251334085","DOIUrl":"10.1177/10711007251334085","url":null,"abstract":"<p><strong>Background: </strong>Weber B (supination external rotation) ankle fractures with complete deltoid ligament rupture (SER4b) are typically considered unstable and treated with plate fixation of the fibula. Recent studies have suggested a significant ankle-stabilizing role of the deep posterior tibiotalar ligament (dPTTL), which questions current practice. To our knowledge, there are few studies on the biomechanical effects of plate fixation and none on dPTTL repair. Therefore, this study aims to evaluate the effects of fibular plate fixation and dPTTL repair on ankle stability in a Weber B fracture model with complete deltoid ligament sectioning.</p><p><strong>Methods: </strong>We robotically tested 15 cadaveric ankle specimens in 5 states: native joint, SER4b injury models, SER4b injury models with plate fixation of the fibula, SER4b injury models with dPTTL repair, and SER4b injury models with combined plate fixation and dPTTL repair. The robot measured ankle stability in lateral translation, valgus, and internal and external rotation. Talar shift and talar tilt were measured on mortise view radiographs. The primary outcome was differences in talar shift in neutral ankle position.</p><p><strong>Results: </strong>When comparing SER4b injury models with plate fixation to native ankles, we found a mean difference in talar shift of 1.18 mm (95% CI 0.88-1.48, <i>P</i> ≤ .001), talar tilt of 14.47 degrees (95% CI 12.90-16.05, <i>P</i> ≤ .001), and external rotation of 11.44 degrees (95% CI 9.00-13.87, <i>P</i> ≤ .001). When comparing SER4b injury models with combined plate fixation and dPTTL repair to native ankles, we found a mean difference in talar shift of 0.23 mm (95% CI -0.07 to 0.54, <i>P</i> = .132), talar tilt of 1.65 degrees (95% CI 0.07-3.22, <i>P</i> = .040), and external rotation of 5.26 degrees (95% CI 2.82-7.70, <i>P</i> ≤ .001).</p><p><strong>Conclusion: </strong>This study's main finding was that plate fixation of the fibula alone did not considerably enhance ankle stability in SER4b injury models. However, ankle stability was substantially improved when plate fixation and dPTTL repair were combined.</p><p><strong>Clinical relevance: </strong>Our study showed that dPTTL repair, in addition to plate fixation, improved ankle stability in Weber B SER4b fracture models. This information should be considered in future clinical research and treatment strategies for these fractures.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"688-696"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340782","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":"Outcomes of Adding Inferior Extensor Retinaculum Reinforcement to Arthroscopic Anterior Talofibular Ligament Repair: A Systematic Review and Meta-Analysis.","authors":"Benjamin Murray, Ali Ghasemi, Ramiz Memon, Clark Yin, James Raphael, Gene Shaffer","doi":"10.1177/10711007251329339","DOIUrl":"10.1177/10711007251329339","url":null,"abstract":"<p><strong>Background: </strong>Arthroscopic anterior talofibular ligament (ATFL) repair procedures generally involve either repair solely of the ATFL or repair of the ATFL with inferior extensor retinaculum (IER) reinforcement. Both techniques produce strong clinical outcomes; however, studies directly comparing ATFL repair techniques with and without IER reinforcement are limited. We hypothesize that patients receiving arthroscopic ATFL repair with IER reinforcement have superior clinical outcome scores.</p><p><strong>Methods: </strong>A systematic review and meta-analysis per PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines was conducted. To assess the relationship of type of surgical procedure (repair of only the ATFL or repair of the ATFL plus IER reinforcement) to reported clinical outcomes based on the Karlsson and Peterson Scoring System for Ankle Function (KAFS), visual analog scale (VAS), and the American Orthopaedic Foot & Ankle Society (AOFAS) score, we used the standardized mean difference (SMD) with a 95% CI of preoperative to postoperative scores as an effect size. A meta-regression analysis was conducted to identify the source of differences in the observed effect size between studies.</p><p><strong>Results: </strong>A total of 638 studies met the initial search criteria. The meta-analysis included 34 studies to compare clinical outcomes of arthroscopic ATFL repair. Arthroscopic ATFL repair both with and without IER reinforcement resulted in significantly improved preoperative to postoperative clinical outcome scores. Arthroscopic ATFL repair with IER reinforcement resulted in a significantly higher preoperative to postoperative SMD for KAFS (<i>P</i> = .091) and VAS (<i>P</i> = .065) scores compared to arthroscopic ATFL repair without IER reinforcement. There was no significant difference in the preoperative to postoperative SMD of AOFAS (<i>P</i> = .453) scores when comparing surgical procedures. ATFL repair with IER reinforcement had a significantly greater rate of superficial peroneal nerve (SPN) injury (<i>P</i> = .004).</p><p><strong>Conclusion: </strong>Arthroscopic ATFL repair with IER reinforcement leads to improved clinical outcome scores but carries a higher risk of SPN injury compared to arthroscopic ATFL repair without IER reinforcement. Patients receiving either arthroscopic procedure should achieve excellent functional outcomes.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"794-805"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047345","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":"Reflexive and Perceptual Characteristics as Functional Outcome Measures of Chronic Ankle Instability.","authors":"Annalee M H Friedman, Leif P Madsen","doi":"10.1177/10711007251338279","DOIUrl":"10.1177/10711007251338279","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous reflexes serve an integral role in maintaining efficient movement patterns and may be linked to sensory-perceptual deficits experienced by those with chronic ankle instability (CAI), namely, during the stance and transitional phases of the gait cycle. Abnormal reflex characteristics and perceptions of instability following unexpected perturbation have the potential to serve as potential patient-specific biomarkers for neuromuscular recovery following a lateral ankle sprain (LAS), however, these outcomes are scarcely explored.</p><p><strong>Methods: </strong>The purpose of this retrospective case control study (level III) was to observe lower limb cutaneous reflex patterns and variability as well as perceived instability following sural nerve stimulation in those with CAI. These outcomes were measured via electromyography of 6 lower limb muscles and self-reported perceived instability as participants received random, non-noxious stimulations while walking on a treadmill.</p><p><strong>Results: </strong>Those with CAI exhibited elevated peroneus longus facilitation and gastrocnemius reflex variability during midstance that were correlated with greater levels of perceived instability following sural stimulation.</p><p><strong>Conclusion: </strong>These findings indicate reflex alterations may contribute to perceived instability during functional activity, a hallmark symptom of CAI.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"774-783"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164192","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":"Postoperative Complications After Acute Achilles Tendon Rupture Repair: A Survival Analysis of Minimally Invasive vs Open Techniques.","authors":"Joris R H Hendriks, Siddhartha Sharma, Matthias Peiffer, Tom M de Groot, Gregory Waryasz, Gino M M J Kerkhoffs, Soheil Ashkani-Esfahani, Christopher W DiGiovanni, Daniel Guss","doi":"10.1177/10711007251333777","DOIUrl":"10.1177/10711007251333777","url":null,"abstract":"<p><strong>Background: </strong>The complication rates after surgical repair of acute Achilles tendon ruptures (ATRs) using open repair or minimally invasive surgical techniques (MIS) have been debated extensively. Despite significant research, a literature hiatus exists on the timing of these complications between techniques. In this study, we aimed to address this gap by conducting a Kaplan-Meier survival analysis to compare the incidence and timing of complications after open vs MIS repair of acute ATRs and examine associated risk factors.</p><p><strong>Methods: </strong>This retrospective study included patients ≥18 years who underwent surgical treatment of an acute ATR within 28 days of injury and had a minimum of 90-day follow-up. Demographics, surgical technique (open vs MIS repair), and the occurrence and timing of postoperative complications were collected. Postoperative complications were classified as venous thromboembolism, rerupture, surgical site infection, wound dehiscence, and sural nerve injury. A Kaplan-Meier curve was employed to compare the complication rates between groups. The log-rank test was used to test the equality of survivor functions. The Cox proportional hazards model was used to determine predictors of complications.</p><p><strong>Results: </strong>In total, out of 417 patients, 52 complications were reported in 50 patients. We found no significant difference in the complication rates between the MIS and open repair groups. Cox proportional hazards modeling revealed that BMI was a significant predictor of rerupture (HR 1.2, 95% CI 1.05-1.4) and that surgical delay increased the risk of wound dehiscence (HR 1.2, 95% CI 1.01-1.3) and sural nerve injury (HR 1.2, 95% CI 1.1-1.3).</p><p><strong>Conclusion: </strong>MIS and open repair techniques for acute ATRs demonstrate comparable complication rates. However, patients with elevated BMI exhibit a modest increased risk of rerupture, regardless of the technique used. Those with surgical delay beyond 2 weeks are also modestly more likely to experience wound dehiscence with open surgical approach and sural nerve injury among MIS-treated patients.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"707-714"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046198","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":"Nonoperative Treatment for Osteochondral Lesions of the Talus Provides Clinical Improvement in the Minority of the Patients at Short-term Follow-up.","authors":"Tristan M F Buck, Jason A H Steman, Jari Dahmen, Quinten G H Rikken, Inger N Sierevelt, Sjoerd A S Stufkens, Gino M M J Kerkhoffs","doi":"10.1177/10711007251330881","DOIUrl":"10.1177/10711007251330881","url":null,"abstract":"<p><strong>Background: </strong>Often, the preferred initial treatment for osteochondral lesions of the talus (OLTs) is nonoperative for at least 6 months before considering more invasive surgical strategies. The primary aim of this study was to evaluate the clinical effectiveness of nonoperative management for OLTs on prospective clinical outcomes over a 1-year period. Secondary aims included assessing the radiologic outcomes, the rate of conversion to surgery, and the influence of baseline factors on return to a higher level of activity.</p><p><strong>Methods: </strong>Patients who underwent nonoperative management for primary OLTs were prospectively included. Clinical outcome measures were assessed at baseline, 6 months, and 12 months. The primary outcome of this prospective cohort study is the change in the numeric rating scale (NRS) for pain score during walking between baseline and 12 months. Secondary outcomes included changes in NRS during rest, NRS during running, NRS during stair climbing, Foot and Ankle Outcome Scale (FAOS) subscales, changes in lesion volume and surface area, and conversion to surgery rate.</p><p><strong>Results: </strong>A total of 40 patients (42 ankles) mean age 31.6 years with a primary symptomatic OLT were included. The primary outcome, NRS during walking, significantly improved between 0 and 12 months (4.8 to 3.3; <i>P</i> = .0003). However, the mean decrease did not exceed the minimal clinically important difference (MCID), with only 38% of the patients exceeding the MCID at 12-month follow-up. NRS scores during running and stair climbing showed improvements from baseline to 6 months (<i>P</i> = .0004 and <i>P</i> = .002) and from baseline to 12 months (<i>P</i> = .0001 and <i>P</i> = .0002). None of these average NRS change scores at 12-month follow-up exceeded the MCID. FAOS sports and quality of life subscales improved significantly from baseline to 6 months (<i>P</i> = .003 and <i>P</i> = .011) and remained stable from 6 to 12 months. The FAOS pain subscale showed significant improvement only after 12 months. Lesion sizes remained stable throughout the one-year period.</p><p><strong>Conclusion: </strong>Nonoperative treatment resulted in statistically significant improvements in pain during walking after 1 year, with clinically relevant improvement observed in 38% of patients. These findings suggest that nonoperative treatment held the potential for meaningfully improving symptoms in the minority of our patients, with no appreciable change in OLTT size. We think it should be considered as a preferred approach for the first line of treatment.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"699-706"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059122","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":"Radiographic Results of Percutaneous Reduction of Calcaneal Fractures and Posterior Arthroscopic Subtalar Arthrodesis (C-PASTA).","authors":"Srihan Anand, Anthony D Belmonte, Elise Grzeskiewicz, Adam Groth, Kevin D Martin","doi":"10.1177/10711007251333367","DOIUrl":"10.1177/10711007251333367","url":null,"abstract":"<p><strong>Background: </strong>Displaced intraarticular calcaneal fractures (DIACFs) are associated with high rates of posttraumatic arthritis. Traditional management with open subtalar arthrodesis often results in high revision rates and complications. Acute open arthrodesis has shown success in Sanders III and IV calcaneus fractures, with favorable return-to-work and radiographic fusion outcomes. This study evaluates the radiographic results of calcaneus percutaneous reduction and posterior arthroscopic subtalar arthrodesis (C-PASTA) for acute Sanders III and IV fractures.</p><p><strong>Methods: </strong>A retrospective study reviewed 22 patients with acute Sanders III and IV DIACFs treated with C-PASTA. Surgeries delayed beyond 24 days were excluded. Radiographic measures included preoperative and postoperative computed tomographic (CT) scans to assess arthrodesis, screw placement, and potential complications. Patient demographics, surgical data (eg, screw count, bone graft use, tourniquet time), and changes in Bohler and Gissane angles were analyzed.</p><p><strong>Results: </strong>Of 22 DIACFs treated, 19 met inclusion criteria (median age 46 years, range 25-82). Preoperative CT classified 6 fractures as Sanders III (32%) and 13 as Sanders IV (68%). Three-month CT showed a 100% fusion rate (n=19), with no screw penetration into the tibial-talar joint, prominence >2 mm, or flexor hallucis longus tendon impingement. Bohler angles improved significantly postoperatively, whereas Gissane angles remained unchanged. There were no major complications or return trips to the operating room.</p><p><strong>Conclusion: </strong>C-PASTA demonstrates excellent fusion rates, significant restoration of calcaneal alignment, and minimal complications. These findings suggest that C-PASTA is a viable, minimally invasive technique for acute Sanders III and IV fractures.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"679-687"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065460","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}