Foot & ankle international最新文献

{"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}

{"title":"Soft Tissue Complications Following Temporary External Fixation vs Splinting of Trimalleolar Ankle Fractures.","authors":"Elias G Joseph, Joseph Kocan, Mitchell Scull, Paul Mercado, Andrew W Wilson, Bernard Rohrbacher, Bryce A Cunningham, Dirk Kiner, Warren Gardner","doi":"10.1177/10711007251337743","DOIUrl":"10.1177/10711007251337743","url":null,"abstract":"<p><strong>Background: </strong>Temporary management of closed trimalleolar ankle fractures may involve closed reduction and splint application vs external fixation (ex-fix). One of the primary concerns of using splinting is loss of reduction and soft tissue compromise. The objective of this study was to determine if there is a clinically significant difference in short-term soft tissue complications (STCs) in patients with trimalleolar or trimalleolar-equivalent ankle fractures treated with temporary closed reduction and splinting vs ex-fix.</p><p><strong>Methods: </strong>In this multicenter retrospective review from 2 level 1 trauma centers, patients with closed trimalleolar ankle fractures treated surgically from 2017 to 2022 were identified. Demographic data, surgical details, radiographic data, and postoperative details were reviewed and collected to determine postoperative soft tissue complications.</p><p><strong>Results: </strong>Overall, 488 patients met inclusion criteria; 395 patients (80.9%) were managed with temporary splinting and 93 with ex-fix (19.1%). Median follow-up was 24 weeks (range 8-292). The cohort's STC rate was 8.4% (41 of 488), including 2.9% (14 of 488) that required reoperation and 5.5% (27 of 488) that required nonoperative treatment. STC occurred in 6 of 93 ex-fix patients (6.5%) and 35 of 395 temporary splinting patients (8.9%) (risk difference -2.4% [95% CI -7.1% to 4.9%]; OR 0.70 [95% CI 0.28-1.74]; <i>P</i> = .45). Reoperation for STC occurred in 3 of 93 ex-fix patients (3.2%) and 11 of 395 temporary splinting patients (2.8%) (risk difference 0.4% [95% CI -2.5% to 6.4%]; OR 1.16 [95% CI 0.31-4.25]; <i>P</i> = .73).</p><p><strong>Conclusion: </strong>The results suggest similar rates of STC with ex-fix and temporary splinting before definitive fixation of ankle fractures with a posterior malleolus component. Surgeons must consider if there is a benefit to use ex-fix, considering the additional cost and burden to patients.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"723-731"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087107","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":"Systematic Review and Meta-Analysis Comparing Open FHL Tendon Transfer, Hamstring Transfer, and Turndown Flaps to Treat Chronic Achilles Tendon Ruptures.","authors":"Bedri Karaismailoglu, Samir Ghandour, Joris Hendriks, Mani Eftekhari, Ehab Eltouny, Gregory Waryasz, Daniel Guss, John Y Kwon, Soheil Ashkani-Esfahani, Lorena Bejarano-Pineda, Christopher W DiGiovanni","doi":"10.1177/10711007251330287","DOIUrl":"10.1177/10711007251330287","url":null,"abstract":"<p><strong>Background: </strong>Chronic Achilles tendon ruptures (CATRs) present significant challenges because of delayed diagnosis and more complicated salvage treatments that can result in unfavorable outcomes and increased rates of adverse events. Various reconstructive surgical options have been described, each with its own unique advantages and disadvantages. Comprehensive comparison of these techniques, however, is lacking. This meta-analysis aimed to compare clinical outcomes following 3 of the most commonly used salvage techniques including flexor hallucis longus (FHL) transfer, hamstring transfer, and gastric-soleal turndown flap.</p><p><strong>Methods: </strong>This systematic review adhered to PRISMA guidelines and included studies registered on PROSPERO. Searches were conducted across multiple databases, and eligibility criteria encompassed studies reporting on clinical scores and complications following surgical treatment of CATRs with FHL transfer, hamstring tendon transfer, or turndown flaps. Data extraction, quality assessment, and statistical analyses were performed following standardized protocols.</p><p><strong>Results: </strong>Among 1910 identified studies, 25 met inclusion criteria with 11 focusing on FHL transfer, 9 on hamstring tendon transfer, and 6 on turndown flap management. A meta-analysis revealed variations in patient demographics, surgical techniques, and rehabilitation protocols across the 3 intervention groups. Although the mean improvement in American Orthopaedic Foot & Ankle Society scores was comparable (38.9 for turndown flap, 31.8 for FHL transfer, and 26.0 for hamstring transfer), complication rates differed significantly. The turndown flap group exhibited the highest overall complication rate, particularly because of wound-related complications, with a wound complication rate of 12.5%, compared with 5.7% for FHL transfer and 3.5% for hamstring transfer.</p><p><strong>Conclusion: </strong>This study underscores the challenge of evidence-based decision making in the surgical management of CATRs. Despite apparently similar functional outcomes, the choice of open surgical technique affects complication rates. Turndown flaps, although effective in restoring musculotendinous continuity, carry higher risks of wound complications compared with the other techniques evaluated.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"784-793"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061384","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":"Corrigendum to \"Plantar Pressure Analysis and the Ankle Instability Index: Quantifying 'Giving Way' in Functional Ankle Instability\".","authors":"","doi":"10.1177/10711007251350162","DOIUrl":"https://doi.org/10.1177/10711007251350162","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251350162"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487495","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":"Open Reduction and Internal Fixation vs Primary Tibiotalocalcaneal Hindfoot Nailing for Ankle Fractures in Elderly Patients: A Systematic Review and Meta-analysis.","authors":"John McDonald, Michael Oravic, William Wardell, Wonyong Lee","doi":"10.1177/10711007251325841","DOIUrl":"10.1177/10711007251325841","url":null,"abstract":"<p><strong>Background: </strong>Current literature lacks comprehensive information comparing primary tibiotalocalcaneal (TTC) hindfoot nailing and open reduction internal fixation (ORIF) in the ankle fractures in the elderly population. This systematic review and meta-analysis was conducted to evaluate and compare the clinical outcomes of 2 surgical techniques, primary TTC nailing and ORIF, for ankle fractures in the elderly.</p><p><strong>Methods: </strong>Our comprehensive literature review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and used databases including PubMed, Embase, Web of Science, and the Cochrane Library. Data investigated in this study included total infection, deep infection, superficial infection, hardware problems such as painful hardware, and hardware protrusion/pullout, nonunion/delayed union, reoperation, length of stay, and return to preoperative mobility level.</p><p><strong>Results: </strong>Total 5 studies were included in this study. In aggregate, 127 patients (42.9%) underwent TTC nailing, whereas 169/296 patients (57.1%) underwent ORIF. A lower rate of superficial infection was reported for the TTC nailing group: 2.1% (2/95) in TTC nailing vs 10.2% (14/137) in ORIF, with a relative ratio of 0.26 (95% CI, 0.08-0.85). The other outcome measures were not significantly different between groups.</p><p><strong>Conclusion: </strong>Based on our review of these studies that reported mostly early follow-up data, it appears that primary TTC nailing may be a viable alternative to ORIF for ankle fracture fixation in the elderly population. However, these findings should be interpreted cautiously because of heterogeneity across the included studies.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"661-671"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055874","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":"2024 Evidence-Based Medicine (EBM) Update.","authors":"Thomas I Sherman, Marc Chodos, Naji S Madi, Bryan G Vopat, John Louis-Ugbo, Mark Nazal, Jeannie Huh","doi":"10.1177/10711007251336749","DOIUrl":"10.1177/10711007251336749","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"600-607"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012093","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":"Rate of Subsequent Hallux Interphalangeal Joint Fusion After First Metatarsophalangeal Fusion: A National Database Study with Verified Continued Patient Enrollment.","authors":"Eslam Alkaramany, Solangel Rodriguez-Materon, Amos Z Dai, Nacime S B Mansur, Gregory P Guyton","doi":"10.1177/10711007251328656","DOIUrl":"https://doi.org/10.1177/10711007251328656","url":null,"abstract":"<p><strong>Background: </strong>The risk of symptomatic degeneration at the interphalangeal (IP) joint after arthrodesis of the hallux metatarsophalangeal (MTP) joint remains undetermined and is a common question from patients considering the procedure. This study investigated the rate of subsequent hallux IP joint fusion after first MTP joint arthrodesis.</p><p><strong>Methods: </strong>Patients who underwent hallux MTP joint arthrodesis were identified from a large national commercial insurance database (PearlDiver) by <i>Current Procedural Terminology</i> (<i>CPT</i>) code. Patients who underwent first IP fusion were also identified. To ensure continued enrollment of patients, the subset of patients with verified insurance claims in the database for all of the subsequent 10 years were analyzed. The Kaplan-Meier curve for survivorship free of subsequent IP fusion was generated covering 10 years from the index operation.</p><p><strong>Results: </strong>Of 15,771 patients with MPT joint arthrodesis active on the database to 10 years, 166 had IPJ fusion after MPT joint fusion. The risk of undergoing IP fusion within 10 years after a previous first MTP fusion was 1.052% (95% CI 0.9%-1.1%). The mean time between the 2 procedures was 4.0 years. Because <i>CPT</i> codes in the database were reported without laterality, a small subset of patients may have undergone subsequent contralateral IP fusion. Therefore, this result should be regarded as an upper limit of the estimated rate.</p><p><strong>Conclusion: </strong>The rate of subsequent hallux IP joint fusion of around 1% within 10 years after a first MTP joint fusion in this large database population highlights the durability of the clinical result of first MTP joint fusion and should reassure patients and surgeons considering the procedure.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"46 6","pages":"629-632"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268235","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":"Sometimes the Answers Are Simple.","authors":"Anthony I Riccio","doi":"10.1177/10711007251337685","DOIUrl":"10.1177/10711007251337685","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"598-599"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103424","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 OsteoPeriostic Grafting From the Iliac Crest (TOPIC): Prospective 2-Year Outcomes for Large Lateral Osteochondral Lesions of the Talus.","authors":"Julian J Hollander, Kaj S Emanuel, Jari Dahmen, Gino M M J Kerkhoffs, Sjoerd A S Stufkens","doi":"10.1177/10711007251329033","DOIUrl":"10.1177/10711007251329033","url":null,"abstract":"<p><strong>Background: </strong>The results of the Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) procedure for lateral osteochondral lesions of the talus (OLTs) are unknown. Therefore, the present prospective study aims to assess the numeric rating scale (NRS) of pain during walking at 2-year follow-up. Secondarily, the aim is to assess other clinical, radiologic, and safety outcomes.</p><p><strong>Methods: </strong>This is a single-center, nonrandomized prospective cohort study in which all press-fit lateral TOPIC patients for an OLT are included. Patients with a follow-up of at least 2 years without a concomitant osteochondral lesion of the tibial plafond were included. The primary outcome is the NRS of pain during walking. Secondary clinical outcomes included the NRS during rest and during stair climbing. Additionally, the Foot and Ankle Outcome Score (FAOS), the AOFAS ankle-hindfoot score, and the mental and physical component summary of the 36-Item Short Form Health Survey were recorded. Radiologic follow-up was performed using computed tomography (CT) scans.</p><p><strong>Results: </strong>After application of the inclusion and exclusion criteria, 7 patients were included in the present study. The median age at time of surgery was 31.1 years. The NRS of pain during walking improved from a median of 5 (4-7) preoperatively to 1 (0-1) at 2 years of follow-up (<i>P</i> = .02). All FAOS subscales improved significantly, except the FAOS symptoms subscale. Graft consolidation was observed in 100% of the patients and cysts were present in 5 of 6 patients. No complications occurred and no patients complained of donor site morbidity. No reoperations were performed.</p><p><strong>Conclusion: </strong>In the first 7 prospectively followed patients who underwent the TOPIC procedure for large osteochondral lesions of the lateral talar dome, an improvement of the NRS of pain during walking from median 5 preoperatively to 1 at 2-year follow-up was observed.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"580-586"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028175","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":"Comparative Analysis of Isolated Nitinol Staple Fixation vs Staple Plus Screw Fixation In Midfoot and Hindfoot Arthrodesis.","authors":"Abhinav R Balu, John Dalloul, Peter C Shen, Rachel Bergman, Ryan Filler, Armen S Kelikian, Milap Patel, Anish R Kadakia, Muhammad Y Mutawakkil","doi":"10.1177/10711007251329021","DOIUrl":"10.1177/10711007251329021","url":null,"abstract":"<p><strong>Background: </strong>Nitinol staples are increasingly used in orthopaedic surgery for arthrodesis because of their superelasticity properties, which enable sustained dynamic compression. This study evaluates and compares outcomes of isolated nitinol staple fixation vs staple plus screw fixation in midfoot and hindfoot arthrodesis.</p><p><strong>Methods: </strong>This retrospective study analyzed 101 patients (103 joints) who underwent midfoot or hindfoot arthrodesis over 10 years, with an average follow-up of 2.2 years. Primary outcomes included fusion and revision rates. Patients without postoperative CT scans were excluded from fusion analysis but contributed to complication analysis. A musculoskeletal radiologist evaluated imaging for bony union. Fusion rates between constructs were compared using an omnibus test, followed by Fisher exact test for pairwise comparisons. Analysis of variance assessed demographic differences, with Tukey test for post hoc analysis.</p><p><strong>Results: </strong>Overall joint fusion rates were identical across the staple and staple plus screw constructs (89.1% vs 89.5%, <i>P</i> > .99). There was no significant difference between the constructs in any region of the foot. Staple and screw fixation demonstrated significantly higher joint revision rates compared with staples alone, most often due to symptomatic hardware removal.</p><p><strong>Conclusion: </strong>In our series, nitinol staples used in isolation or alongside static screws resulted in nearly identical fusion rates across the foot. However, the addition of a static screw to a nitinol staple significantly increases the revision surgery rate and may not be recommended in younger, more active patients who may desire future hardware removal.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"622-628"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038898","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}