Q2 Health Professions

Foot

Pub Date : 2025-09-26 DOI: 10.1016/j.foot.2025.102207

Harald Böhm , Jakob Ender , Andreas Brand , Frank Braatz , Ferdinand Wagner

Background

The heel rise test (HRT) is widely used to evaluate triceps surae strength and to detect posterior tibial tendon dysfunction, a key factor in flatfoot pathology. In children with flexible flatfoot, the presence or absence of heel inversion during push-off is an important clinical sign that distinguishes muscularly compensated from decompensated feet. Identifying decompensated flatfoot is clinically relevant, as it is associated with impaired gait mechanics, reduced plantarflexor performance, and potential balance deficits. This study examined whether heel inversion observed during a standardized bilateral HRT can serve as a reliable indicator of decompensated flatfoot during walking.

Methods

We analyzed 358 feet from children and adolescents (aged 7–17) with idiopathic flexible flatfeet. Heel positions during HRT were rated on a five-point scale (-2 to +2), and results were correlated with 3D gait analysis.

Results

Reliability analysis showed high reliability and consistency. A positive HRT (neutral/everted heel) indicated decompensation in 77 % of cases, with 100 % of everted heels decompensated. However, 28 % of feet with negative HRT results (heel inversion) were also decompensated.

Conclusion

The HRT score is a reliable tool for assessing foot function during gait. It correlates with hindfoot-to-tibia inversion and foot kinematics, where lower scores indicate greater eversion, forefoot supination, and abduction. The HRT score provides a simple, quick measure of flatfoot severity.

背景：足跟上升试验（HRT）被广泛用于评估肱三头肌表面强度和检测胫骨后腱功能障碍，这是扁平足病理的关键因素。对于柔性扁平足患儿，蹬蹬时足跟内翻的存在与否是区分肌肉代偿与失代偿足的重要临床标志。鉴别失代偿性扁平足具有临床意义，因为它与步态力学受损、跖屈肌功能降低和潜在的平衡缺陷有关。本研究考察了在标准化双侧HRT中观察到的足跟内翻是否可以作为步行时失代偿扁平足的可靠指标。方法：我们分析了358英尺的儿童和青少年（7-17岁）特发性柔性扁平足。HRT期间脚跟位置按五分制（-2至+2）进行评分，结果与3D步态分析相关。结果：信度分析显示具有较高的信度和一致性。HRT阳性（中性/外翻跟）表明77 %的病例失代偿，100 %的外翻跟失代偿。然而，28% % HRT结果阴性的足部（脚跟内翻）也出现失代偿。结论：HRT评分是评估步态过程中足部功能的可靠工具。它与后脚到胫骨内翻和足部运动学相关，得分越低表明外翻、前脚旋后和外展越大。HRT评分提供了一种简单、快速的测量平足严重程度的方法。

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引用次数: 0

The role of neuroma size in the management of Morton's neuroma 神经瘤大小在莫顿神经瘤治疗中的作用。

Q2 Health Professions

Foot

Pub Date : 2025-09-26 DOI: 10.1016/j.foot.2025.102204

Sonam Vadera , Pip Divall , Maneesh Bhatia

Background

Morton's neuroma is a common forefoot pathology characterised by fibrosis and thickening of the interdigital nerve in the intermetatarsal space. This scoping review aims to systematically map and summarise current evidence regarding the role of neuroma size in diagnosing and managing Morton's neuroma, with particular focus on correlations between symptom severity and treatment outcomes.

Methods

Following the frameworks of Arksey and O’Malley, Levac, and Peters, this scoping review used a comprehensive search strategy to identify relevant studies across multiple databases. A two-stage screening process was conducted independently by two reviewers.

Results

A total of 242 studies were identified, with 34 included for review. Both MRI and ultrasound were found to be effective in detecting neuromas, although definitions and diagnostic criteria varied. Findings on the correlation between neuroma size and symptom severity were mixed; larger neuromas were sometimes, but not consistently, associated with more severe symptoms. Treatment outcomes following steroid injections or surgical excision did not show a clear dependency on neuroma size, with mixed evidence across studies. Corticosteroid injections demonstrated variability in effectiveness based on neuroma size, while surgical outcomes showed no consistent correlation with neuroma size.

Conclusions

Despite the utility of imaging in diagnosing Morton's neuroma, clinical evaluation remains crucial, as neuroma size alone may not reliably predict symptoms or treatment response. Further research with standardised imaging criteria and extended follow-up is essential to better understand the relationship between neuroma size, symptom severity, and treatment outcomes, aiming to enhance treatment precision and efficacy.

背景：莫顿神经瘤是一种常见的前足病理，其特征是跖间隙指间神经的纤维化和增厚。本综述旨在系统地描绘和总结当前关于神经瘤大小在诊断和治疗莫顿神经瘤中的作用的证据，特别关注症状严重程度和治疗结果之间的相关性。方法：遵循Arksey和O'Malley、Levac和Peters的框架，本综述使用综合搜索策略在多个数据库中识别相关研究。两名审稿人独立进行了两阶段的筛选过程。结果：共纳入242项研究，其中34项纳入综述。尽管定义和诊断标准有所不同，但MRI和超声都能有效地检测神经瘤。神经瘤大小与症状严重程度的相关性研究结果不一；较大的神经瘤有时（但不一致）与更严重的症状相关。类固醇注射或手术切除后的治疗结果与神经瘤大小没有明确的依赖关系，各研究的证据不一。皮质类固醇注射显示出基于神经瘤大小的有效性差异，而手术结果显示与神经瘤大小没有一致的相关性。结论：尽管影像学在诊断莫顿神经瘤中的应用，但临床评估仍然至关重要，因为神经瘤的大小本身并不能可靠地预测症状或治疗反应。为了更好地了解神经瘤大小、症状严重程度和治疗结果之间的关系，提高治疗的准确性和疗效，有必要进一步研究标准化的影像学标准和延长随访时间。

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引用次数: 0

A new point for calcaneal pin insertion: A radiographic study measuring bone density on computed tomography 一个新的跟骨钉插入点：用计算机断层扫描测量骨密度的影像学研究

Q2 Health Professions

Foot

Pub Date : 2025-09-18 DOI: 10.1016/j.foot.2025.102206

G. Faria, A. Trockels, I Thomas-Jones, S. Shin, O. Tawfiq, R. Freeman

Introduction

External fixator schanz pins are often sited in the calcaneal mid-portion. This area is shown to have lower bone density than the posterior region. We propose a safer, more rigid site for pin insertion in the posterior fifth of the bone. This is likely to reduce the risk of early pin loosening and is a higher distance from the neurovascular structures. This study aims to evaluate differences in bone density between the traditional point and our proposed posterior point.

Methods

We identified a sample of 46 patients who underwent an ankle computed tomography (CT) scan. We excluded skeletally immature patients and metal artefact on CT. A uniform region-of-interest rectangle to measure Hounsfield Units at the traditional point and posterior calcaneal points was created using software. Data was reviewed separately by three raters. Statistical analysis was performed using the Shapiro-Wilk and Wilcoxon Signed Ranks test.

Results

46 patients of mean age 48 were included. The average bone density at the traditional point was lower at 202 HU (95 % Confidence Interval (CI) 183–222) compared to 335 HU (95 % CI 300–371) at the posterior calcaneal point (p < 0.001). Inter-rate agreement was excellent with average measures intraclass correlation coefficient (ICC) of 0.894 for the AO point and 0.877 for the posterior calcaneal point (both p < 0.001).

Conclusions

Our data demonstrates that the bone density in the posterior fifth of the calcaneus is significantly higher than the traditional insertion point and there is an increased distance to the vital neurovascular structures. Previous research has verified that Hounsfield units as a measure of bone density correlates strongly with screw pull-out strength.

外固定钉常位于跟骨中段。该区域的骨密度低于后区。我们建议在骨后五分之一处选择一个更安全、更坚固的针插入位置。这可能会降低早期针松脱的风险，并且与神经血管结构的距离更远。本研究旨在评估传统点与我们建议的后点之间骨密度的差异。方法选取46例接受踝关节计算机断层扫描（CT）的患者。我们排除了骨骼不成熟的患者和CT上的金属伪影。使用软件创建了一个统一的兴趣区域矩形，用于测量传统点和后跟骨点的霍斯菲尔德单位。数据由三名评分员分别审查。统计分析采用Shapiro-Wilk和Wilcoxon sign rank检验。结果纳入46例患者，平均年龄48岁。传统点的平均骨密度为202 HU(95 %置信区间（CI） 183-222)，低于跟骨后点的335 HU(95 % CI 300-371) （p <； 0.001）。间率一致性极好，AO点的平均测量类内相关系数（ICC）为0.894，跟骨后点的平均测量类内相关系数（ICC）为0.877（均p <； 0.001）。结论我们的数据表明，跟骨后1 / 5骨密度明显高于传统的插入点，并且与重要神经血管结构的距离增加。先前的研究已经证实，Hounsfield单位作为骨密度的测量与螺钉拔出强度密切相关。

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引用次数: 0

Biomechanical evaluation of sanders type IIB calcaneal fractures: A cadaveric analysis of fixation strategies sanders IIB型跟骨骨折的生物力学评价：固定策略的尸体分析

Q2 Health Professions

Foot

Pub Date : 2025-09-17 DOI: 10.1016/j.foot.2025.102205

Stephanie Potten , Zhikai Li , Emma Cohen , Cecilia Brassett , Mohammad Abrar , Alan Norrish , Tom Dymond , Chandra Pasapula

Introduction

Calcaneal fractures present significant treatment challenges due to their complex anatomy and load-bearing function. Increasingly, minimally invasive techniques are used in treatment. This study evaluates the biomechanical performance of 3 different fixation methods using embalmed cadaver calcanei subjected to a controlled linear increase in load.

Methods

18 cadaveric calcanei were dissected and a simulated Sanders IIB joint depression calcaneal fracture was created with a saw. The fixation techniques used were: plate and 6.5 mm longitudinal screws, plate alone, and screws alone. Biomechanical testing was conducted using a uniaxial loading machine to assess stability, load transmission, and fragment displacement characteristics.

Results

There was no statistically significant difference in the force/energy to failure between fixation types. Plate fixation did not result in any displacement of the fracture fragments in all specimens tested. Failure of fixation occurred in both screw fixation and plate with screw fixation, predominantly affecting the anterior process.

Conclusions

In this cadaver model, minimally invasive techniques provide similar stability of fracture fixation with uniaxial loading to plate fixation, however further consideration of fixation of the anterior process may be required with minimally invasive techniques.

跟骨骨折由于其复杂的解剖结构和承重功能，给治疗带来了巨大的挑战。微创技术越来越多地用于治疗。本研究评估了三种不同的固定方法，使用经防腐处理的尸体跟骨，在负荷可控的线性增加下，其生物力学性能。方法解剖18具尸体跟骨，用锯子模拟Sanders IIB关节凹陷跟骨骨折。采用的固定技术为：钢板和6.5 mm纵向螺钉，单独钢板和单独螺钉。使用单轴加载机进行生物力学测试，以评估稳定性、载荷传递和碎片位移特性。结果两种固定方式的失效力/能量差异无统计学意义。在所有测试的标本中，钢板固定没有导致骨折碎片的任何移位。螺钉内固定和钢板内固定均发生失败，主要影响前突。结论在该尸体模型中，微创技术提供了与钢板固定类似的单轴载荷骨折固定的稳定性，但可能需要进一步考虑微创技术对前突的固定。

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引用次数: 0

Occupational risk factors for major lower extremity amputation： A retrospective cohort study from a single center 下肢主要截肢的职业危险因素：来自单一中心的回顾性队列研究

Q2 Health Professions

Foot

Pub Date : 2025-08-20 DOI: 10.1016/j.foot.2025.102195

Soma Nakaso , Hyakuzoh Ueda , Chiemi Kaku , Yuki Ideguchi , Aya Miyama , Rei Ogawa

Introduction

Lower-limb amputation (LLA) is associated with a significantly declined quality of life and high mortality rates, highlighting the importance of early intervention. Occupational and environmental factors may contribute to delayed healing of foot ulcers in patients with chronic limb-threatening ischemia (CLTI) or diabetic foot ulcers (DFU). However, few studies have investigated the association between occupation and LLA. In this study, we aimed to elucidate the relationship between occupation and LLA and identify occupational risk factors for the development of preventive and interventional strategies.

Methods

We conducted a retrospective analysis of 83 patients (mean age; 71 ± 12.6 years) who underwent major LLA for leg ulcers at our hospital between January 2019 and June 2024. Data on the longest-held occupation, ankle-brachial index (ABI), and clinical outcomes were collected and analyzed.

Results

Among the 96 amputated limbs, 71 were below-knee amputations (BKA), 22 were above-knee amputations (AKA), and one was hip disarticulation. The mortality rate was 27 % at 1 year and 40 % at 3 years post-amputation. Occupational classification revealed that 24 (44 %) patients had standing occupations, 27 (49 %) had sedentary occupations, and 16 (18 %) were unemployed. No significant occupational differences were observed in the incidence of arteriosclerosis obliterans. No significant differences were observed between occupational groups regarding the presence of osteomyelitis or ABI values.

Conclusion

This study focused on the occupational background of patients who underwent LLA, particularly on the relative risks of standing and sedentary occupations. Large-scale epidemiological research is warranted to refine occupation-specific risk assessments, improve workplace conditions, and develop preventive strategies.

下肢截肢（LLA）与生活质量显著下降和高死亡率相关，突出了早期干预的重要性。职业和环境因素可能导致慢性肢体威胁性缺血（CLTI）或糖尿病足溃疡（DFU）患者足溃疡愈合延迟。然而，很少有研究调查职业与LLA之间的关系。在本研究中，我们旨在阐明职业与LLA之间的关系，并识别职业风险因素，以制定预防和干预策略。方法回顾性分析2019年1月至2024年6月在我院因腿部溃疡行重大LLA治疗的83例患者（平均年龄：71 ± 12.6岁）。收集并分析了最长职业、踝肱指数（ABI）和临床结果的数据。结果96例截肢中，膝下截肢71例，膝上截肢22例，髋部骨折1例。截肢后1年死亡率为27. %，3年死亡率为40. %。职业分类显示，站立性职业24例（44 %），久坐性职业27例（49 %），无业16例（18 %）。动脉硬化闭塞症的发生率无明显职业差异。在骨髓炎或ABI值方面，职业组之间没有观察到显著差异。结论本研究关注的是LLA患者的职业背景，特别是站立和久坐职业的相对风险。有必要进行大规模流行病学研究，以完善特定职业的风险评估，改善工作场所条件，并制定预防策略。

{"title":"Occupational risk factors for major lower extremity amputation： A retrospective cohort study from a single center","authors":"Soma Nakaso , Hyakuzoh Ueda , Chiemi Kaku , Yuki Ideguchi , Aya Miyama , Rei Ogawa","doi":"10.1016/j.foot.2025.102195","DOIUrl":"10.1016/j.foot.2025.102195","url":null,"abstract":"<div><h3>Introduction</h3><div>Lower-limb amputation (LLA) is associated with a significantly declined quality of life and high mortality rates, highlighting the importance of early intervention. Occupational and environmental factors may contribute to delayed healing of foot ulcers in patients with chronic limb-threatening ischemia (CLTI) or diabetic foot ulcers (DFU). However, few studies have investigated the association between occupation and LLA. In this study, we aimed to elucidate the relationship between occupation and LLA and identify occupational risk factors for the development of preventive and interventional strategies.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 83 patients (mean age; 71 ± 12.6 years) who underwent major LLA for leg ulcers at our hospital between January 2019 and June 2024. Data on the longest-held occupation, ankle-brachial index (ABI), and clinical outcomes were collected and analyzed.</div></div><div><h3>Results</h3><div>Among the 96 amputated limbs, 71 were below-knee amputations (BKA), 22 were above-knee amputations (AKA), and one was hip disarticulation. The mortality rate was 27 % at 1 year and 40 % at 3 years post-amputation. Occupational classification revealed that 24 (44 %) patients had standing occupations, 27 (49 %) had sedentary occupations, and 16 (18 %) were unemployed. No significant occupational differences were observed in the incidence of arteriosclerosis obliterans. No significant differences were observed between occupational groups regarding the presence of osteomyelitis or ABI values.</div></div><div><h3>Conclusion</h3><div>This study focused on the occupational background of patients who underwent LLA, particularly on the relative risks of standing and sedentary occupations. Large-scale epidemiological research is warranted to refine occupation-specific risk assessments, improve workplace conditions, and develop preventive strategies.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"65 ","pages":"Article 102195"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865649","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

Syndesmotic reduction: What technique is most accurate? 联合复位：什么技术最准确？

Q2 Health Professions

Foot

Pub Date : 2025-08-13 DOI: 10.1016/j.foot.2025.102191

Calvin J. Rushing

The purpose of the present study was to assess the reliability of three syndesmotic reduction methods (Indirect clamp reduction, direct reduction with palpation of the incisura congruence, direct reduction with articular surface visualization) across various syndesmotic injury conditions (ventral disruption; AITFL, 2-ligament injury; AITFL/IOL, and 3-ligament injury; AITFL/IOL/PITFL) in an in-vitro model. It was hypothesized that indirect clamp reduction would be the least reliable method, with a higher mal-reduction rate. A cadaveric model of syndesmotic injury in eight through the knee specimens was employed. Sagittal plane translation following reduction was recorded using a digital caliper. Malreduction was defined as a difference of > 2 mm from the intact condition. Overall, direct reduction with articular surface visualization was the most accurate method, irrespective of the injury state across all specimens (p > 0.01). Direct reduction with palpation of the incisura was reliable for 2 and 3-ligament injury conditions (p = 0.518); while indirect clamp reduction was least reliable (p = 585). As the injury condition progressed, the incidence of malreduction increased for direct palpation, and clamp reduction. No malreductions were recorded using direct visualization of the articular surface. In the present cadaveric model, indirect clamp reduction was the least reliable method for syndesmotic realignment, with the highest incidence of malreduction. Surgeons should be cognizant of the inherent subjectivity, and limited reliability of the historically popularized clamp reduction method.

Level of Evidence

Level V, cadaveric

本研究的目的是在体外模型中评估三种韧带联合复位方法（间接钳位复位、触诊切牙一致性直接复位、关节面可视化直接复位）在各种韧带联合损伤情况（腹侧断裂、AITFL、2韧带损伤、AITFL/IOL、3韧带损伤、AITFL/IOL/PITFL）下的可靠性。假设间接钳位复位是最不可靠的方法，有较高的误复位率。采用8个膝关节标本的骨联合损伤尸体模型。复位后矢状面平移用数字卡尺记录。复位不良定义为与完好状态差>； 2 mm。总体而言，无论所有标本的损伤状态如何，直接复位关节面可视化是最准确的方法（p >； 0.01）。触诊切牙直接复位治疗2、3韧带损伤是可靠的（p = 0.518）；而间接钳位复位最不可靠（p = 585）。随着损伤情况的进展，直接触诊和钳位复位不当的发生率增加。直接观察关节面无复位不良记录。在目前的尸体模型中，间接钳位复位是最不可靠的联合复位方法，复位不良的发生率最高。外科医生应该认识到固有的主观性，以及历史上流行的钳复位方法的有限可靠性。证据等级V级，尸体

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引用次数: 0

The relation between the anterior talofibular ligament and the calcaneofibular ligament during range of motion of the ankle: A cadaveric study 距腓骨前韧带和跟腓骨韧带在踝关节活动范围内的关系：一项尸体研究。

Q2 Health Professions

Foot

Pub Date : 2025-07-30 DOI: 10.1016/j.foot.2025.102193

Louis Brepoels , Jan Dauwe , Peter Grechenig , Gloria Hohenberger , Angelika Schwarz , Axel Gänsslen

The aim of the study is to analyze the relationship between the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) by measuring the angle between them in different ankle positions. Understanding these ligament dynamics can aid orthopedic and trauma surgeons in reconstructing the lateral ligament complex in cases of chronic ankle instability (CAI).

Methods

A cadaveric study was conducted using 22 embalmed human left ankles, with soft tissues removed except for the ligament structures. The angle between the ATFL and CFL was measured in five different ankle positions: neutral, dorsiflexion, plantar flexion, supination, and pronation. A goniometer was used for measurements, recorded twice by two independent surgical residents. Statistical analysis, including one-way repeated measures ANOVA, was performed to determine significant differences across positions.

Results

The mean angles measured in the five positions were 107.8° (neutral), 115.4° (dorsiflexion), 112.6° (plantar flexion), 107.9° (supination), and 114.8° (pronation). Although variations were observed, statistical analysis showed no significant differences in the angle across different positions.

Conclusion

This study provides insight into the anatomical relationship between the ATFL and CFL in various ankle positions. The relatively consistent angle suggests that the ligament orientation remains the same, which may have implications for reconstructive surgery and ankle stability assessment. Further research with a larger sample size is recommended to validate these findings and enhance surgical approaches for CAI treatment.

本研究的目的是通过测量距腓骨前韧带（ATFL）与跟腓骨韧带（CFL）在不同踝关节体位下的夹角来分析两者之间的关系。了解这些韧带动力学可以帮助骨科和创伤外科医生在慢性踝关节不稳定（CAI）的情况下重建外侧韧带复合体。方法：对22例经防腐处理的人左踝关节进行尸体研究，除韧带结构外，其余软组织均被切除。在五种不同的踝关节位置测量ATFL和CFL之间的角度：中性、背屈、足底屈、旋后和旋前。测量使用角计，由两名独立外科住院医师记录两次。统计分析包括单因素重复测量方差分析，以确定不同职位之间的显著差异。结果：5个体位测得的平均角度分别为：中性107.8°、背屈115.4°、足底屈112.6°、旋后107.9°、旋前114.8°。虽然观察到差异，但统计分析显示不同位置的角度没有显著差异。结论：本研究揭示了不同踝关节体位下ATFL和CFL的解剖关系。相对一致的角度表明韧带方向保持不变，这可能对重建手术和踝关节稳定性评估有影响。建议进行更大样本量的进一步研究，以验证这些发现，并加强CAI治疗的手术方法。

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引用次数: 0

Discrepancies between plantar pressure devices: Evaluating cross-system reliability for biomechanics, clinical use and predictive modelling 足底压力装置之间的差异：评估生物力学、临床使用和预测模型的跨系统可靠性

Q2 Health Professions

Foot

Pub Date : 2025-07-23 DOI: 10.1016/j.foot.2025.102190

Nachiappan Chockalingam , Claudia Giacomozzi , Aoife Healy , Isabel C.N. Sacco

Plantar pressure measurement systems are widely used to assess foot function and gait, yet discrepancies in sensor design, measurement protocols, and population characteristics can undermine data comparability. This study investigated three platform‑based and two in‑shoe systems to evaluate key parameters such as the contact area, maximum force, force‑time integral, peak pressure, pressure‑time integral, maximum mean pressure and contact time. Fifteen healthy adults walked at a self‑selected pace, providing a total of 360 footprints from the platforms (barefoot) and 1200 footprints from the in‑shoe devices (shod). Each footprint was then divided into hindfoot, midfoot, and forefoot regions. A two‑way repeated‑measures ANOVA (systems × regions) revealed that mean values (MV) and coefficients of variation (CV) frequently differed among devices, indicating limited cross‑system comparability. Moreover, intraclass correlation coefficients for peak pressure ranged between poor (<0.5) and, on rare occasions, moderate (0.5–0.75), further confirming substantial variability. These discrepancies highlight the importance of standardising calibration, data extraction, and analysis protocols, as even devices based on similar resistive or capacitive technologies can produce dissimilar outcomes. Environmental factors such as footwear selection and lab‑based “targeting” errors also contribute to inconsistencies. These challenges are especially relevant as emerging technologies integrate high-resolution wearable sensors with artificial intelligence to support real-time clinical decision-making, disease prediction and personalised interventions. Establishing uniform reporting and validation standards will be essential to ensure robustness and comparability in both traditional biomechanical studies and future AI-driven applications.

足底压力测量系统被广泛用于评估足部功能和步态，然而传感器设计、测量方案和人群特征的差异会破坏数据的可比性。该研究调查了三种基于平台和两种鞋内系统，以评估接触面积、最大力、力-时间积分、峰值压力、压力-时间积分、最大平均压力和接触时间等关键参数。15名健康成年人以自己选择的速度行走，从平台（赤脚）提供360个脚印，从鞋内装置（穿鞋）提供1200个脚印。然后将每个足迹分为后足、中足和前足区域。双向重复测量方差分析（系统×区域）显示，设备之间的平均值（MV）和变异系数（CV）经常不同，表明有限的跨系统可比性。此外，峰值压力的类内相关系数介于差（<0.5）和少数情况下的中等（0.5 - 0.75）之间，进一步证实了实质性的变异性。这些差异突出了标准化校准、数据提取和分析协议的重要性，因为即使是基于类似电阻或电容技术的设备也可能产生不同的结果。环境因素，如鞋类选择和基于实验室的“目标”错误也会导致不一致。随着新兴技术将高分辨率可穿戴传感器与人工智能相结合，以支持实时临床决策、疾病预测和个性化干预，这些挑战尤为重要。建立统一的报告和验证标准对于确保传统生物力学研究和未来人工智能驱动应用的稳健性和可比性至关重要。

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引用次数: 0

Splints versus external fixation in ankle fracture dislocations: A systematic review and meta-analysis 夹板与外固定治疗踝关节骨折脱位：系统回顾和荟萃分析

Q2 Health Professions

Foot

Pub Date : 2025-07-23 DOI: 10.1016/j.foot.2025.102194

Kyle P. O’Connor , Troy B. Puga , Mason Poffenbarger , John T. Riehl

Introduction

Ankle fracture-dislocations represent an injury pattern with potential for ongoing damage to soft tissues and bone if not managed appropriately and often require temporizing measures with a splint (S) or external fixation (EF) before definitive fixation. This review aims to compare the outcomes of splinting versus external fixation in ankle fracture-dislocations using existing literature.

Methods

A search was conducted across several databases (PubMed, Ovid Medline, Embase, SCOPUS, Cochrane Review, and clinicaltrials.gov). Studies were screened and included if they met eligibility criteria. Demographics and results of the studies were extracted from the articles that met inclusion criteria. Meta-analysis was performed and reported using odds ratios (OR).

Results

This review included six studies comparing S to EF. Cohorts consisted of 547 and 427 patients, respectively. S maintained reduction in 73.1 % and EF maintained reduction in 96.8 %. Complications were reported in 9.5 % (S) and 14.1 % (EF). Meta-analysis determined that external fixation was nine times more likely to maintain reduction (OR: 9.24, p < 0.001). Skin necrosis, wound dehiscence, surgical site infection, and total complications were similar between groups based on meta-analysis results (p > 0.05).

Conclusion

This study demonstrates superiority of external fixation over splinting due to improved maintenance of reduction with an equivalent complication profile. Both external fixation and splinting are viable treatment options, and surgeons should weigh the risks and benefits of each procedure to optimize patient outcomes.

踝关节骨折脱位是一种损伤模式，如果处理不当，可能会对软组织和骨骼造成持续损伤，通常需要在最终固定之前使用夹板(S)或外固定物（EF）进行临时措施。本综述旨在利用现有文献比较夹板和外固定治疗踝关节骨折脱位的疗效。方法在多个数据库（PubMed、Ovid Medline、Embase、SCOPUS、Cochrane Review和clinicaltrials.gov）中进行检索。对符合资格标准的研究进行筛选和纳入。从符合纳入标准的文章中提取研究的人口统计学和结果。采用优势比（OR）进行meta分析并进行报告。结果本综述包括6项比较S和EF的研究。队列分别由547例和427例患者组成。S保持了73.1 %的减少，EF保持了96.8% %的减少。并发症发生率分别为9.5% % (S)和14.1% % （EF）。meta分析确定外固定支架维持复位的可能性是前者的9倍（OR: 9.24, p <； 0.001）。meta分析结果显示，两组间皮肤坏死、伤口裂开、手术部位感染和总并发症相似（p >； 0.05）。结论：该研究证明了外固定优于夹板，因为在相同的并发症情况下，外固定能更好地维持复位。外固定和夹板都是可行的治疗选择，外科医生应该权衡每种手术的风险和收益，以优化患者的预后。

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引用次数: 0

Correlation between functional and structural variables in patients undergoing achilles tendon surgical repair 跟腱手术修复患者功能和结构变量的相关性

Q2 Health Professions

Foot

Pub Date : 2025-07-23 DOI: 10.1016/j.foot.2025.102192

Emmanuel Souza da Rocha , Mariane Bernardi Scheeren , Francesca Chaida Sonda , Gustavo do Nascimento Petter , Marco Aurélio Vaz

Achilles tendon (AT) rupture promotes deficits in the plantar flexors and AT’s structural properties, which have been related to deficits in the ankle joint range of motion (ROM), in the plantar flexors’ ability to produce force and in functionality. The objective of this study was to evaluate possible correlations between the triceps surae’s structural variables with performance in functional tests, and to compare these correlations between the uninjured limb and the limb that underwent AT surgical repair. Both legs from 28 participants (37 ± 5 years) were evaluated after tendon surgical repair. Structural variables included plantar flexors’ cross-sectional area (CSA), muscle thickness (MT) and echo intensity (EI) and AT’s CSA. Functional variables included ankle ROM, maximal isometric plantar flexion torque (at 10° of dorsiflexion) and the single leg hop test (SLHT, single leg triple jump test). Bivariate Pearson and Spearman correlations were performed, and the partial correlation test contained the time after surgical repair as a moderating variable. There was a correlation between medial gastrocnemius CSA and SLHT (r: −0.457 and p: 0.037) in the injured limb, and between medial gastrocnemius MT and torque in the uninjured limb (r: −0.521; p: 0.011). When we added time as a moderating variable, the same correlations were significant. The results of the correlations with and without the moderating variable do not support the above-mentioned causal hypothesis between AT rupture and functional deficits.

跟腱（AT）断裂会导致足底屈肌及其结构特性的缺陷，这与踝关节活动范围（ROM）的缺陷、足底屈肌产生力量的能力和功能的缺陷有关。本研究的目的是评估三头肌结构变量与功能测试表现之间的可能相关性，并比较未受伤肢体和接受AT手术修复肢体之间的相关性。28名参与者（37 ± 5年）的双腿在肌腱手术修复后进行评估。结构变量包括足底屈肌横截面积（CSA）、肌肉厚度（MT）、回声强度（EI）和足底屈肌的CSA。功能变量包括踝关节ROM，最大等距足底屈曲扭矩（10°背屈）和单腿跳测试（SLHT，单腿三级跳测试）。进行双变量Pearson和Spearman相关，偏相关检验包含手术修复后的时间作为调节变量。损伤肢内侧腓肠肌CSA与SLHT （r: - 0.457和p: 0.037）相关，未损伤肢内侧腓肠肌MT与扭矩相关(r: - 0.521；p: 0.011)。当我们增加时间作为调节变量时，同样的相关性是显著的。有或没有调节变量的相关结果不支持上述AT断裂与功能缺陷之间的因果假设。

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引用次数: 0