Foot最新文献

{"title":"Minimally invasive orthopaedic surgery for diabetic foot disease: A systematic review","authors":"Cheng Tong Chuah ,&nbsp;Yousef Hamed ,&nbsp;Gregory AJ Robertson","doi":"10.1016/j.foot.2025.102187","DOIUrl":"10.1016/j.foot.2025.102187","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic foot disease is a common life altering complication of diabetes mellitus that results from a combination of neuropathy, angiopathy, and structural deformities. Minimally invasive orthopaedic surgeries (MIOS) are known to shorten recovery time, reduced length of stay in hospital, reduce wound complications, all of which would benefit diabetic patients. Current evidence-based guidance on the use of minimally invasive orthopaedic surgeries (MIOS) in managing diabetic foot disease is limited.</div></div><div><h3>Aim</h3><div>To systematically review all studies on the use of MIOS in managing diabetic foot disease affecting various anatomical locations, and to compile data on ulcer healing, recurrence, complication rates.</div></div><div><h3>Methods</h3><div>A systematic literature search of Medline (PubMed), Embase, Scopus and Cochrane Library from inception until 31st October 2024, using the keywords ‘diabetes’, ‘diabetic foot’, ‘minimally invasive surgery’, ‘minimally invasive procedure’. Articles were reviewed for demographic details and surgical outcomes. PRISMA guidelines were adhered to and reported.</div></div><div><h3>Results</h3><div>Twenty-nine studies were included in the review: 13 reported on forefoot interventions, 4 on midfoot interventions, 3 on hindfoot interventions, and 9 on lower limb interventions. Forefoot MIOS, such as distal metatarsal osteotomies, phalangeal osteotomies and flexor tenotomies, showed significant improvements in ulcer healing times (mean 1.5–3.7 weeks) and reduced recurrence rates (0–21 %). Midfoot MIOS included Taylor Spatial Frame external fixator with percutaneous arthrodesis, solid bolt fixation and metatarsal ray resection. These interventions demonstrated promising outcomes with minimal complications, particularly in managing Charcot neuroarthropathy. MIOS techniques in hindfoot explored were tibio-talo-calcaneal arthrodesis, vertical contour calcanectomy and combination of subtalar arthroereisis with Achilles tendon lengthening. They showed favourable results in lowering post-operative infections (0–3 %) and raising functional scores (improved American Orthopaedic Foot &amp; Ankle Society scores of 44.8). Lower leg MIOS, including percutaneous Achilles tendon lengthening, showed improved plantar forefoot ulcers healing (30–57.5 days) and lower recurrence rates (0–38 %) compared to total contact cast.</div></div><div><h3>Conclusion</h3><div>MIOS exhibits a promising role in the management of diabetic foot disease and ulcers, especially when paired with rigorous patient selection criteria and preoperative patient optimisation through a multidisciplinary team approach.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"64 ","pages":"Article 102187"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672430","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":"Concomitant lisfranc injuries in the setting of ankle fractures: A case series","authors":"Emily M. Shipman ,&nbsp;Katelyn A. Cole ,&nbsp;Natalie R. Black ,&nbsp;Jie Chen","doi":"10.1016/j.foot.2025.102179","DOIUrl":"10.1016/j.foot.2025.102179","url":null,"abstract":"<div><div>Lisfranc injuries are rare and commonly misdiagnosed, which can lead to severe complications. This paper presents patients with concomitant Lisfranc injuries and ankle fractures. We report 3 cases. Case 1 is a 14-year-old girl with trimalleolar fractures and Lisfranc dislocation who achieved a full recovery. Case 2 is a 55-year-old woman with complex Lisfranc and ankle fractures, where delayed intervention resulted in persistent instability and pain. Case 3 is a 62-year-old woman with a previously missed Lisfranc injury with an ankle fracture that was fixed with full recovery after correct diagnosis. The purpose of this study is to illustrate the necessity of monitoring for Lisfranc injuries in the setting of ankle fractures to prevent misdiagnosis and long-term complications.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"64 ","pages":"Article 102179"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489545","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 foot drop after gastrocsoleus lengthening in children with unilateral and bilateral cerebral palsy","authors":"Leonie P. Bartsch ,&nbsp;Axel Horsch ,&nbsp;Marco Götze ,&nbsp;Lara Petzinger ,&nbsp;Sebastian I. Wolf,&nbsp;Cornelia M. Putz","doi":"10.1016/j.foot.2025.102188","DOIUrl":"10.1016/j.foot.2025.102188","url":null,"abstract":"<div><h3>Background</h3><div>Equinus foot is a frequent deformity in children with cerebral palsy (CP). After calf-muscle lengthening surgery, foot drop is frequent and seems to occur mainly in unilateral CP cases. It remains unclear if this complication can be prevented with same-procedure transfer or shortening of dorsiflexor tendons.</div></div><div><h3>Methods</h3><div>Retrospective analysis of 167 ambulant children with unilateral and bilateral CP, GMFCS levels I to III, who received surgical calf-muscle lengthening. Pre- and postoperative 3D instrumented gait analysis and clinical examination data were reviewed.</div></div><div><h3>Results</h3><div>Stance and swing phase dorsiflexion improved in both groups. Postoperative mean swing phase dorsiflexion was significantly lower in unilaterally affected than in bilaterally affected children (median −6° vs. +1°, <em>P</em> &lt; .001). The incidence of postoperative foot drop in unilaterally and bilaterally affected patients was 50 % and 16 %, respectively, with a significant group difference (<em>P</em> &lt; .001). Tendon transfers did not lead to a lower rate of postoperative foot drop, but were performed in children with more severe preoperative findings.</div></div><div><h3>Conclusion</h3><div>Children with unilateral CP are at a higher risk of postoperative foot drop after calf muscle lengthening than the bilaterally affected. Although the range of motion improved postoperatively, tendon transfers did not improve active dorsiflexion in children with unilateral CP and could thus not prevent foot drop effectively. Due to these findings, prospective research with preoperative assessment of tendon-muscle function is needed in this field.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"64 ","pages":"Article 102188"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513740","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":"Concentrated bone marrow aspirate applications in bony fusion for foot and ankle orthopaedic surgery: A review","authors":"Albert T. Anastasio ,&nbsp;Lindsey G. Droz ,&nbsp;Brenden D. Pearce ,&nbsp;Samuel B. Adams","doi":"10.1016/j.foot.2025.102162","DOIUrl":"10.1016/j.foot.2025.102162","url":null,"abstract":"<div><div>There is an emerging role for orthobiologic adjuncts including concentrated bone marrow aspirate (CBMA) for the treatment of bony pathology of the foot and ankle. Animal studies and basic science investigations have provided the framework for the theoretical benefit of CBMA in augmenting bone healing. There is moderate to high level evidence to support the use of CBMA injectate for the non-operative treatment of delayed or non-union of bony fracture, possibly decreasing the need for surgical fixation and open fracture site augmentation, especially in high-risk patients. Additionally, direct application of CBMA or use of CBMA in conjunction with autograft, allograft, or bioceramics has shown promise in enhancing bony union in revision surgery for nonunion. Individual studies have indicated that CMBA could augment the rate of union for arthrodesis procedures of the foot and ankle, but systematic reviews have called this finding into question. Osteochondral lesions of the talus (OLT) may benefit little from CBMA; although initial accelerated healing of OLTs may occur, ultimate fibrocartilaginous repair may predominate. CBMA exhibits significant potential in the treatment of bony foot and ankle pathology, but additional high-quality, randomized controlled trials are needed to justify the cost burden and potential donor site morbidity associated with CBMA harvest.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"64 ","pages":"Article 102162"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656887","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":"Discrepancies between plantar pressure devices: Evaluating cross-system reliability for biomechanics, clinical use and predictive modelling","authors":"Nachiappan Chockalingam ,&nbsp;Claudia Giacomozzi ,&nbsp;Aoife Healy ,&nbsp;Isabel C.N. Sacco","doi":"10.1016/j.foot.2025.102190","DOIUrl":"10.1016/j.foot.2025.102190","url":null,"abstract":"<div><div>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 (&lt;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.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"64 ","pages":"Article 102190"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722985","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":"Patient and treatment related factors associated with prolonged opioid use following foot and ankle surgery: A scoping review","authors":"Ibrahim Inzarul Haq ,&nbsp;Zaki Arshad ,&nbsp;Mohamed Elshial ,&nbsp;Parmjeet Chattha ,&nbsp;Ryan McWilliams ,&nbsp;Maneesh Bhatia","doi":"10.1016/j.foot.2025.102178","DOIUrl":"10.1016/j.foot.2025.102178","url":null,"abstract":"<div><h3>Background</h3><div>The need for adequate analgesia postoperatively must be balanced against the risks of excessive or prolonged opioid use. This scoping review aims to identify the most common risk factors for prolonged or increased opioid use following foot and ankle surgery.</div></div><div><h3>Methods</h3><div>A scoping review was performed according to the PRISMA guidelines. An electronic literature search was performed in PubMed, Web of Science, Embase and CINAHL. Two reviewers independently performed title/abstract and full-text screening. English language articles describing preoperative patient or treatment related factors associated with an increased risk of prolonged opioid use or increased long-term opioid dosage were included.</div></div><div><h3>Results</h3><div>A total of 17 studies describing 223,532 patients undergoing foot and ankle surgery were included. The most commonly reported factors associated with a higher risk of prolonged or increased use of opioids were: preoperative opioid use (13 studies), mental health disorders (9 studies), tobacco use (7 studies), chronic pain disorders (7 studies), female sex (7 studies), older age (5 studies) and diabetes (4 studies). A similar distribution of risk factors was found in studies using multivariate statistical techniques to identify independent risk factors specifically.</div></div><div><h3>Conclusions</h3><div>Preoperative opioid use, mental health disorders, tobacco use, chronic pain disorders, female sex and older age are the most frequently reported risk factors for increased opioid use following foot and ankle surgery. These factors can be used to guide clinical decision making with regards to surgical selection criteria and in the development of targeted interventions aimed at reducing unnecessary or excessive opioid use.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"64 ","pages":"Article 102178"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536214","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":"Splints versus external fixation in ankle fracture dislocations: A systematic review and meta-analysis","authors":"Kyle P. O’Connor ,&nbsp;Troy B. Puga ,&nbsp;Mason Poffenbarger ,&nbsp;John T. Riehl","doi":"10.1016/j.foot.2025.102194","DOIUrl":"10.1016/j.foot.2025.102194","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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 &lt; 0.001). Skin necrosis, wound dehiscence, surgical site infection, and total complications were similar between groups based on meta-analysis results (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"64 ","pages":"Article 102194"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714347","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":"Correlation between functional and structural variables in patients undergoing achilles tendon surgical repair","authors":"Emmanuel Souza da Rocha ,&nbsp;Mariane Bernardi Scheeren ,&nbsp;Francesca Chaida Sonda ,&nbsp;Gustavo do Nascimento Petter ,&nbsp;Marco Aurélio Vaz","doi":"10.1016/j.foot.2025.102192","DOIUrl":"10.1016/j.foot.2025.102192","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"64 ","pages":"Article 102192"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144748724","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":"Treatment of Juvenile Hallux Valgus with a Simple, Effective, Rapid, and Inexpensive (SERI) technique: A systematic review and meta-analysis","authors":"Stephanie Fontyn ,&nbsp;Raheef Alatassi ,&nbsp;Lee R. Benaroch ,&nbsp;Ali Ahmadi Pirshahid ,&nbsp;Debra Bartley ,&nbsp;Timothy Carey ,&nbsp;Christopher Del Balso ,&nbsp;Patrick Thornley","doi":"10.1016/j.foot.2025.102189","DOIUrl":"10.1016/j.foot.2025.102189","url":null,"abstract":"<div><div>Juvenile hallux valgus presents pediatric challenges ranging from cosmetic to functional issues, with multiple surgical management strategies reported. The simple, effective, rapid, and inexpensive (SERI) technique has gained attention for its potential to offer effective correction with minimal complications. Its effectiveness in younger patients is still uncertain. This systematic review and meta-analysis evaluates the outcomes of SERI in treating Juvenile hallux valgus. Medline, Embase, Cochrane CENTRAL, CINAHL Complete, and SPORTDiscus databases were searched from inception to April 5, 2024, for studies on SERI outcomes in JHV. Following the PRISMA/R-AMSTAR guidelines and Cochrane Handbook for Systematic Reviews of Interventions, studies were screened, and data were collected on demographics, radiographic measurements, patient-reported outcomes, and complications. A meta-analysis using random-effects models to estimate study weights was performed. Five studies comprising 153 patients (208 feet) treated with SERI met inclusion criteria. Mean age was 14.6 (±4.3) years; with 80 % female patients and a mean follow-up of 43 months. Postoperative mean hallux valgus angle improved from 26.1° (±4.8) to 10.5°(±3.5), intermetatarsal angle from 14.2° (±0.6) to 6.8 (±1.7), and distal metatarsal articular angle from 12.4° (±5.9) to 4.9° (±3.1). The American Orthopedic Foot &amp; Ankle Society (AOFAS) scores achieved the minimal clinically important difference in all studies. Minor complications were documented without significant long-term effects. The SERI technique appears effective and safe for treating juvenile hallux valgus, leading to significant improvements in radiographic measurements and patient outcomes.</div></div><div><h3>Level of Clinical Evidence</h3><div>Level 3</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"64 ","pages":"Article 102189"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536215","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":"Comparison of the measurement of the calcaneal X/Y ratio on plain radiograph and CT scan","authors":"Hesham Oshba ,&nbsp;Kate Nicholls ,&nbsp;Neeraj Purohit ,&nbsp;Raghda Shaaban ,&nbsp;Togay Koç","doi":"10.1016/j.foot.2025.102186","DOIUrl":"10.1016/j.foot.2025.102186","url":null,"abstract":"<div><h3>Background</h3><div>Tourne et al. introduced the calcaneal X/Y ratio measured on standing radiographs to describe the “overlong” calcaneal morphology in the assessment of Haglund’s syndrome, concluding that a ratio less than 2.5 can predispose to heel pain. Our study aimed to evaluate the reliability of X/Y ratio measurement on the plain radiographs reflecting the morphology of the calcaneum. This was achieved by comparing the X/Y ratio on X-rays and CT scans.</div></div><div><h3>Methods</h3><div>A cross-sectional observational study was conducted on 50 patients. Two assessors (one foot and ankle fellow and one registrar) were trained by a specialist Musculoskeletal Radiologist and fellowship-trained Orthopaedic Foot &amp; Ankle Surgeon to measure the X/Y ratio on both plain radiographs and CT scans. The CT images on the sagittal cuts were adjusted to run parallel to the calcaneum's long axis at its centre to reflect the true morphological length of the calcaneum. For each assessor, the intra-observer agreement between X-ray and CT measurements of the X/Y ratio was assessed. The inter-observer agreement between the two assessors was evaluated for each modality (X-ray and CT).</div></div><div><h3>Results</h3><div>The mean X/Y ratio measured by both assessors was lower on X-ray (2.71 ± 0.43, 2.69 ± 0.41) than on CT (3.14 ± 0.44, 3.10 ± 0.44). The intra-observer agreement between X-ray and CT scan measurements of the X/Y ratio was poor for both assessors (ICC =.487,.476). Inter-observer reliability was good on X-ray and excellent on CT (ICC =.808,.956).</div></div><div><h3>Conclusions</h3><div>The X/Y ratio assessment on plain radiograph remains the only clinically correlated method of measuring the ratio however, it doesn’t necessarily reflect the true calcaneal morphology. The published association between Haglund's Syndrome and an X/Y ratio of 2.5 requires further research using advanced cross-sectional imaging techniques with clinical correlation. This is a Level III diagnostic study.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"64 ","pages":"Article 102186"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581021","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}