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":"2025-07-10","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":"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":"2025-07-05","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}

{"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":"2025-07-04","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":"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":"2025-07-03","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":"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":"2025-06-28","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":"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":"2025-06-27","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":"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":"2025-06-25","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":"Prediction of dynamic foot function based on demographic, anthropometric, and clinical foot evaluations","authors":"Felipe H. Palma ,&nbsp;Paula Kozma-Guerra ,&nbsp;Isidora Cañas ,&nbsp;María Ignacia Vial-Muzio ,&nbsp;Nicolás Eltit ,&nbsp;Francisco J. Berral de la Rosa","doi":"10.1016/j.foot.2025.102175","DOIUrl":"10.1016/j.foot.2025.102175","url":null,"abstract":"<div><div>Dynamic foot function plays a crucial role in maintaining stability and efficient locomotion under varying loads. To date, no studies have attempted to predict dynamic foot function using commonly available clinical measurements. This study aimed to develop a predictive model for dynamic foot function based on demographic, anthropometric, and clinical foot assessments. A total of 330 individuals aged ≥ 18 years were evaluated. Clinical variables included demographic data, general health assessments, the Foot Posture Index, and the Foot Health Status Questionnaire. The Center of Pressure Excursion Index (CPEI) served as an indicator of dynamic foot function. Simple linear regressions (p &lt; 0.05) were performed, with CPEI as the dependent variable. Afterwards, a backward stepwise regression identified the best multivariate model for each foot. The mean age of participants was 45.1 ± 18.4 years; 82.1 % were right-foot dominant, and 56.4 % were women. Data from 321 and 323 individuals were analyzed for the dominant and non-dominant foot models, respectively. The two feet exhibited distinct behaviors, with their CPEI influenced by different variables (p &lt; 0.05). Coefficients of determination for the multivariate models were &lt; 14 %, indicating limited clinical applicability of the current model in their present form and highlighting the need to refine predictions with additional functional and biomechanical measures in future research.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"63 ","pages":"Article 102175"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320978","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":"Increased Achilles tendon force required to achieve heel-lift in cadaveric model of midfoot instability - A cadaveric study","authors":"Kenneth Kai Wei Saw ,&nbsp;Ziki Gurney ,&nbsp;Natasha Noel-Barker ,&nbsp;Leia Boote ,&nbsp;Chandra Pasapula ,&nbsp;Alan R. Norrish","doi":"10.1016/j.foot.2025.102174","DOIUrl":"10.1016/j.foot.2025.102174","url":null,"abstract":"<div><div>The progressive ligament instability associated with flatfoot deformity <u>may</u> result in altered foot biomechanics and represent a risk factor for the development of Achilles Tendinopathy (AT). The aim of this study was to determine whether an increased tendo-Achilles (TA) force was required to generate a set heel lift in a cadaveric flatfoot model. Thirteen fresh (previously frozen) cadavers, with no previous foot pathology and sectioned from the knee were mounted on a testing frame. The frame maintained a dorsiflexed ankle position, to simulate the terminal stance phase of gait, and allowed a constant axial load to be applied through the tibia. The heel was elevated 3 cm by a measured traction force through the TA to a pre-determined laser mark. The flatfoot model was created by sequential sectioning of the medial arch supporting structures, creating progressive midfoot instability and flatfoot deformity, from mild to severe. The force (N) required to generate heel lift was recorded at each stage of the development of the flatfoot. Initially, following Spring ligament and Tibialis Posterior sectioning, the force required to generate heel lift decreased. However, as the flatfoot deformity progressed the force required for heel lift increased. A severe flat foot deformity, characterised by medial ray destabilisation significantly increased the force required to generate a heel lift (5.1 ± 7.2 N, p = 0.02) as did sectioning of the (ii) short and long plantar ligaments (5.5 ± 8.7 N, p = 0.03). Progressive ligament failure associated with acquired flatfoot deformity may be a risk for AT overload due to increased TA force required for heel lift, resulting in TA overload symptoms. The paradoxical decrease in force required to generate heel lift with isolated SL sectioning has not been previously described. This biomechanical study raises the possibility that interventions that support the medial longitudinal arch, such as orthotics, may protect against TA overload.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"63 ","pages":"Article 102174"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196217","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":"Clinical evaluation of orthoplastic limb salvage protocol using anterolateral femoral free flap and kickstand fixation: A retrospective case-control study","authors":"Jingjing Wen ,&nbsp;Zhegang Zhou ,&nbsp;Johnson Boey ,&nbsp;Longbiao Yu ,&nbsp;Abdelhakim Ezzat Marei ,&nbsp;Fanbin Meng ,&nbsp;Yingfeng Xiao ,&nbsp;Hui Zeng ,&nbsp;Shengxiang Wan","doi":"10.1016/j.foot.2025.102176","DOIUrl":"10.1016/j.foot.2025.102176","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the clinical outcome of orthoplastic limb salvage approach for the management of diabetic foot ulcers (DFUs).</div></div><div><h3>Methods</h3><div>Patients with DFUs who received treatment at the Peking University Shenzhen Hospital between January 2019 and June 2024 were analyzed. All patients received standard of care, including surgical wound debridement and revascularization, and were followed up for 6 months. Patients were divided into two different wound closure strategies: anterolateral thigh free flap transfer and Kickstand external fixation (n = 24; ALT group) and regular wound dressing (n = 24; control group).</div></div><div><h3>Results</h3><div>The ALT group exhibited a 50 % faster healing rate compared to the control group (33.7 ± 19.9 days versus 69.29 ± 23.5 days; P &lt; 0.001). The flap success rate was 91.7 %, with two instances of flap necrosis (8.3 %) necessitating revision. The mean 6-month AOFAS score in the limb salvage group (90.8 ± 6.2) was significantly greater than that of the control group (85.8 ± 7.7; P = 0.017). No reports of hardware infection were noted.</div></div><div><h3>Conclusion</h3><div>The orthoplastic limb salvage approach integrates concepts from both orthopedic and plastic surgery. The incorporation of Kickstand fixation techniques mitigates flap complications and expedites wound healing. Consequently, patients experience improved quality of life, which enable them to return to their daily activities more quickly.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"63 ","pages":"Article 102176"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314570","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}