Foot and Ankle Surgery最新文献

英文中文

Letter to the editor to comment on “Endoscopic flexor hallucis longus transfer for acute Achilles tendon ruptures is associated with a high re-rupture rate: A prospective case series” 致编辑评论“内窥镜下拇长屈肌转移治疗急性跟腱断裂与高再断裂率相关：一个前瞻性病例系列”。

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery

Pub Date : 2025-09-09 DOI: 10.1016/j.fas.2025.07.008

Nicola Maffulli, Filippo Spiezia

引用次数: 0

Response to the letter to the editor to comment on “Endoscopic flexor hallucis longus transfer for acute Achilles tendon ruptures is associated with a high re-rupture rate: A prospective case series” 回复编辑对“内窥镜下幻长屈肌转移治疗急性跟腱断裂与高再断裂率相关：前瞻性病例系列”的评论。

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery

Pub Date : 2025-09-06 DOI: 10.1016/j.fas.2025.09.002

Tiago Baumfeld, Victor Barbosa

引用次数: 0

Assessing the medial distal tibial angle based on a long ankle view radiograph – Reliability of and differences between three approaches 基于长踝位x线片评估胫骨内侧远端角度-三种入路的可靠性和差异。

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery

Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2025.02.010

Flavia A. Miesch , Werner Vach , Isabella Zbinden , Markus Knupp

Background

Lower limb alignment on plain radiographs is commonly examined in orthopedics. Measurement of the medial distal tibial angle (MDTA) requires determining the tibial axis. Traditionally, in orthopedic practice, anatomical or surgical axes have been used. Due to the increasing availability of stitching tools, assessing the mechanical axis of the tibia in a lower leg mortise view radiograph has arisen as a third option. This study evaluated the reliability of three approaches to determine the MDTA on whole lower leg radiographs and the magnitude of the disparities between the approaches.

Methods

Thirty-eight patients were assessed on weightbearing, anteroposterior radiographs. The images included an anterior-posterior image (‘mortise view’) of the ankle joint, including the entire tibia. The radiographs were captured twice in each patient to analyze the reliability of the technique. The MDTA was measured according to the three approaches by two independent examiners.

Results

The mean absolute difference between MDTAs across two images was 0.8° for the anatomical axis and 0.74° for the mechanical. It was distinctly larger for the surgical axis with 1°. The MDTA differed by more than 2° between the anatomical and mechanical axes in 22 % of the patients and between the mechanical and the surgical axis in 10 % of the patients.

Conclusion

Weightbearing, lower leg mortise view radiographs centered on the proximal tibia and ankle joint provide reproducible values for the MDTA based on the mechanical axis. This approach should be preferred over the anatomical axis in future. The tibial tuberosity should not be used as a reference to determine the MDTA. The choice of the axis can lead to differences in the MDTA of clinically relevant magnitude.

Level of evidence

Level II, Prospective Cohort Study.

背景：下肢x线平片是骨科中常用的检查方法。测量胫骨内侧远端角（MDTA）需要确定胫骨轴。传统上，在骨科实践中，解剖或手术轴已被使用。由于缝合工具的可用性越来越高，在下肢榫眼x线片中评估胫骨的机械轴已成为第三种选择。本研究评估了三种入路的可靠性，以确定全下肢x线片上的MDTA，以及不同入路之间的差异程度。方法：对38例患者进行负重、正位x线片检查。图像包括踝关节的前后图像（“榫卯视图”），包括整个胫骨。每位患者的x线片拍摄两次，以分析该技术的可靠性。MDTA由两名独立检查员根据这三种方法进行测量。结果：两幅图像的mdta在解剖轴上的平均绝对差为0.8°，在机械轴上的平均绝对差为0.74°。手术轴为1°时明显更大。在22 %的患者中，解剖轴和机械轴之间的MDTA差异大于2°，在10 %的患者中，机械轴和手术轴之间的MDTA差异大于2°。结论：以胫骨近端和踝关节为中心的负重、下肢透视片为基于机械轴的MDTA提供了可重复的价值。今后应优先采用这种入路而不是解剖轴入路。胫骨结节不应作为确定MDTA的参考。轴的选择可导致MDTA临床相关量级的差异。证据等级：II级，前瞻性队列研究。

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引用次数: 0

Forefoot morphology change following subtalar arthroereisis for symptomatic flexible flatfoot in children 有症状的儿童屈曲扁平足的距下关节挛缩后前足形态改变。

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery

Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2025.02.007

Kuang-Yu Cheng , Chui-Jia Farn , Chia-Che Lee , Kevin Chun-Kai Chiu , Kuan-Wen Wu , Ken N. Kuo , Ting-Ming Wang

Background

When symptomatic pediatric flexible flatfoot treated with subtalar arthroereisis to improve hindfoot alignment, the postoperative forefoot supinatus can be a concern.

Methods

We retrospectively reviewed 110 patients (220 feet), ages 5–12, who underwent subtalar arthroereisis from January 2017 to December 2019, with at least two years of follow-up. Of these, 22 patients (44 feet) developed forefoot supinatus with metatarsus primus elevatus (MPE). Radiographic evaluations assessed postoperative forefoot supinatus, calcaneus and talus height. Functional outcomes were measured using the modified American Orthopaedic Foot & Ankle Society (AOFAS) Forefoot Score.

Results

Improvements in forefoot supinatus were seen over time, with self-correction typically occurring around 6–7 months post-surgery. Bone growth positively influenced symptom relief, while demographic factors had minimal impact. The modified AOFAS score also improved.

Conclusion

Forefoot supinatus and MPE following subtalar arthroereisis tend to self-correct over several months, aligning with pediatric foot bone growth.

Level of evidence

III

背景：当有症状的儿童柔性扁平足用距下关节挛缩术治疗以改善后足对齐时，术后的前足旋后肌是一个值得关注的问题。方法：我们回顾性分析了110例（220英尺），年龄5-12岁，从2017年1月到2019年12月接受距下关节挛缩的患者，随访至少两年。其中22例（44英尺）出现前足旋后肌并跖骨前突（MPE）。影像学评估术后前足旋肌、跟骨和距骨高度。使用改良的美国矫形足踝学会（AOFAS）前足评分测量功能结果。结果：随着时间的推移，前足旋后肌得到了改善，自我矫正通常发生在手术后6-7 个月左右。骨生长对症状缓解有积极影响，而人口因素影响最小。改进后的AOFAS评分也有所提高。结论：距下关节挛缩后的前足旋后肌和MPE在几个月内趋于自我纠正，与儿童足骨生长一致。证据水平：III。

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引用次数: 0

Finite element analysis of biomechanical effects of oversized total talar prosthesis and collateral ligament reconstruction on total talar replacement 超大全距假体及副韧带重建对全距置换术生物力学影响的有限元分析。

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery

Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2025.02.003

Hao Li , Haitao Xie , Yuanqiang Li , Wan Chen , Haiqiong Xie , Xu Cai , Kai Wei

Background

Total talar replacement (TTR) using a personalized customized total talar prosthesis (TTP) is an emerging and promising surgical option for the treatment of ankle problems. However, how to solve ankle instability after total talar replacement, and the influence of related solutions on foot biomechanics has not been investigated.

Methods

Our preliminary studies have found that enlarging a personalized total talar prosthesis (TTP0) by 1.5 % along the coronal axis (TTP-FP1.5) and reconstructing the anterior talofibular ligament (ATFL) significantly can enhance ankle stability. However, there is a lack of insight into the effect of the two options on biomechanics. Consequently, this work constructed anatomically detailed finite element models of the foot, including an intact model and four surgical models, including replacement of TTP0, replacement of TTP-FP1.5, and two models of TTP-coupled ATFL reconstruction. Biomechanical differences were evaluated by numerical simulation of a balanced-standing and three characteristic instants of the stand phase.

Results

Changes in plantar pressure distribution, joint contact pressure and force transmission, von Mises stress on bone, and prosthesis stress were predicted and analyzed. It was found that significant changes in foot biomechanics occurred after TTP-FP1.5 replacement compared to TTP0 replacement. In contrast, no ligament reconstruction versus ATFL reconstruction exerts a minor effect on biomechanics.

Conclusion

The findings indicate that the shape of the prosthesis is the primary factor affecting foot biomechanics after total talar replacement. In contrast, reconstruction of the ATFL has only a minimal effect on the biomechanics of the foot. The above findings will provide a solid basis for the improvement of TTR surgical plans in clinical.

背景：使用个性化定制的全距骨假体（TTP）的全距骨置换（TTR）是治疗踝关节问题的一种新兴且有前途的手术选择。然而，如何解决全距置换术后的踝关节不稳，以及相关解决方案对足部生物力学的影响尚未得到研究。方法：我们的初步研究发现，沿冠状轴（TTP-FP1.5）扩大个性化全距骨假体（TTP0） 1.5 %并重建距腓骨前韧带（ATFL）可显著提高踝关节稳定性。然而，人们对这两种选择对生物力学的影响缺乏深入的了解。因此，本研究构建了解剖学详细的足部有限元模型，包括一个完整的模型和四个手术模型，包括TTP0置换、TTP-FP1.5置换和两个ttp耦合ATFL重建模型。通过平衡站立和站立阶段的三个特征时刻的数值模拟来评估生物力学差异。结果：预测和分析了足底压力分布、关节接触压力和传力、骨von Mises应力和假体应力的变化。与TTP0置换相比，TTP-FP1.5置换后足部生物力学发生了显著变化。相比之下，无韧带重建与ATFL重建对生物力学的影响较小。结论：假体形态是影响全距置换术后足部生物力学性能的主要因素。相比之下，前屈韧带的重建对足部生物力学的影响很小。以上结果将为临床改进TTR手术方案提供坚实的依据。

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引用次数: 0

Clinical outcomes of all-inside arthroscopic lateral ankle ligament reconstruction for chronic lateral ankle instability: A prospective series with minimum 12 month outcomes 全内关节镜下踝关节外侧韧带重建治疗慢性踝关节外侧不稳定的临床结果：一项至少12个月预后的前瞻性研究。

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery

Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2025.02.008

Vikramman Vignaraja , Thomas L. Lewis , Samuel Franklin , Gabriel Ferraz Ferreira , Gustavo Araujo Nunes , Yasser Aljabi , Peter Lam , Robbie Ray

Background

Chronic lateral ankle instability (CAI) is a common condition that can be effectively treated with lateral ankle ligament reconstruction to restore ankle stability and function. The aim was to assess the functional outcomes of arthroscopic lateral ligament reconstruction using the Manchester-Oxford Foot Questionnaire (MOXFQ), Visual Analog Score (VAS) and Euroqol-5D-5L (EQ-5D) patient-reported outcome measures (PROMs).

Methods

This prospective series included 36 consecutive patients who underwent isolated arthroscopic lateral ligament reconstruction for CAI between November 2020 and November 2022 with minimum 12-month follow up. All patients completed the MOXFQ, VAS, and EQ5D PROMs preoperatively, and a minimum of 12 months postoperatively. The MOXFQ is a foot and ankle-specific PROM that assesses foot and ankle function, the VAS measures pain and the EQ5D evaluates general health-related quality of life.

Results

Patients were followed up for 12–25 months. In all patients, there was significant improvement in all postoperative PROMs (p < 0.05). The MOXFQ index decreased from 59.1 ± 19.2–13.5 ± 18.1 (p < 0.01), EQ-5D index increased from 0.607 ± 0.224–0.854 ± 0.175 (p < 0.01) and VAS pain decreased from 36.6 ± 22.3–13.6 ± 18.4 (p < 0.01).A total of 6 patients(16.3 %) were lost to follow up and mean follow-up time was 1.63 ± 0.54 years.

Conclusion

Arthroscopic lateral ankle ligament reconstruction is an effective treatment for chronic ankle instability, with significant improvements in clinical and health-related quality of life outcomes.

Level of evidence

背景：慢性外侧踝关节不稳定（CAI）是一种常见病，通过外侧踝关节韧带重建术可有效治疗，恢复踝关节的稳定性和功能。本研究旨在使用曼彻斯特-牛津足部问卷（MOXFQ）、视觉模拟评分（VAS）和Euroqol-5D-5L（EQ-5D）患者报告结果指标（PROMs）评估关节镜下外侧韧带重建术的功能结果：该前瞻性系列研究包括在 2020 年 11 月至 2022 年 11 月期间接受孤立关节镜外侧韧带重建术治疗 CAI 的 36 例连续患者，随访至少 12 个月。所有患者均在术前和术后至少 12 个月完成了 MOXFQ、VAS 和 EQ5D PROMs。MOXFQ是一种评估足踝功能的足踝专用PROM，VAS测量疼痛，EQ5D评估一般健康相关生活质量：对患者进行了 12-25 个月的随访。结果：对患者进行了 12-25 个月的随访，所有患者的术后 PROM 均有明显改善（P关节镜下外侧踝关节韧带重建术是治疗慢性踝关节不稳的有效方法，可显著改善临床和与健康相关的生活质量：证据级别：IV。

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引用次数: 0

Minimally invasive surgical techniques compared to an extensile lateral approach in the management of displaced intra-articular calcaneal fractures. A systematic review and meta-analysis of randomised controlled trials 微创手术技术与伸展外侧入路在治疗移位的跟骨关节内骨折中的比较。随机对照试验的系统回顾和荟萃分析。

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery

Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2025.02.012

Scott D. Purdie , Niamh Hoskins , Regina Jesslyn Sumarlie , Natthaya Eiamampai , Paul Lebeslé , Fergus Wood , Anagha Chinmayee , Wei Qi Lim , Sriskandarasa Senthilkumaran , Louise Fisher , Santosh Baliga

Background

Developments in minimally invasive surgical techniques (MIS) have sparked debate over the optimal intervention for calcaneal fractures. This meta-analysis compares the extensile lateral approach (ELA) to two MIS techniques; the sinus tarsi approach and percutaneous approaches.

Methods

A systematic search was conducted across seven databases for randomised control trials (RCTs). The clinical outcomes were wound complications, functional scores (American Orthopaedic Foot & Ankle Society score, and Maryland Foot Score) and radiological measures (Böhler’s and Gissane’s angles).

Results

Fourteen RCTs (n = 1367; mean age: 36.3 years; 25.7 % female) were included. MIS significantly reduced wound complications compared to ELA (RR 6.48, 95 %CI 4.03–10.41, p < 0.00001, n = 1380, GRADE: High). Functional scores favoured MIS, and radiological outcomes were equivalent.

Conclusions

Both MIS techniques reduce wound complications, improve functional outcomes, and achieve comparable anatomical reduction, making them suitable alternatives to the extensile lateral approach, to significantly improve patient’s outcomes.

Level of Evidence

Level 1

背景：微创手术技术（MIS）的发展引发了对跟骨骨折最佳干预措施的争论。本荟萃分析比较了可伸展侧入路（ELA）和两种MIS技术；鼻窦入路和经皮入路。方法：对7个随机对照试验（rct）数据库进行系统检索。临床结果包括伤口并发症、功能评分（美国骨科足踝协会评分和马里兰足部评分）和放射学测量（Böhler's和Gissane's角）。结果：14项随机对照试验(n = 1367；平均年龄36.3岁；25.7 %女性)。与ELA相比，MIS明显减少了伤口并发症（RR 6.48, 95 %CI 4.03-10.41, p ）结论：两种MIS技术都减少了伤口并发症，改善了功能预后，并实现了相当的解剖复位，使其成为可伸展外侧入路的合适选择，显著改善了患者的预后。证据等级：一级。

{"title":"Minimally invasive surgical techniques compared to an extensile lateral approach in the management of displaced intra-articular calcaneal fractures. A systematic review and meta-analysis of randomised controlled trials","authors":"Scott D. Purdie , Niamh Hoskins , Regina Jesslyn Sumarlie , Natthaya Eiamampai , Paul Lebeslé , Fergus Wood , Anagha Chinmayee , Wei Qi Lim , Sriskandarasa Senthilkumaran , Louise Fisher , Santosh Baliga","doi":"10.1016/j.fas.2025.02.012","DOIUrl":"10.1016/j.fas.2025.02.012","url":null,"abstract":"<div><h3>Background</h3><div>Developments in minimally invasive surgical techniques (MIS) have sparked debate over the optimal intervention for calcaneal fractures. This meta-analysis compares the extensile lateral approach (ELA) to two MIS techniques; the sinus tarsi approach and percutaneous approaches.</div></div><div><h3>Methods</h3><div>A systematic search was conducted across seven databases for randomised control trials (RCTs). The clinical outcomes were wound complications, functional scores (American Orthopaedic Foot & Ankle Society score, and Maryland Foot Score) and radiological measures (Böhler’s and Gissane’s angles).</div></div><div><h3>Results</h3><div>Fourteen RCTs (<em>n</em> = 1367; mean age: 36.3 years; 25.7 % female) were included. MIS significantly reduced wound complications compared to ELA (RR 6.48, 95 %CI 4.03–10.41, p < 0.00001, <em>n</em> = 1380, GRADE: High). Functional scores favoured MIS, and radiological outcomes were equivalent.</div></div><div><h3>Conclusions</h3><div>Both MIS techniques reduce wound complications, improve functional outcomes, and achieve comparable anatomical reduction, making them suitable alternatives to the extensile lateral approach, to significantly improve patient’s outcomes.</div></div><div><h3>Level of Evidence</h3><div>Level 1</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 6","pages":"Pages 473-485"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to letter to the editor to comment on : Prevalence and risk factors of ankle osteoarthritis in a population-based study 回复编辑对一项基于人群的研究中踝关节骨关节炎患病率和危险因素的评论。

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery

Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2025.07.001

Akinobu Nishimura, Yoshiyuki Senga, Yuki Fujikawa, Chihiro Konno, Akihiro Sudo

引用次数: 0

Anatomohistological study of the peroneus longus tendon in the cuboid bone tunnel: Correlation with tunnel dimensions and the presence of os peroneum 长方体骨隧道中腓骨长肌腱的解剖组织学研究：与隧道尺寸和腓骨肌存在的相关性。

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery

Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2025.02.006

Henrique César Temóteo Ribeiro , José Alberto Dias Leite , Marcos Vinícius Lopes de Queiroz , João Felipe Martins Tomaz , Maria Luzete Costa Cavalcante , Diego Ariel de Lima

Background

Peroneal tendon injuries, particularly of the peroneus longus, contribute to lateral ankle pain and instability. However, limited literature addresses the anatomical influence of the cuboid tunnel and the os peroneum on such injuries. This study investigates histological changes in the peroneus longus tendon and their relationship to cuboid tunnel dimensions, os peroneum presence, and age.

Methods

This cross-sectional study examined 60 peroneus longus tendons from 30 cadavers (ages 15–71). Tendons were sectioned and histologically analyzed for cellularity and collagen composition. Cuboid tunnel dimensions were measured, and the presence of os peroneum, an accessory ossicle located within the peroneus longus tendon, was recorded. Statistical correlations were performed.

Results

Increased type III collagen and cellularity were significantly associated with advanced age, reduced tunnel width, and increased tunnel height (p < 0.05). No significant association was found with tunnel length or os peroneum presence.

Conclusions

Age, reduced cuboid tunnel width, and increased tunnel height are associated with peroneus longus tendon degeneration, with collagen type I replacement by type III, predisposing factors for tendinosis.

Level of Evidence

Level IV (Anatomical Study)

背景：腓骨肌腱损伤，尤其是腓骨长肌损伤，可导致踝关节外侧疼痛和不稳定。然而，关于长方体隧道和腓骨肌对这类损伤的解剖影响的文献有限。本研究探讨了腓骨长肌腱的组织学变化及其与长方体隧道尺寸、腓骨是否存在和年龄的关系。方法：本横断面研究检查了30具尸体（15-71岁）的60根腓骨长肌腱。对肌腱进行切片并对其细胞结构和胶原组成进行组织学分析。测量了长方体隧道的尺寸，并记录了位于腓骨长肌腱内的副听骨腓骨的存在。进行统计相关性分析。结论：年龄、长方隧道宽度减小、隧道高度增加与腓骨长肌腱退行性变有关，III型胶原替代I型胶原是肌腱变性的易感因素。证据等级：四级（解剖研究）。

{"title":"Anatomohistological study of the peroneus longus tendon in the cuboid bone tunnel: Correlation with tunnel dimensions and the presence of os peroneum","authors":"Henrique César Temóteo Ribeiro , José Alberto Dias Leite , Marcos Vinícius Lopes de Queiroz , João Felipe Martins Tomaz , Maria Luzete Costa Cavalcante , Diego Ariel de Lima","doi":"10.1016/j.fas.2025.02.006","DOIUrl":"10.1016/j.fas.2025.02.006","url":null,"abstract":"<div><h3>Background</h3><div><span>Peroneal tendon injuries, particularly of the peroneus longus, contribute to lateral ankle pain and instability. However, limited literature addresses the anatomical influence of the cuboid tunnel and the </span><em>os peroneum</em> on such injuries. This study investigates histological changes in the peroneus longus tendon and their relationship to cuboid tunnel dimensions, <em>os peroneum</em> presence, and age.</div></div><div><h3>Methods</h3><div>This cross-sectional study examined 60 peroneus longus tendons from 30 cadavers (ages 15–71). Tendons were sectioned and histologically analyzed for cellularity and collagen composition. Cuboid tunnel dimensions were measured, and the presence of <em>os peroneum</em>, an accessory ossicle located within the peroneus longus tendon, was recorded. Statistical correlations were performed.</div></div><div><h3>Results</h3><div><span>Increased type III collagen and cellularity were significantly associated with advanced age, reduced tunnel width, and increased tunnel height (p < 0.05). No significant association was found with tunnel length or </span><em>os peroneum</em> presence.</div></div><div><h3>Conclusions</h3><div>Age, reduced cuboid tunnel width, and increased tunnel height are associated with peroneus longus tendon degeneration, with collagen type I<span> replacement by type III, predisposing factors for tendinosis.</span></div></div><div><h3>Level of Evidence</h3><div>Level IV (Anatomical Study)</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 6","pages":"Pages 521-524"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes of metatarsal Ewing sarcoma following the resection and intercalary reconstruction with fibular strut allograft: A retrospective case series 跖骨尤文氏肉瘤切除术及腓骨支架异体移植物骨间重建的结果：回顾性病例系列。

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery

Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2025.02.001

Khodamorad Jamshidi , Abolfazl Bagherifard , Seyyed Saeed Khabiri , Alireza Mirzaei

Background

Traditionally, metatarsal Ewing sarcoma (ES) is managed with disarticulation above the tarsometatarsal joint and ray amputation. In this study, we evaluate the outcomes of a less invasive approach in patients with metatarsal ES and good response to neoadjuvant chemotherapy.

Methods

Eleven patients with metatarsal ES (mean age: 11.5 ± 3) and complete radiologic response to neoadjuvant chemotherapy who underwent resection and reconstruction with fibular strut allograft were included.

Results

At a mean follow-up of 8.5 ± 4 years, the mean Musculoskeletal Tumor Society (MSTS) score of the patients was 29 ± 1.7. Patients with metatarsophalangeal joint fusion had limitations in reactional activities. One patient had a local recurrence. Postoperative complications included wound dehiscence (n = 1), superficial infection (n = 1), and allograft fracture (n = 1). Only one patient required revision surgery.

Conclusion

Fibular allograft reconstruction after resection of metatarsal ES can be regarded as a valuable alternative to amputation in patients who respond well to neoadjuvant chemotherapy.

Level of evidence

背景：传统上，跖骨尤文氏肉瘤（ES）的治疗方法是跗跖关节以上的关节分离和射线截肢。在这项研究中，我们评估了微创入路治疗跖骨ES患者的结果，并对新辅助化疗有良好的反应。方法：11例跖骨ES患者（平均年龄：11.5 ± 3），放射学对新辅助化疗反应完全，行同种异体腓骨支架切除术重建。结果：平均随访8.5 ± 4年，患者的平均肌肉骨骼肿瘤学会（MSTS）评分为29 ± 1.7。跖趾关节融合术患者的反应活动受限。1例患者局部复发。术后并发症包括伤口裂开（n = 1）、浅表感染（n = 1）和同种异体骨骨折（n = 1）。只有一名患者需要翻修手术。结论：对新辅助化疗反应良好的跖骨ES术后腓骨异体移植重建是一种有价值的替代截肢的方法。证据等级：四级。

{"title":"Outcomes of metatarsal Ewing sarcoma following the resection and intercalary reconstruction with fibular strut allograft: A retrospective case series","authors":"Khodamorad Jamshidi , Abolfazl Bagherifard , Seyyed Saeed Khabiri , Alireza Mirzaei","doi":"10.1016/j.fas.2025.02.001","DOIUrl":"10.1016/j.fas.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Traditionally, metatarsal Ewing sarcoma<span><span> (ES) is managed with disarticulation above the </span>tarsometatarsal joint<span> and ray amputation. In this study, we evaluate the outcomes of a less invasive approach in patients with metatarsal ES and good response to neoadjuvant chemotherapy.</span></span></div></div><div><h3>Methods</h3><div>Eleven patients with metatarsal ES (mean age: 11.5 ± 3) and complete radiologic response to neoadjuvant chemotherapy who underwent resection and reconstruction with fibular strut allograft were included.</div></div><div><h3>Results</h3><div><span><span><span>At a mean follow-up of 8.5 ± 4 years, the mean Musculoskeletal Tumor Society (MSTS) score of the patients was 29 ± 1.7. Patients with metatarsophalangeal </span>joint fusion had limitations in reactional activities. One patient had a local recurrence. </span>Postoperative complications included </span>wound dehiscence (n = 1), superficial infection (n = 1), and allograft fracture (n = 1). Only one patient required revision surgery.</div></div><div><h3>Conclusion</h3><div>Fibular allograft reconstruction after resection of metatarsal ES can be regarded as a valuable alternative to amputation in patients who respond well to neoadjuvant chemotherapy.</div></div><div><h3>Level of evidence</h3><div>IV</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 6","pages":"Pages 492-497"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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