Journal of Foot & Ankle Surgery最新文献

{"title":"Are interfragmentary lag screws necessary in surgical treatment of Weber B ankle fractures?","authors":"Alyssa Schreiber BS ,&nbsp;Jane Brennan MS ,&nbsp;Andrea Johnson MSN, CRNP ,&nbsp;Adrienne Spirt MD, PhD ,&nbsp;Elizabeth Friedmann MD ,&nbsp;David Keblish MD ,&nbsp;Justin Turcotte PhD, MBA","doi":"10.1053/j.jfas.2025.08.007","DOIUrl":"10.1053/j.jfas.2025.08.007","url":null,"abstract":"<div><h3>Background</h3><div>Traditionally, open reduction and internal fixation (ORIF) for Weber B fibular fractures involves placement of a lag screw across the fracture plane along with plate fixation.</div></div><div><h3>Purpose</h3><div>To compare outcomes of Weber B fractures treated with plate-only (PO) vs. plate and lag screw (PLS) fixation.</div></div><div><h3>Study Design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>Retrospective review of 318 patients undergoing ORIF for Weber B fractures (2022-2024) was performed. Univariate and multivariate statistics were used to compare patient characteristics and outcomes of those treated with PLS (n=167) vs. those treated with PO (n=151) fixation.</div></div><div><h3>Results</h3><div>Patients in the PO-group were older, had a greater comorbidity burden (measured as Charlson Comorbidity Index [CCI]), and were more likely to have osteoporosis/osteopenia and diabetes than those in the PLS-group. Further, the PO-group was more likely to present with a trimalleolar fracture. Similar rates of complications (PO: 20.5 vs. PLS: 22.2%, p=0.829), reoperations (PO: 7.9 vs. PLS: 9.0%, p=0.897) and reporting “normal or nearly normal” levels of function at 6-months postoperatively (PO: 54.8 vs. PLS: 60.2%, p=0.630) were observed. After adjusting for age, CCI, osteoporosis/osteopenia, fracture type, and surgical setting in the multivariate regression models there were no significant differences in complication rates, reoperation rates, or patient-reported outcomes at 6-months postoperatively between groups.</div></div><div><h3>Conclusion</h3><div>Surgical correction of Weber B fractures with a fibular plate yielded similar outcomes with and without placement of a lag screw. While further studies are needed to confirm these findings, plate-only fixation of Weber B ankle fractures appears to be a safe technique.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 19.e1-19.e5"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterotopic ossifications in anterior and lateral approach total ankle replacement: A retrospective evaluation","authors":"Giammarco Gardini ,&nbsp;Silvio Caravelli ,&nbsp;Carlo Capodagli ,&nbsp;Giulio Vara ,&nbsp;Stefano Ratti ,&nbsp;Marco Di Ponte ,&nbsp;Massimiliano Mosca","doi":"10.1053/j.jfas.2025.08.001","DOIUrl":"10.1053/j.jfas.2025.08.001","url":null,"abstract":"<div><div>Heterotopic periarticular ossifications (HO) are a frequent short to mid-term complication following Total Ankle Replacement (TAR). Historically two primary surgical approaches exist—Lateral Approach (LA) and Anterior Approach (AA)—each bound with different prosthetic designs. However, there is no consensus on the incidence, real clinical impact, or need for reintervention of HO between these approaches, nor on the necessity of prophylactic treatments. This retrospective, monocentric, comparative study (evidence level III) involved radiological classification of patients using the modified Brooker Classification System (mBCS) by two independent orthopedic surgeons. A total of 105 patients undergoing LA or AA TAR at the same center were included. Radiographic HO was observed in 84 patients (80 %). Of these, 19 (23 %) required surgical intervention due to symptomatic HO. In the AA group (62 patients, Vantage Exactech prosthesis), 45 (73 %) developed HO, with 10 having sufficient symptoms which were treated with arthrolysis. In the LA group (43 patients, Trabecular Metal Zimmer prosthesis), 39 (91 %) developed HO, with 9 requiring arthrolysis. HO was more prevalent in the LA group than in the AA group (91 % vs. 73 %). A direct correlation was found between clinical scores (FAAM and Pain Score) and HO severity. Prosthesis with LA more frequently develop HO than AA. In addition, young patients, delayed ankle mobilization and weightbearing can be accounted as risk factors in the development of HOs; conversely smoking, BMI, duration of surgery and post-traumatic arthritis were not found to have a significant impact.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 15.e1-15.e6"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical variations of the deep plantar arterial arch: surgical implications for partial foot amputations and soft tissue reconstruction","authors":"Jessica L. Morehouse ,&nbsp;Jordan M. Konstanty ,&nbsp;Anna C. Cacini ,&nbsp;Jamie M. Stern ,&nbsp;Sara S. Sloan","doi":"10.1053/j.jfas.2025.07.012","DOIUrl":"10.1053/j.jfas.2025.07.012","url":null,"abstract":"<div><h3>Background</h3><div>The forefoot receives its primary blood supply through the deep plantar arterial arch, typically formed by an anastomosis between the deep branch of the lateral plantar artery and the deep plantar artery. Accurate identification and localization of the deep plantar arch are critical during flap procedures and transmetatarsal amputations to minimize the risk of vascular compromise.</div></div><div><h3>Purpose</h3><div>To assess the anatomical variability, dominance patterns, and location of the deep plantar arch to inform surgical planning and reduce intraoperative vascular complications.</div></div><div><h3>Study Design</h3><div>This was a descriptive anatomical study conducted through cadaveric dissection.</div></div><div><h3>Methods</h3><div>Eighty-nine feet from 45 formalin-embalmed cadavers were dissected, with associated arteries traced from their origins and external diameters measured to determine arterial dominance. Distances from key anatomic landmarks were recorded to identify the arch’s position within the foot.</div></div><div><h3>Results</h3><div>The deep plantar arch was present in all specimens. Lateral plantar artery dominance and deep plantar artery dominance were each observed in 42.70%, while co-dominance occurred in 12.36%, and medial plantar artery dominance in 2.25%. On average, the arch was located 58.48% of the distance from the calcaneal tuberosity to the distal phalanx. Medial deviation of the arch was found to be influenced by biological sex and the type of vascular dominance.</div></div><div><h3>Conclusion</h3><div>The deep plantar arch demonstrates variability in both its dominance patterns and anatomic position. These findings underscore the importance of preoperative vascular assessment to optimize surgical outcomes and reduce the risk of ischemic complications during forefoot procedures.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 14.e1-14.e6"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic and clinical outcomes following single stage brachymetatarsia correction of greater than or equal to 15 mm","authors":"Shane Sato DPM ,&nbsp;Matthew Greenblatt DPM ,&nbsp;Noman A. Siddiqui DPM, MHA, FACFAS","doi":"10.1053/j.jfas.2025.08.011","DOIUrl":"10.1053/j.jfas.2025.08.011","url":null,"abstract":"<div><h3>Background</h3><div>Brachymetatarsia is a shortening of one or more metatarsal bones. This condition can result in pedal complaints of metatarsalgia, calluses, toe deformities, and shoe irritation. When non-surgical treatments fail, surgical options include acute one-stage lengthening with a bone graft or gradual callus distraction with an external fixator. Acute correction is preferred for lengthening under 14 mm, while gradual methods are favored for corrections over 15 mm due to concerns of neurovascular injury and achieving incomplete correction. Gradual correction, however, can be associated with prolonged treatment, malalignment risk, pin tract infections, and patient compliance issues.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to assess the clinical and radiographic outcomes of acute one-stage lengthening of 15 mm or more.</div></div><div><h3>Methods</h3><div>A retrospective review of patients who underwent acute brachymetatarsia correction of greater than or equal to 15 mm at a single institution was performed.</div></div><div><h3>Results</h3><div>Twenty-one patients (26 corrections) underwent an average lengthening of 17.6 mm, with a mean osseous consolidation time of 9.7 weeks. No cases of delayed union, malunion, nonunion, or neurovascular injury occurred. The most common complication was radiographic, asymptomatic fourth metatarsophalangeal joint arthritis (34.6 %). Preoperative metatarsal parabola length averaged 12.7 mm and significantly decreased to 0.27 mm postoperatively (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>These findings support acute corrections exceeding 15 mm, challenging concerns of neurovascular injury with this approach.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 22.e1-22.e6"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early weight-bearing following modified Lapidus arthrodesis: A retrospective review of 104 cases & postoperative protocol","authors":"Akram Uddin BSc (Hons), MSc, FRCPodS ,&nbsp;John. W. Bramall BSc (Hons), FRCPodS ,&nbsp;Keng Leong NG ,&nbsp;Kajetan Klos ,&nbsp;Edgar Roth ,&nbsp;Derek Santos BSc (Hons), MSc, PhD","doi":"10.1053/j.jfas.2025.09.001","DOIUrl":"10.1053/j.jfas.2025.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Lapidus arthrodesis is indicated for the treatment of first ray dysfunction or hypermobility, hallux valgus (HV) and functional hallux limitus (FHL). Postoperative weightbearing protocols vary amongst surgeons.</div></div><div><h3>Purpose</h3><div>To report radiographic osseous healing and patient-reported outcome measures (PROMS) following a single early weightbearing protocol.</div></div><div><h3>Study Design</h3><div>Retrospective review of 104 adults (≥18 years) (104 feet) who underwent open modified Lapidus arthrodesis (without bone graft) by single compression screw and medial locking plate by two surgeons at one centre (between January 2019 to May 2023).</div></div><div><h3>Methods</h3><div>Pre- and postoperative radiographs and electronic records were reviewed for evidence of osseous healing and return to full weightbearing. Secondary measures included deformity reduction and PROMS.</div></div><div><h3>Results</h3><div>At 6-weeks follow-up 98 patients (94 %) were confirmed of osseous healing and returned to full weightbearing. Six patients (6 %) had delayed osseous healing at 6-weeks but showed signs of osseous healing by 3-months follow-up. Postoperative HV and intermetatarsal angle (IMA) showed significant reduction (mean difference: -12 (SD = 8) and -5 (SD = 4) degrees respectively; <em>p</em> &lt; 0.001 for both). Ten patients (10 %) had postoperative complications: hardware irritation 5 (5 %), sesamoiditis 2 (2 %), hypertrophic scar 2 (2 %) and joint stiffness 1 (1 %). Eight patients (8 %) required further surgery (5 required fixation removal due to hardware irritation. Three underwent either; 1st MTPJ open-mobilization, excision of scar or distal metatarsal osteotomy with tibial sesamoid planing). Manchester-Oxford Foot Questionnaire (MOXFQ) showed significant improvement across all domains (mean difference (SD): -51 (SD = 22); walking/standing -49 (SD = 24); pain -52 (SD = 22); and social interaction -51 (SD = 28); (<em>p</em> &lt; 0.001 for all) with clinically significant effect size (Cohen’s d: 2.37; 2.01; 2.37; and 1.84 respectively). Patient satisfaction questionnaire (PSQ-10) score was high mean of 91 (SD = 8). 5 patients (5 %) were lost by 6-months follow-up.</div></div><div><h3>Conclusion</h3><div>Early weightbearing achieved consistent osseous healing and high PROMS. Larger controlled studies are required to validate these results.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 24.e1-24.e8"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cadaveric evaluation of MIS akin variation on length and angular correction","authors":"Steven R. Cooperman DPM, MBA, AACFAS ,&nbsp;Jaeyoon Kim DPM, AACFAS ,&nbsp;Orlando Martinez DPM ,&nbsp;Lauren M. Christie DPM, AACFAS ,&nbsp;Roberto A. Brandão DPM, FACFAS","doi":"10.1053/j.jfas.2025.07.010","DOIUrl":"10.1053/j.jfas.2025.07.010","url":null,"abstract":"<div><h3>Background</h3><div>Hallux abductovalgus, or bunion deformity, is a common forefoot condition with numerous described techniques for surgical correction. Minimally invasive surgery (MIS) is gaining popularity in the foot and ankle community; however, limited data exists regarding the degree of correction achievable with MIS Akin osteotomies.</div></div><div><h3>Purpose</h3><div>To compare the angular and length changes produced by oblique and transverse Akin osteotomies using two burr sizes (2.0 and 2.9 mm) in a cadaveric model.</div></div><div><h3>Ethics</h3><div>The authors state that every effort was made to follow all local and international ethical guidelines and laws that pertain to the use of human cadaveric donors in anatomical research. As a cadaveric study, no IRB review was required.</div></div><div><h3>Study Design</h3><div>Level IV cadaveric study</div></div><div><h3>Methods</h3><div>Twenty thawed above-knee cadaveric limbs (ten bilateral pairs) were used. Matched pairs underwent either oblique or transverse osteotomies, with the left limbs treated using a 2.0 mm burr and the right limbs with a 2.9 mm burr. Angular correction of the longitudinal axis of the proximal phalanx and medial cortical bone shortening were measured.</div></div><div><h3>Results</h3><div>The 2.9 mm burr produced significantly greater angular correction and bone shortening than the 2.0 mm burr across all groups (<em>p</em> = 0.002). For oblique osteotomies, the 2.9 mm burr achieved a mean correction of 9.40° versus 4.43° with the 2.9 mm burr (<em>p</em> = 0.037). For transverse osteotomies, angular correction was 14.87° with the 2.9 mm burr compared to 6.64° with the 2.0 mm burr (<em>p</em> = 0.037)</div></div><div><h3>Conclusion</h3><div>Burr size and osteotomy orientation significantly affect the degree of correction in MIS Akin osteotomies. These findings support careful preoperative planning and deliberate burr selection to optimize surgical outcomes.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 12.e1-12.e6"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hallux rigidus with an increased or equal first metatarsal length after a cheilectomy and first metatarsal shortening osteotomy (FMSO) using a small shortening scarf: A retrospective 7-year clinical and gait analysis follow-up","authors":"Karl-Heinz Kristen ,&nbsp;Hans Jörg Trnka ,&nbsp;Aneele Fischer ,&nbsp;Peter Bock","doi":"10.1053/j.jfas.2025.07.002","DOIUrl":"10.1053/j.jfas.2025.07.002","url":null,"abstract":"<div><h3>Background</h3><div>In hallux rigidus, the relative length of the first metatarsal has been implicated in its pathogenesis, suggesting a potential benefit from combined surgical approaches.</div></div><div><h3>Purpose</h3><div>To evaluate the long-term outcomes of a combined surgical approach using cheilectomy and shortening SCARF osteotomy for moderate hallux rigidus (Coughlin grades 2-3) in active patients with a first metatarsal index equal to or longer than the second metatarsal.</div></div><div><h3>Study Design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>Twenty-three feet in 20 patients (mean age 49.4 ± 8.4 years) underwent combined cheilectomy and 4-mm shortening SCARF osteotomy. Outcomes were assessed at a mean follow-up of 6.7 ± 2.5 years using the American Orthopedic Foot and Ankle Society and European Foot and Ankle Surgery scores, range of motion, and gait analysis.</div></div><div><h3>Results</h3><div>American Orthopedic Foot and Ankle Society scores improved from 32.2±11.7 preoperatively to 86.6±6.2 at the follow-up, and European Foot and Ankle Surgery scores increased from 13.8±2.8 perioperatively to 35.4±3.9 at the follow-up. The total range of motion increased from 32.8° to 44.7° ±16,3°. Gait analysis revealed a physiological plantar pressure distribution at follow-up. Complications included the recurrence of joint stiffness and pain in three patients and transient transfer metatarsalgia in one patient.</div></div><div><h3>Conclusion</h3><div>Shortening SCARF osteotomy plus mild cheilectomy may be an effective joint-preserving procedure in patients with first metatarsal overlength, with results comparable to those of cheilectomy and other first metatarsal shortening osteotomies.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 5.e1-5.e11"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficiency of the combination of Wide Awake Local Anesthesia No Tourniquet (WALANT) and sciatic nerve block for Achilles tendon repair: A preliminary study of feasibility","authors":"Sébastien Bloc MD ,&nbsp;Cyril Quemeneur MD ,&nbsp;Cécile Naudin PhD ,&nbsp;David Barouk MD ,&nbsp;Guillaume Dufour MD ,&nbsp;Mario Bucciero MD ,&nbsp;Anaelle Fedida MD ,&nbsp;Matthieu Karoubi MD ,&nbsp;Xavier Deloin MD ,&nbsp;Romain Rousseau MD ,&nbsp;Marc Elkaim MD ,&nbsp;Anthony Wajsfisz MD ,&nbsp;Fréderic Le Saché MD","doi":"10.1053/j.jfas.2025.07.009","DOIUrl":"10.1053/j.jfas.2025.07.009","url":null,"abstract":"<div><h3>Background</h3><div>Various anesthetic techniques are available for surgical repair of Achilles tendon rupture. The main limitation of peripheral nerve blocks is the risk of failure that can be attributed to the failure of the \"tourniquet\" block or of the “surgical” block.</div></div><div><h3>Purpose</h3><div>This retrospective study assessed the feasibility and the reproducibility of the association of WALANT technique to sciatic nerve block for Achilles tendon repair surgery.</div></div><div><h3>Study Design</h3><div>Data from 34 adult patients scheduled for Achilles tendon repair were collected retrospectively from January 2022 to April 2023.</div></div><div><h3>Methods</h3><div>Sciatic nerve block (15 ml of Ropivacaine 0.375 %) and WALANT (30 ml of lidocaine 1 % with epinephrine) were performed under ultrasound guidance 30 minutes before surgery. A pneumatic thigh tourniquet was applied but not inflated. The primary endpoint was the efficiency of the combination of sciatic nerve block and WALANT, defined by anesthetic and hemostasis qualities.</div></div><div><h3>Results</h3><div>Efficacy of the combination of sciatic nerve block and WALANT was 91.2 %: one patient required sedation due to pain during skin incision (percutaneous technique), and two others due to discomfort. The hemostatic quality of WALANT was appropriate in 100 % of cases, no pneumatic tourniquet was required.</div></div><div><h3>Conclusion</h3><div>The combination of sciatic nerve block and WALANT infiltration provides an efficient and reproducible technique for the Achilles tendon repair. It avoids the need for a pneumatic tourniquet and limits the risk of peripheral nerve block failure.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 11.e1-11.e5"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for surgical site infections in patients with pilon fractures: A systematic review and meta-analysis","authors":"Pei Zhen Li ,&nbsp;Jia Wei He ,&nbsp;Xian Sheng Xia","doi":"10.1053/j.jfas.2025.08.006","DOIUrl":"10.1053/j.jfas.2025.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Pilon is a severe ankle fracture, and surgical site infections is an important postoperative complication that often leads to catastrophic consequences. Understanding its risk factors is crucial for optimizing patient outcomes and improving clinical management strategies.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, Web of Science, and the Cochrane Library for prospective and retrospective studies related to surgical site infections in patients with Pilon fractures, covering the period from January 2000 to March 2025. Following the screening and quality assessment of eligible studies, data were extracted and a meta-analysis was conducted utilizing Stata 16.0 and RevMan 5.3 software.</div></div><div><h3>Result</h3><div>Ten studies involving 4,120 patients were included in the analysis. The meta-analysis revealed that the pooled incidence of surgical site infections was 17 % (95 % CI: 12 %–23 %). Significant risk factors identified for surgical site infections in patients with Pilon fractures included age, diabetes, hypertension, albumin, open fracture, AO/OTA fracture type(≥<em>C</em>), preoperative hospital stay, and surgical duration.</div></div><div><h3>Conclusion</h3><div>This study identified several significant risk factors linked to surgical site infections in patients with Pilon fractures. Surgeons should closely monitor high-risk populations, optimize perioperative management, and implement effective preventive measures to prevent unnecessary complications.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 35.e1-35.e5"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superiority of ultra-shortterm clinical outcome after minimally invasive distal metatarsal chevron osteotomy in comparison to the open technique: a prospective study","authors":"Viktoria Hofmann MD ,&nbsp;Gerhard Kaufmann MD ,&nbsp;Michael Liebensteiner MD, PhD ,&nbsp;Franz Endstrasser MD ,&nbsp;Moritz Wagner MD ,&nbsp;Hanno Ulmer PhD ,&nbsp;Luke Cicchinelli DPM, FACFAS","doi":"10.1053/j.jfas.2025.08.013","DOIUrl":"10.1053/j.jfas.2025.08.013","url":null,"abstract":"<div><div>Swelling and pain is a frequent finding after hallux valgus correction. Aim of our study was to detect clinical differences in the initial postoperative period after minimally invasive chevron osteotomy (MIS) and the open chevron technique (OC). From the included patients clinical outcome was assessed preoperatively, and then at two, four, six and 12 weeks postopertively in terms of the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot Score, the Japanese Society for Surgery of the Foot (JSSF) metatarsophalangeal-interphalangeal Scale, the Maryland Foot Score (MFS), the SF12 Life Quality Scale, the Visual Analogue Scores (VAS) of pain, swelling of the foot, range of motion (ROM) and patient satisfaction. Radiographic parameters were taken preoperatively, as well as two, six and twelve weeks after surgery. The Charlson Comorbidity Index (CCI) was recorded preoperatively only, pain medication consumption was documented for the intial two weeks after surgery. Sixty-three feet were analyzed (33 MIS; 30 OC). Patient demographic characteristics and amount of the deformity in both groups did not differ significantly. Both techniques demonstrated good radiographic correction of the hallux deformity without superiority of one technique. We detected lower pain levels and reduced pain medication consumption as well as reduced swelling in the MIS group at the time points two, four and six weeks postoperatively. AOFAS score and the satisfaction score showed significantly better results in the MIS group as well. Minimally invasive chevron osteotomy shows better clinical ultra-shortterm outcome and lower pain levels in comparision to the open technique with comparable radiographic results.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 25.e1-25.e7"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}