Journal of Foot & Ankle Surgery最新文献_第2页

Surgical outcomes after superior peroneal retinaculum repair without bony procedures for chronic peroneal tendon instability: A consecutive case series. 慢性腓骨肌腱不稳定的腓上网膜修复术后无骨手术的手术结果：连续病例系列。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-04 DOI: 10.1053/j.jfas.2026.02.018

Minsung Kwon, Ki-Sun Sung

Background: Although bony procedures tailored to retromalleolar groove morphology have been advocated to reduce recurrence in chronic peroneal tendon instability, concerns remain regarding tendon adhesion and procedure-related morbidity. Consequently, it remains unclear whether isolated superior peroneal retinaculum repair alone is sufficient across different fibular morphologies, providing the rationale for the present study.

Purpose: This study evaluated whether isolated superior peroneal retinaculum repair, without adjunctive bony procedures, can restore stability and function in chronic peroneal tendon instability while avoiding tendon adhesion risk.

Study design: Level IV, retrospective cohort study METHODS: From September 2014 to December 2024, all patients with chronic peroneal tendon instability were treated with isolated superior peroneal retinaculum repair. Recurrence of instability, surgery-related complications, and functional outcomes were assessed by the Karlsson-Peterson score and the AOFAS Ankle-Hindfoot Scale.

Results: A total of 38 patients underwent superior peroneal retinaculum repair; 22 patients (23 ankles) had a minimum 12-month follow-up. The average follow-up duration was 20.7 months (range, 12.4-36.3 months). No patient experienced recurrent instability or postoperative complications, including nerve injury or wound problems. The mean Karlsson-Peterson score improved from 57.5 ± 20.4 preoperatively to 86.0 ± 10.0 postoperatively, and the mean AOFAS Ankle-Hindfoot Scale improved from 61.9 ± 19.1 to 88.9 ± 7.9.

Conclusions: Superior peroneal retinaculum repair without bony procedures provided stable tendon reduction, significant functional improvement, and a low complication rate in chronic peroneal tendon instability, regardless of retromalleolar groove morphology.

背景：尽管针对踝后沟形态的骨手术已被提倡减少慢性腓骨肌腱不稳定的复发，但对肌腱粘连和手术相关发病率的担忧仍然存在。因此，目前尚不清楚单独的腓上网膜修复是否足以跨越不同的腓骨形态，这为本研究提供了基本原理。目的：本研究评估在不进行辅助骨手术的情况下，孤立腓骨上网膜修复是否可以恢复慢性腓骨肌腱不稳定的稳定性和功能，同时避免肌腱粘连风险。方法：2014年9月至2024年12月，对所有慢性腓骨肌腱不稳患者行腓上网膜孤立修复术。通过Karlsson-Peterson评分和AOFAS踝关节-后足量表评估不稳定复发、手术相关并发症和功能结局。结果：38例患者行腓上网膜修复术；22例患者（23踝关节）进行了至少12个月的随访。平均随访时间为20.7个月（12.4 ~ 36.3个月）。没有患者出现复发性不稳定或术后并发症，包括神经损伤或伤口问题。平均Karlsson-Peterson评分由术前57.5±20.4分改善至术后86.0±10.0分，平均AOFAS踝-后足评分由61.9±19.1分改善至88.9±7.9分。结论：不论踝后沟形态如何，无骨手术的腓骨上网膜修复提供了稳定的肌腱复位，显著的功能改善，慢性腓骨肌腱不稳定的并发症发生率低。证据等级：IV级，回顾性队列研究。

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引用次数: 0

The role of foot alignment in the effectiveness of extracorporeal shockwave therapy for chronic plantar fasciitis. 足部对准在体外冲击波治疗慢性足底筋膜炎疗效中的作用。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-02 DOI: 10.1053/j.jfas.2026.02.016

Hakan Bahar, Abdurrahman Aydın

Background: Plantar fasciitis is a common cause of heel pain, and extracorporeal shockwave therapy (ESWT) is widely used in patients who fail conservative treatment. The role of radiographic foot alignment parameters in predicting ESWT response remains unclear.

Purpose: To evaluate the association between radiographically assessed foot alignment parameters and clinical response to ESWT in patients with chronic plantar fasciitis.

Study design: Retrospective comparative study; Level III evidence.

Methods: Plantar fasciitis patients were compared with age-matched healthy individuals. The plantar fasciitis group was divided into those who benefited from ESWT (n = 84) and those who did not (n = 85), and the effects of demographic variables and radiological measurements on treatment success were examined.

Results: Significant differences in calcaneal inclination, lateral talus-first metatarsal, talonavicular coverage, anteroposterior talocalcaneal, and anteroposterior talus-first metatarsal angles were observed between plantar fasciitis patients and healthy individuals. No significant differences in radiological parameters were observed between ESWT responders and non-responders (p > 0.05), while body mass index differed between the groups in univariate analysis (p < 0.05).

Conclusions: Findings suggest that radiological parameters may contribute to development of plantar fasciitis but do not predict ESWT success.

背景：足底筋膜炎是引起足跟疼痛的常见原因，体外冲击波治疗（ESWT）被广泛应用于保守治疗失败的患者。x线摄影足部对准参数在预测ESWT反应中的作用尚不清楚。目的：评估慢性足底筋膜炎患者放射学评估的足部对准参数与ESWT临床反应之间的关系。研究设计：回顾性比较研究；III级证据。方法：将足底筋膜炎患者与年龄匹配的健康人进行比较。足底筋膜炎组分为ESWT受益组（n = 84）和未受益组（n = 85），并检查人口统计学变量和放射学测量对治疗成功的影响。结果：足底筋膜炎患者与健康人在跟骨倾斜度、距骨第一外侧跖骨、距骨舟骨覆盖、距骨前后角、距骨第一跖骨前后角等指标上存在显著差异。ESWT应答者和无应答者的放射学参数无显著差异（p < 0.05），而单变量分析中，两组之间的体重指数存在差异（p < 0.05）。结论：研究结果表明放射学参数可能有助于足底筋膜炎的发展，但不能预测ESWT的成功。证据等级：III级，回顾性比较研究。

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引用次数: 0

Subtalar joint nonunions following isolated ipsilateral ankle arthrodesis a systematic review and meta analysis 离侧踝关节融合术后距下关节不连：系统回顾和Meta分析。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 Epub Date: 2025-11-10 DOI: 10.1053/j.jfas.2025.11.005

Cameron Meyer DPM, AACFAS , Steven Cooperman DPM, MBA, AACFAS , Roberto Brandão DPM, FACFAS

Open arthrodesis remains the gold standard for management of end stage subtalar joint arthritis. Rate of isolated subtalar fusion complicated by nonunion has been documented between 4-22.8 %. However, little is known about success of subtalar joint fusion when performed underneath a previously constructed ankle arthrodesis. The aim of this systematic review was to assess the cases of nonunion in patients who underwent a subtalar joint fusion with documented history of previous ipsilateral ankle fusion. A broad literature search was performed through PubMed, Google Scholar, and Cochrane Database using the following search terms: “Time to fusion, ankle fusion complication, outcomes ankle fusion.” Meta-regression was performed to assess the effects of study sample size and publication year on the non-union rate. Three studies met inclusion and exclusion criteria. The non-union rates of subtalar joint arthrodesis following ankle fusion in the included studies ranged from 20 % to 55.6 %. The pooled rate was 38 % (95 % CI: 18.2 % to 59.8 %). Our series included a larger number of cases, allowing statistical analysis that clearly demonstrated a markedly lower subtalar fusion rate in patients with previous ipsilateral ankle fusion when compared to what has been documented in the literature.

开放关节融合术仍然是治疗终末期距下关节关节炎的金标准。孤立离骨下融合合并骨不连的发生率在4-22.8%之间。然而，对于距下关节融合术在先前构建的踝关节融合术下进行的成功率知之甚少。本系统综述的目的是评估既往有同侧踝关节融合病史的距下关节融合术患者骨不连的病例。通过PubMed、谷歌Scholar和Cochrane数据库进行广泛的文献检索，检索词如下：“融合术时间，踝关节融合术并发症，踝关节融合术结果。”meta回归评估研究样本量和出版年份对不连率的影响。三项研究符合纳入和排除标准。在纳入的研究中，距下关节融合术后的不愈合率从20%到55.6%不等。合并率为38% （95% CI: 18.2% ~ 59.8%）。我们的研究纳入了大量的病例，通过统计分析可以清楚地表明，与文献记载的情况相比，以前同侧踝关节融合的患者的距下融合率明显较低。

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引用次数: 0

Trends in medicare procedure utilization and physician fee reimbursement for foot and ankle arthrodesis and arthroplasty procedures 足、踝关节融合术和关节成形术的医疗保险程序使用和医生费用报销趋势。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 Epub Date: 2025-11-11 DOI: 10.1053/j.jfas.2025.10.014

LaMiah Hall MD, MPH (Research Fellow) , Simon P. Lalehzarian MD, MHA, MS (Research Fellow) , Tyler Kelly MD (Research Fellow) , Garrett Jebeles BS (Research Fellow) , Jordan Myers (Medical Student) , Gerald McGwin PhD, Professor , Aarvi Shah Student Researcher , Ashish Shah MD, Professor

Background

Total ankle arthroplasty and arthrodesis utilization has significantly increased in recent years with limited current studies examining physician reimbursement rates.

Purpose

This study provides an analysis of physician fee reimbursement from 2007 to 2025 and utilization trends from 2007 to 2022 for foot and ankle arthrodesis and arthroplasty procedures.

Study Design

Retrospective analysis

Methods

Physician reimbursement data were extracted from the CMS Physician Fee Schedule Look-Up Tool using CPT codes between 2007 and 2025. National payment amounts were inflation-adjusted using the Consumer Price Index (January 2025 values) and reported in 2025 USD. For each CPT code, nominal and inflation-adjusted reimbursement trends were analyzed. Medicare Part B Summary Data File was used to collect utilization trends per CPT code from 2007 to 2022.

Results

From 2007 to 2025, nominal reimbursement rates changed for most CPT codes: 27702 (-1.21 %), 27815 (- 0.38 %), 27870 (- 0.44 %), 28725 (- 1.52 %), and 29899 (-1.71 %). The procedures that showed nominal increases were 27871 (+3.41 %) and 28740 (+1.46 %). When adjusted for inflation, all procedures experienced declines: 27702 (-37.05 %), 27815 (-36.52 %), 27870 (-36.56 %), 27871 (-34.11 %), 28725 (-37.25 %), 28740 (-35.35 %), and 29899 (-37.37 %). The total percentage change from 2007 to 2022 showed increased utilization for CPT codes 27702 (+502.54 %), 27870 (+8.06 %), 28725 (+69.78 %), and 28740 (+156.98 %) and reductions for CPT codes 27871 (-32.88 %), 28715 (-9.52 %), and 29899 (-17.35 %).

Conclusion

Between 2007 and 2025, inflation-adjusted reimbursement reductions ranged from 34.11 % to 37.25 %, while utilization rates varied for foot and ankle arthroplasty and arthrodesis procedures.

背景：近年来，全踝关节置换术和关节融合术的使用率显著增加，但目前关于医生报销率的研究有限。目的：本研究分析2007 - 2025年足踝关节融合术和关节置换术的医师费用报销和2007 - 2022年的使用趋势。研究设计：回顾性分析方法：2007年至2025年间，使用CPT代码从CMS医生收费表查询工具中提取医生报销数据。国家支付金额使用消费者价格指数（2025年1月的价值）进行通货膨胀调整，并以2025年美元报告。对于每个CPT代码，分析了名义和通货膨胀调整后的报销趋势。医疗保险B部分摘要数据文件用于收集2007年至2022年每个CPT代码的使用趋势。结果：从2007年到2025年，大多数CPT代码的名义报销率发生了变化：27702（-1.21%）、27815（- 0.38%）、27870（- 0.44%）、28725（- 1.52%）和29899（-1.71%）。显示名义增长的程序分别为27871宗（+3.41%）和28740宗（+1.46%）。经通货膨胀调整后，所有程序均出现下降：27702（-37.05%）、27815（-36.52%）、27870（-36.56%）、27871（-34.11%）、28725（-37.25%）、28740（-35.35%）和29899（-37.37%）。从2007年到2022年的总百分比变化显示，CPT代码27702（+502.54%）、27870（+8.06%）、28725（+69.78%）和28740（+156.98%）的利用率增加，而CPT代码27871（-32.88%）、28715（-9.52%）和29899（-17.35%）的利用率降低。结论：2007年至2025年间，通货膨胀调整后的报销减少幅度从34.11%到37.25%不等，而足、踝关节置换术和关节融合术的使用率则有所不同。证据等级：四级，经济分析。

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引用次数: 0

Evaluating fracture healing in tibial plafond injuries: RUST score analysis after ORIF and MIPO with adjuvant teriparatide therapy 评估胫骨平台损伤骨折愈合：ORIF和MIPO配合特立帕肽辅助治疗后的RUST评分分析。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 Epub Date: 2025-11-12 DOI: 10.1053/j.jfas.2025.11.011

Luigi Meccariello MD , Giuseppe Cusano MD , Alfonso Meluccio MD , Antonio Pompilio Gigante MD, Full Prof , Luigi Matera MD

Introduction

Fracture healing remains a complex and multifactorial biological process, influenced by mechanical stability, vascular supply, and biological environment. The aim of this study was to assess whether statistically significant prognostic differences in fracture healing exist between ORIF and MIPO after teriparatide therapy, using the RUST scores.

Materials and methods

Twenty seven patients with tibial plafond fractures were divided into two groups: 14 treated with ORIF and 13 with MIPO. All patients received postoperative teriparatide injections. Functional outcomes were assessed using the AOFAS score, and quality of life was evaluated with SF-12 and VAS. Continuous data were analyzed using Student’s t-test, with statistical significance set at p < .05.

Results

VAS and RUST scores showed moderate correlation (.001 < p < .034). Postoperative AOFAS scores initially declined, with significant difference favoring MIPO (p = .024), but converged by 6 months. At 6 months, ORIF demonstrated higher RUST all cortices (p = .035) and medial-lateral (p = .001), with no difference in anterior-posterior. ORIF may achieve superior cortical consolidation and alignment versus MIPO.

Discussion

The ORIF group demonstrated superior bone consolidation, as indicated by higher RUST in cortical 4 and medial-lateral (M-L) views (P = .035 and P = .001). Despite these differences, clinical outcomes depend on fracture type, patient health, and surgical timing. ORIF should be considered the preferred approach for complex tibial plafond fractures.

Conclusion

ORIF may offer advantages in anatomical reduction and bone healing over MIPO in tibial plafond fractures, with comparable clinical outcomes. The authors believe that teriparatide was a useful adjuvant in the healing of pilon fractures.

骨折愈合是一个复杂的、多因素的生物学过程，受机械稳定性、血管供应和生物环境的影响。本研究的目的是利用RUST评分评估特立帕肽治疗后ORIF和MIPO在骨折愈合方面是否存在统计学上显著的预后差异。材料与方法：27例胫骨平台骨折患者分为两组，14例采用ORIF， 13例采用MIPO。所有患者术后均接受特立帕肽注射。功能结局采用AOFAS评分评估，生活质量采用SF-12和VAS评估。连续资料分析采用Student’st检验，统计学意义设为p。结果：VAS评分与RUST评分呈中度相关(p。0.001 < p < .034)。术后AOFAS评分最初下降，MIPO评分有显著差异（p = ）。024)，但却在6个月前收敛。6个月时，ORIF显示所有皮质（p = .035）和内侧外侧（p = ）的RUST较高。001)，前后比较无差异。与MIPO相比，ORIF可以实现更好的皮质巩固和对齐。讨论：ORIF组表现出更好的骨巩固，在皮质4和中外侧（M-L）视图中显示更高的RUST （P= 0.035和P= 0.001）。尽管存在这些差异，但临床结果取决于骨折类型、患者健康状况和手术时机。ORIF应被认为是复杂胫骨平台骨折的首选入路。结论：与MIPO相比，ORIF在胫骨平台骨折的解剖复位和骨愈合方面具有优势，其临床效果相当。作者认为，特立帕肽是一种有效的辅助治疗皮隆骨折。

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引用次数: 0

Progressive collapsing foot deformity: short and mid-term correction with arthroereisis compared with lateral column lengthening 进行性塌陷足畸形：短期和中期关节内缩矫正与侧柱延长比较。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 Epub Date: 2025-12-17 DOI: 10.1053/j.jfas.2025.10.015

Héctor José Masaragian MD, Fernando Perin MD , Nicolas Ameriso MD , Cecilia Diamante MD , Taiel Fiorentino MD , Leonel Rega MD

Background

Progressive collapsing foot deformity (PCFD) grade I AB can cause progressive structural changes and functional limitations. Surgical intervention is indicated when deformity progression or symptoms significantly impair daily activities.

Purpose

To compare the effectiveness of lateral column lengthening (LCL) and subtalar arthroereisis (STA) in the surgical treatment of early-stage PCFD.

Study Design

Retrospective comparative study.

Methods

Fifty-six patients with grade I AB PCFD were reviewed retrospectively; 16 underwent STA and 40 underwent LCL combined with medializing calcaneal osteotomy and medial soft tissue procedures. All radiographic measurements were performed by a single surgeon not involved in the surgeries. Primary outcomes were changes in angular parameters and American Orthopaedic Foot and Ankle Society (AOFAS) scores. Mean follow-up was 28.6 months (range, 18–72 months).

Results

Preoperative functional scores averaged 47.15 points, improving to 98.3 points postoperatively. Both techniques achieved statistically significant improvements in most angular parameters and functional scores. The Costa-Bartani angle did not significantly change in the STA group. No statistically significant differences were observed between groups in postoperative angular correction or functional scores. Patients aged 42–65 years showed greater improvements in the lateral talocalcaneal angle compared to other age groups, suggesting a possible age-related influence on certain radiographic outcomes.

Conclusion

Both LCL and STA are effective surgical options for the management of early-stage PCFD, producing significant radiographic and functional improvements. Age may influence specific radiographic parameters, warranting further investigation.

背景：进行性塌陷足畸形（PCFD） I级AB可引起进行性结构改变和功能限制。当畸形进展或症状严重影响日常活动时，需要手术干预。目的：比较外侧柱延长术（LCL）与距下关节挛缩术（STA）在早期PCFD手术治疗中的疗效。研究设计：回顾性比较研究。方法：回顾性分析56例AB级PCFD患者的临床资料；16例行STA手术，40例行LCL联合内侧跟骨截骨和内侧软组织手术。所有放射测量均由一名未参与手术的外科医生完成。主要结果是角度参数和美国骨科足踝协会（AOFAS）评分的变化。平均随访28.6个月（18-72个月）。结果：术前功能评分平均47.15分，术后改善至98.3分。两种技术在大多数角度参数和功能评分方面都取得了统计学上显著的改善。STA组Costa-Bartani角无明显变化。术后角度矫正和功能评分组间无统计学差异。与其他年龄组相比，42-65岁的患者距跟侧角的改善更大，这表明年龄可能对某些放射学结果有影响。结论：LCL和STA都是治疗早期PCFD的有效手术选择，能显著改善影像学和功能。年龄可能会影响特定的放射参数，需要进一步研究。

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引用次数: 0

Influence of keel shape of Salto TalarisTM total ankle prosthesis on the biomechanical performance on the bone-implant interface: A finite-element analysis Salto TalarisTM全踝关节假体龙骨形状对骨-种植体界面生物力学性能影响的有限元分析

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 Epub Date: 2025-10-02 DOI: 10.1053/j.jfas.2025.09.011

Zhang Yingdong MBBS , Li Heng MD , Xu Xiangyu MD , Wu Yong MD

Purpose

This study aimed to evaluate the effects of changing the keel shape of the tibial component of a keel-type total ankle prosthesis on its biomechanical behavior and to identify possible directions for further prosthesis selection and improvement.

Methods

Finite elements analysis was applied to analysis the influence on biomechanical effects of the shape of tibia implant keel in total ankle prostheses. CT of a male volunteer was used to develop tibia models with different prosthesis designs based on the tibia implant of Salto TalarisTM ankle prosthesis. Biomechanical properties including stress, micromotion and strain were evaluated.

Results

The peak stress and micromotion of the design with short keel and vertical holes were 85.3 MPa and 62.87 μm, respectively, which were 36.7 % and 84.4 % lower than the original design. The proportion of units with satisfactory osseointegration in the periprosthetic bone tissue reached 20.09 % in this design and was 19.1 % more than the original design.

Conclusion

Reducing the length of keel of the tibia prosthesis to the underlying support structure and reorienting the lateral holes to the vertical direction could improve the stability of the prosthesis by reducing possible sterile loosening through the improvement of the mechanical effects mentioned above. But this may require further experiments for verification.

目的：本研究旨在评估改变龙骨型全踝假体胫骨部分龙骨形状对其生物力学行为的影响，并确定进一步选择和改进假体的可能方向。方法：采用有限元方法分析全踝关节假体胫骨龙骨形状对生物力学效应的影响。在Salto TalarisTM踝关节假体胫骨植入物的基础上，利用男性志愿者的CT建立不同假体设计的胫骨模型。生物力学性能包括应力、微动和应变。结果：短龙骨和垂直孔设计的峰值应力和微动分别为85.3 MPa和62.87 μm，分别比原设计降低了36.7%和84.4%。在本设计中，假体周围骨组织中骨融合满意的单元比例达到20.09%，比原设计提高19.1%。结论：通过减少胫骨假体龙骨对下支撑结构的长度，将侧孔重新定位到垂直方向，可以通过改善上述力学效应，减少假体可能发生的无菌性松动，从而提高假体的稳定性。但这可能需要进一步的实验来验证。

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引用次数: 0

Minimally invasive repair with improved oval forceps suture-guiding method versus open repair with modified Kessler method for acute achilles tendon rupture: A randomized prospective study 改良卵圆钳引导缝线微创修复与改良Kessler法开放修复急性跟腱断裂：一项随机前瞻性研究

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 Epub Date: 2025-11-10 DOI: 10.1053/j.jfas.2025.11.001

Gaole Dai MD , Xuyan Fu MD , Linfeng Jin MD , Yi Jiang MD , Jianjun Hong MD , Yuanming Luo MD

Background: Acute Achilles tendon rupture is a common injury. The optimal management of acute Achilles tendon rupture remains controversial. Purpose: Compare the efficacy and complications of minimally invasive repair with improved oval forceps suture-guiding method and open repair with modified Kessler method. Study design: A clinical measurement. Methods: We enrolled 60 patients from Jan 2017 to Jun 2019. Patients were randomly divided into Group Mini (30 cases) and Group Open (30 cases). The operation duration and length of incision were compared. The functional outcomes were evaluated using the American Orthopedic Foot and Ankle Society score, Achilles tendon total rupture score, range of motion of the ankle and plantarflexion strength ratio. The time from surgery to return to work and sports were recorded and the complications were also assessed. Results: The operation duration and length of incision in Group Mini were significantly less than that in Group Open, which reduced wound complications and improved cosmesis. However, there were no significant differences between the two groups in term of the functional outcomes. The time from surgery to return to work and sports in Group Mini were significantly shorter than that in Group Open. As for complications, the postoperative complication rate in Group Mini were significantly lower than that in Group Open. Conclusions: There may be benefits to the minimally invasive approach in the treatment of acute Achilles tendon rupture compared to open.

背景：急性跟腱断裂是一种常见的损伤。急性跟腱断裂的最佳治疗方法仍有争议。目的：比较改良卵圆钳引导缝线微创修复与改良Kessler法开放性修复的疗效及并发症。研究设计：临床测量。方法：我们从2017年1月至2019年6月招募了60例患者。患者随机分为Mini组（30例）和Open组（30例）。比较手术时间和切口长度。功能结果采用美国骨科足踝学会评分、跟腱总断裂评分、踝关节活动范围和跖屈强度比进行评估。从手术到恢复工作和运动的时间被记录下来，并发症也被评估。结果：Mini组的手术时间和切口长度明显少于Open组，减少了创面并发症，改善了美观。然而，两组在功能结果方面没有显著差异。从手术到恢复工作和运动的时间，Mini组明显短于Open组。并发症方面，Mini组术后并发症发生率明显低于Open组。结论：微创入路治疗急性跟腱断裂比开放入路更有优势。

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引用次数: 0

The reduction of bowing of the fifth metatarsal after intramedullary screw insertion for jones fractures may reduce risk of refracture 琼斯骨折髓内螺钉置入后减少第五跖骨屈曲可降低再骨折风险。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 Epub Date: 2025-11-17 DOI: 10.1053/j.jfas.2025.11.012

Miyu Inagawa MD , Hiroshi Iwaso MD, PhD , Atsushi Fukai MD, PhD , Eisaburo Honda MD, PhD , Shin Sameshima MD , Hiroki Yoshitomi MD , Kazumi Goto MD , Yutaro Ishida MD , Koji Matuso MD , Ryota Kuzuhara MD , Takaki Sanada MD

Background

Bone morphological change intramedullary screw fixation, characterized by gap widening at the plantar side of the fifth metatarsal shaft, is considered a factor contributing to delayed union and pseudoarthrosis. However, the reduction in bowing of the fifth metatarsal, which occurs alongside the plantar gap, has not been reported. A reduction in bowing height, concurrent with plantar gap widening, may protect against refracture.

Purpose

This study aimed to investigate the effects of surgery for Jones fractures on morphological changes associated with refractures.

Methods

From 2008 to 2019, 222 patients underwent headless intramedullary screw fixation for Jones fractures. Of these, 19 feet had postoperative refractures, which were matched to 57 feet with normal bony union (1:3 ratio) based on bone graft, screw diameter, and metatarsal screw ratio.

Results

X-ray analysis compared the height of bowing of the fifth metatarsal between group R (refracture patients) and group U (normal union patients).In Group R, the bowing height remained at 4.5 mm before and after surgery. In Group U, the bowing height decreased from 4.5 mm preoperatively to 4.3 mm postoperatively (P < 0.01).

Conclusion

The reduction in bowing height of the fifth metatarsal was significantly greater in the normal union group than in the refracture group after intramedullary screw fixation. This suggests that the alignment change post-surgery may help prevent refracture.

背景：骨形态改变髓内螺钉固定，以第五跖骨干足底侧间隙变宽为特征，被认为是导致延迟愈合和假关节的一个因素。然而，发生在足底间隙附近的第五跖骨屈曲的减少尚未见报道。弯曲高度的降低，同时足底间隙的扩大，可以防止再骨折。目的：本研究旨在探讨琼斯骨折手术对骨折后形态学改变的影响。方法：2008 - 2019年222例Jones骨折患者行无头髓内螺钉固定。其中19脚发生术后骨折，57脚根据植骨、螺钉直径和跖骨螺钉比例进行正常骨愈合（1:3比例）。结果：x线分析比较R组（再骨折患者）和U组（正常愈合患者）第五跖骨屈曲高度。R组手术前后弓形高度保持在4.5 mm。U组弓形高度由术前4.5 mm降至术后4.3 mm （P < 0.01）。结论：经髓内螺钉固定后，正常愈合组第五跖骨弓形高度的降低明显大于再骨折组。这表明手术后调整骨位有助于预防再骨折。证据等级：Ⅲ级。

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引用次数: 0

Cover 1 -- cover prints black and PMS 261 封面1 -封面印刷黑色和PMS 261

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 Epub Date: 2026-03-12 DOI: 10.1053/S1067-2516(26)00022-0

引用次数: 0