Journal of Foot & Ankle Surgery最新文献_第3页

Assessing the role of posterior to anterior calcaneal screw fixation in tibiotalocalcaneal nailing after ankle trauma: A retrospective comparative study 评估跟后前螺钉固定在踝关节创伤后胫距跟骨钉中的作用：回顾性比较研究。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 Epub Date: 2025-10-13 DOI: 10.1053/j.jfas.2025.10.001

Karissa Badillo DPM, AACFAS (Resident) , Jeffrey Manway DPM, FACFAS (Residency Program Director) , Gele Moloney MD (Orthopaedic surgeon)

Tibiotalocalcaneal (TTC) nailing is commonly used to treat severe ankle trauma, especially in patients with poor bone quality or compromised soft tissue. Although biomechanical studies suggest that posterior-to-anterior (P-A) screws enhance stability, the clinical impact of these screws remains uncertain. This study aims to compare complication rates between patients who underwent TTC nailing with and without P-A screws after ankle trauma. A retrospective analysis was conducted on 33 patients who underwent TTC nailing for ankle trauma between 2016 and 2022. Patients were divided into two groups: those who received P-A screws (n = 13) and those who did not (n = 20). Demographic and surgical variables, including age, comorbidities, and operative factors, were analyzed. Complication rates were compared using nonparametric Wilcoxon rank sum and Fisher’s exact tests. Significance was set at p < 0.05. The mean age of patients was 70.5 years, with 63.6 % female and 36.4 % diabetic. The overall major complication rate was 15.1 %, with no statistically significant difference between the P-A screw group and the non-P-A screw group (p = 1.00). Other factors, including age (p = 0.24), time to weightbearing (p = 1.00), and the presence of comorbidities such as diabetes or peripheral arterial disease, did not significantly impact complication rate. Our study found no significant difference in complication rates between patients who received P-A screws during TTC nailing and those who did not. Despite biomechanical studies supporting P-A screws for increased stability, this did not translate to improved clinical outcomes. Further prospective research is warranted to evaluate the clinical relevance of P-A screws in TTC nailing for ankle trauma.

胫距跟骨钉（TTC）通常用于治疗严重的踝关节创伤，特别是骨质量差或软组织受损的患者。尽管生物力学研究表明后路-前路（P-A）螺钉可增强稳定性，但这些螺钉的临床效果仍不确定。本研究旨在比较踝关节创伤后行TTC内钉与不行P-A螺钉的患者的并发症发生率。回顾性分析2016年至2022年间33例踝关节创伤行TTC内钉治疗的患者。患者分为两组：接受P-A螺钉治疗组（n = 13）和未接受P-A螺钉治疗组（n = 20）。分析人口统计学和外科变量，包括年龄、合并症和手术因素。采用非参数Wilcoxon秩和和Fisher精确检验比较并发症发生率。p < 0.05为显著性。患者平均年龄70.5岁，女性占63.6%，糖尿病患者占36.4%。总主要并发症发生率为15.1%，p - a螺钉组与非p - a螺钉组比较差异无统计学意义（p = 1.00）。其他因素，包括年龄（p = 0.24）、负重时间（p = 1.00）和合并症（如糖尿病或外周动脉疾病）的存在，对并发症发生率没有显著影响。我们的研究发现，在TTC内钉中使用P-A螺钉与未使用P-A螺钉的患者之间并发症发生率无显著差异。尽管生物力学研究支持P-A螺钉增加稳定性，但这并没有转化为改善临床结果。需要进一步的前瞻性研究来评估P-A螺钉在踝关节创伤TTC内钉治疗中的临床意义。

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引用次数: 0

Clinical and radiological outcomes of screw fixation and suture-button technique in syndesmosis injuries with isolated lateral malleolus fractures 螺钉固定和线扣技术治疗胫腓联合损伤并发孤立性外踝骨折的临床和影像学结果。

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.2025.11.007

Hünkar Çağdaş Bayrak , Bekir Karagöz , Onur Gök

Background

Surgical stabilization is crucial for managing syndesmosis injuries following ankle trauma. While syndesmosis screws provide anatomical stability, they are associated with issues such as potential loosening or the need for removal. Screw breakage, although frequently reported, may not represent a true complication in asymptomatic patients. The suture-button technique aims to preserve physiological mobility and enhance functional outcomes.

Purpose

To compare the clinical and radiological outcomes of screw fixation and suture-button fixation in syndesmosis injuries with isolated lateral malleolus fractures.

Study Design

Retrospective comparative study.

Methods

This study included 73 patients treated between 2018 and 2022. Patients were divided into two groups: suture-button fixation (n = 41) and syndesmosis screw fixation (n = 32). Clinical outcomes were assessed using AOFAS and OMAS scores, while MCS, TFCS, and TFO were used for radiological evaluation. The MCID was applied to determine the clinical relevance of score differences.

Results

Both groups showed significant improvements in AOFAS and OMAS scores (p < 0.05). At final follow-up, the suture-button group demonstrated significantly higher AOFAS (95.9 ± 6.1 vs. 89.4 ± 12.6, p = 0.005) and OMAS (94.2 ± 8.1 vs. 88.9 ± 11.7, p = 0.025) scores, exceeding MCID thresholds. Although complication rates were lower in the suture-button group (p = 0.022), this difference became insignificant after excluding screw breakage (p = 0.951). Range of motion was also significantly better in the suture-button group (p = 0.033).

Conclusion

The suture-button technique provided superior clinical outcomes and joint mobility, while both methods offered comparable radiographic stability.

背景：手术稳定是治疗踝关节创伤后联合损伤的关键。虽然联合螺钉提供了解剖稳定性，但它们与潜在的松动或需要移除等问题有关。螺钉断裂虽然经常被报道，但在无症状患者中并不代表真正的并发症。缝合-按钮技术的目的是保持生理活动能力并提高功能预后。目的：比较螺钉固定与线扣固定治疗孤立性外踝骨折联合损伤的临床和影像学结果。研究设计：回顾性比较研究。方法：本研究纳入2018年至2022年期间接受治疗的73例患者。患者分为两组：缝线扣固定（n = 41）和韧带联合螺钉固定（n = 32）。使用AOFAS和OMAS评分评估临床结果，而使用MCS， TFCS和TFO进行放射学评估。应用MCID来确定评分差异的临床相关性。结果：两组患者AOFAS、OMAS评分均有显著改善（p < 0.05）。在最后随访时，缝合按钮组的AOFAS评分（95.9±6.1比89.4±12.6,p = 0.005）和OMAS评分（94.2±8.1比88.9±11.7,p = 0.025）明显高于MCID阈值。虽然缝线扣组并发症发生率较低（p = 0.022），但排除螺钉断裂后差异不显著（p = 0.951）。缝线-按钮组的活动范围也明显更好（p = 0.033）。结论：缝合-按钮技术提供了优越的临床效果和关节活动能力，而两种方法具有相当的放射学稳定性。

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引用次数: 0

Three-dimensional navigation for talocalcaneal coalition resection: A comparative analysis 距跟关节联合切除术三维导航的比较分析。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 Epub Date: 2025-11-17 DOI: 10.1053/j.jfas.2025.11.015

Jacob Schaefer MD, Emil Varas-Rodriguez MPH, Quinn Johnson MD, Aliya G. Feroe MD, MPH, Anthony Stans MD, A. Noelle Larson MD, Todd A. Milbrandt MD, MS, Emmanouil Grigoriou MD

Objective

Talocalcaneal (TC) coalition is an abnormal connection between the talus and calcaneus, causing painful, restricted subtalar motion, recurrent ankle sprains, and rigid flatfoot. The purpose of this study was to compare 3D-navigation to traditional open techniques in resection of TC coalitions.

Patient and Methods

Patients who underwent TC coalition resection with the assistance of intra-operative 3-D navigation (study cohort = 12 patients, 14 feet) or the traditional non-navigated approach (control group = 4 patients, 5 feet) at a single tertiary referral center were reviewed. Operative time (OT), anesthesia time (AT), tourniquet time (TT), blood loss (EBL), length of hospital stay (LOS), complications, duration of immobilization postoperatively, and average effective dose of radiation in millisieverts (mSv) were reviewed.

Results

OT (p = 0.97), EBL (p = 0.75), LOS (p = 0.58), AT (p = 0.46), and TT (p = 0.76) did not differ between groups. Mean duration of postoperative immobilization was 2 weeks shorter for the navigated group but not statistically significant (p = 0.11). Two complications occurred in the navigated group; one obese patient (BMI=34 kg/m²) had delayed wound healing, and another patient had a superficial skin infection. The average effective dose of radiation for all patients (n = 12) in the navigated group was 0.0081 mSv. The average dose for patients undergoing only one intraoperative CT spin (n = 9) was 0.0052 mSv.

Conclusions

Navigated TC coalition excision had comparable OT, EBL, LOS, AT, and TT to traditional non-navigated approach patients. The addition of intraoperative 3D navigation provides precise resection guidance without significantly increased surgical time with comparable total effective radiation dose to the traditional use of intra-operative fluoroscopy.

目的：距骨跟骨（TC）联合是距骨和跟骨之间的异常连接，引起疼痛，距下运动受限，反复踝关节扭伤和僵硬的扁平足。本研究的目的是比较3d导航与传统开放技术在TC联合切除术中的应用。患者和方法：回顾在单一三级转诊中心接受术中三维导航辅助TC联合切除术的患者（研究队列 = 12例患者，14英尺）或传统的非导航入路（对照组 = 4例患者，5英尺）。回顾了手术时间（OT）、麻醉时间（AT）、止血带时间（TT）、出血量（EBL）、住院时间（LOS）、并发症、术后固定时间和平均有效辐射剂量（mSv）。结果：OT （p=0.97）、EBL （p=0.75）、LOS （p=0.58）、AT （p=0.46）、TT （p=0.76）各组间差异无统计学意义。导航组术后平均固定时间短2周，但无统计学意义（p=0.11）。导航组出现2例并发症；1例肥胖患者（BMI=34 kg/m2）伤口愈合延迟，另1例为浅表皮肤感染。导航组所有患者（n=12）的平均有效辐射剂量为0.0081 mSv。术中仅接受1次CT旋转（n=9）的患者的平均剂量为0.0052 mSv。结论：导航TC联合切除术的OT、EBL、LOS、AT和TT与传统非导航入路患者相当。术中3D导航的加入提供了精确的切除指导，而不会显著增加手术时间，总有效辐射剂量与传统的术中透视相当。证据等级：四级。

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引用次数: 0

Nonunion incidence following differing weightbearing protocols after first metatarsal phalangeal joint arthrodesis: A systematic review 第一跖指关节融合术后不同负重方式的骨不连发生率：一项系统综述。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 Epub Date: 2025-11-19 DOI: 10.1053/j.jfas.2025.10.012

Anthony Schwab DPM, MS, AACFAS , Gregory Rose DPM, MPH , Andrew Meyr DPM, FACFAS , Roland Ramdass DPM, FACFAS

Background

When performing arthrodesis of the first metatarsophalangeal joint (MTPJ), reported fixation options have been vast with high success rates and a low complication profile. Immediate postoperative weightbearing status typically varies by surgeon irrespective of fixation construct.

Purpose

There has been a paucity of literature regarding the effect postoperative weight bearing status has on the nonunion rate following first MTPJ arthrodesis.

Study Design/Methods

We performed a systematic review and identified a total of 40 studies and 3,222 feet that underwent first MTPJ arthrodesis with a cohort of patients that were made heel weightbearing as tolerated (HWB), non weightbearing (NWB), and full weightbearing (FWB). Results: Nonunion rate was found to be lowest in the FWB cohort at 4.34% compared to 8.20% for that of the HWB group, and 9.27% for NWB (p < 0.001). Time to union was found to be fastest in the NWB group at 8.8 weeks, compared to 10.42 weeks for immediate full weight bearing and 12.18 weeks for immediate heel weight bearing (p < 0.001).

Conclusion

While time to union varied, immediate full weightbearing was associated with the lowest nonunion rate, with no adverse effect on fusion success compared to delayed protocols.

背景：当进行第一跖趾关节（MTPJ）的关节融合术时，报道的固定选择很多，成功率高，并发症少。术后即刻负重状态通常因外科医生而异，与固定结构无关。目的：关于首次MTPJ关节融合术后术后负重状态对骨不连率的影响，文献很少。研究设计/方法：我们进行了一项系统回顾，并确定了总共40项研究和3,222只脚进行了首次MTPJ关节融合术，其中一组患者进行了足跟负重耐受（HWB）、非负重（NWB）和完全负重（FWB）。结果：FWB组的骨不愈合率最低，为4.34%，而HWB组为8.20%，NWB组为9.27%(结论：虽然愈合时间不同，但立即完全负重与最低的骨不愈合率相关，与延迟方案相比，对融合成功没有不利影响。临床证据水平：4级回顾性。

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引用次数: 0

Incidence of skin and soft tissue infection in elective foot and ankle surgery utilizing iodine- vs chlorhexidine-based surgical skin preparation: A retrospective study. 选择性足踝关节手术中使用碘与氯己定为基础的外科皮肤制剂的皮肤和软组织感染发生率：一项回顾性研究。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 DOI: 10.1053/j.jfas.2026.02.017

Miranda Royds, Gregory W Rose, Sara Hammond, Stephanie Bush, Anthony Schwab, Tyler Terhune, Roland S Ramdass

Background: Although the incidence of surgical site infection (SSI) in elective orthopedic surgery is low, SSI remains the most common hospital-acquired infection and represents a substantial proportion of nosocomial illness. Elective foot and ankle surgery has been reported to carry a relatively higher risk of SSI compared with other orthopedic procedures. These infections are associated with increased healthcare costs, prolonged recovery, and increased patient morbidity, making perioperative infection prevention a critical aspect of surgical planning.

Purpose: To compare postoperative surgical site infection rates following elective foot and ankle surgery using alcohol-based chlorhexidine versus alcohol-based iodine skin antiseptic agents.

Study design: Single-Surgeon, Retrospective Review.

Methods: A total of 215 consecutive patients undergoing clean, elective foot and ankle surgery were included. Patients were divided into two cohorts based on the preoperative skin preparation used: chlorhexidine-based preparation (n = 116) or iodine-based preparation (n = 99). Postoperative infection rates were recorded. Categorical variables, including infection, were compared using Fisher's exact test, and continuous variables were analyzed using independent-samples t-tests.

Results: Postoperative infection occurred in 1.72 % of patients in the chlorhexidine-based group and 1.02 % of patients in the iodine-based group. No statistically significant difference was observed between groups.

Conclusion: In this retrospective cohort study, no statistically significant difference in postoperative SSI rates was observed between alcohol-based chlorhexidine and alcohol-based iodine skin preparation agents in elective foot and ankle surgery. Given the low incidence of infection and limited statistical power, these findings should not be interpreted as evidence of equivalence between preparations.

Therapeutic study: Level 3 Evidence.

背景：虽然择期骨科手术手术部位感染（SSI）的发生率很低，但SSI仍然是最常见的医院获得性感染，在医院疾病中占很大比例。与其他骨科手术相比，选择性足部和踝关节手术具有相对较高的SSI风险。这些感染与医疗费用增加、恢复时间延长和患者发病率增加有关，因此围手术期感染预防是手术计划的一个关键方面。目的：比较选择性足部和踝关节手术后使用含酒精氯己定和含酒精碘皮肤杀菌剂的手术部位感染率。研究设计：单一外科医生，回顾性评价。方法：215例连续行清洁择期足踝手术的患者。根据术前使用的皮肤制剂将患者分为两组：氯己定基制剂（ = 116）或碘基制剂（ = 99）。记录术后感染率。分类变量（包括感染）采用Fisher精确检验进行比较，连续变量采用独立样本t检验进行分析。结果：氯己定为主组术后感染发生率为1.72%，碘为主组术后感染发生率为1.02%。各组间无统计学差异。结论：在这项回顾性队列研究中，选择性足踝关节手术中，酒精基氯己定与酒精基碘皮肤制剂术后SSI发生率无统计学差异。鉴于感染发生率低且统计效力有限，这些发现不应被解释为制剂之间等效的证据。治疗性研究：3级证据。

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引用次数: 0

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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)00024-4

引用次数: 0

Does the intermetatarsal angle play a role in first metatarsophalangeal joint arthrodesis rate and time to union? 跖间角对第一跖趾关节融合率和愈合时间有影响吗？

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 Epub Date: 2025-10-01 DOI: 10.1053/j.jfas.2025.09.012

Neha Atyam DPM, Michael B. Younes DPM, D. ABFAS, FACFAS, MBA, Zachery Weyandt DPM, FACFAS, ABPM, Samuel Clellen DPM, MBA, Rachel Warner DPM, AACFAS, Jennifer Mulhern DPM, D. ABFAS, FACFAS, ABPM

Background

A first metatarsophalangeal joint (1st MTPJ) arthrodesis is a reliable procedure for treating osteoarthritis with severe hallux valgus deformities. However, the effect of preoperative first–second intermetatarsal (IM) angle deformity on union rates and time to union remains unclear.

Methods

A retrospective review was conducted on patients that underwent a 1st MTPJ arthrodesis for correction of osteoarthritis and hallux valgus deformity from 2010 to 2020 utilizing a dorsal locking plate and interfragmentary lag screw fixation technique. All procedures were performed at a single reconstructive foot and ankle fellowship program. Patients were stratified into three groups based on preoperative IM angle: mild (≤11°), moderate (11.1–14.9°), and severe (≥15°). Exclusion criteria included: prior first ray surgery, other hardware techniques differing from dorsal locking plate and interfragmentary lag screw method, revision cases, and missing preoperative imaging. The Foot Union Scoring Evaluation Tool (FUSET) was utilized at standard postoperative intervals to define union of the 1st MTPJ arthrodesis.

Results

A total of 58 patients met inclusion criteria. Fusion was achieved in one hundred percent of the cases across all IM angle groups. There were no cases of nonunion or hardware failure. Average time to radiographic union was similar between groups. There was no statistically significant difference in FUSET scores observed at any point during the follow-up interval. Additionally, smoking history, diabetes, and vitamin D supplementation had no apparent impact on time to fusion.

Conclusions

The preoperative first–second IM angle did not influence fusion rate or time to union following 1st MTPJ arthrodesis for osteoarthritis and hallux valgus correction using a dorsal locking plate and interfragmentary lag screw construct. Given the 100 % union rate, this fixation technique offers reliable results regardless of the severity of the IM angle.

背景：第一跖趾关节融合术是治疗伴有严重拇外翻畸形的骨关节炎的可靠方法。然而，术前第一-第二跖间角畸形对愈合率和愈合时间的影响尚不清楚。方法：回顾性分析2010年至2020年首次行MTPJ关节融合术治疗骨关节炎和拇外翻畸形的患者，采用背侧锁定钢板和骨折块间螺钉固定技术。所有的手术都是在一个单独的足部和踝关节重建项目中进行的。根据术前IM角度将患者分为轻度（≤11°）、中度（11.1 ~ 14.9°）、重度（≥15°）三组。排除标准包括：先前的一线手术，其他不同于背侧锁定钢板和骨折块间延迟螺钉方法的硬件技术，翻修病例和术前影像学缺失。在标准的术后时间间隔使用足部愈合评分评估工具（FUSET）来确定第1 MTPJ关节融合术的愈合。结果：共有58例患者符合纳入标准。在所有内夹角组中，100%的病例实现了融合。没有骨不连或硬件故障的病例。两组平均x线愈合时间相似。在随访期间的任何时间点，FUSET评分均无统计学差异。此外，吸烟史、糖尿病和维生素D补充对融合时间没有明显影响。结论：采用背侧锁定钢板和骨折块间滞后螺钉结构进行骨关节炎和拇外翻第1次MTPJ关节融合术后，术前第1 - 2 IM角度对融合率和愈合时间没有影响。考虑到100%的愈合率，无论内夹角的严重程度如何，这种固定技术都提供了可靠的结果。临床证据等级：3。

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引用次数: 0

Outcomes of total talus replacement using a 3D-printed reinforced pure titanium prosthesis 3d打印增强纯钛假体全距骨置换术的效果。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-03-01 Epub Date: 2025-10-20 DOI: 10.1053/j.jfas.2025.10.006

Bomsoo Kim MD, PhD , Myung-Geun Song MD

Background

Total talus replacement (TTR) using a customized implant is an effective joint-salvaging option for severe talar destruction. Although favorable results have been reported with ceramic, cobalt-chrome, and titanium alloy prostheses, outcomes of pure titanium implants have not been described.

Purpose

To evaluate clinical outcomes of TTR using a pure titanium prosthesis.

Study design

Retrospective cohort study.

Methods

Thirty-nine patients underwent TTR for primary or post-traumatic avascular necrosis (AVN) of the talus with a mean follow-up of 23.2 ± 10.2 months (range, 12–55). Each prosthesis was fabricated from commercially pure titanium (Cp-Ti). Patient-reported outcomes, satisfaction, range of motion (ROM), and complications were assessed.

Results

Pain VAS improved from 8.2 ± 1.0 preoperatively to 2.1 ± 2.4 at final follow-up (p < 0.001). FAOS, FFI, EQ-5D, and EQ-VAS showed significant improvement. ROM increased from 52.2 ± 31.3° to 95.9 ± 23.3° (p < 0.001). Asymptomatic tibial osteophytes developed in 5 cases (12.8 %), and subchondral cysts in 3 (7.7 %), including two with mild implant settling. Thirty-six patients (92.3 %) were very satisfied and three (7.7 %) satisfied; all would undergo the same procedure again. The post-traumatic group had stiffer ankles and more concomitant procedures but achieved comparable improvement.

Conclusion

Short-term outcomes of TTR using pure titanium prostheses were favorable, showing significant pain relief, functional recovery, and high satisfaction. Pure titanium TTR is a feasible and effective treatment for primary or post-traumatic talar AVN.

背景：使用定制种植体的全距骨置换（TTR）是严重距骨破坏的有效关节挽救选择。虽然陶瓷、钴铬和钛合金假体有良好的结果报道，但纯钛假体的结果尚未报道。目的：评价使用纯钛假体修复TTR的临床效果。研究设计：回顾性队列研究。方法：39例距骨原发性或外伤性缺血性坏死（AVN）患者行TTR治疗，平均随访23.2±10.2个月（范围12-55）。每个假体由商业纯钛（Cp-Ti）制成。评估患者报告的结果、满意度、活动范围（ROM）和并发症。结果：疼痛VAS由术前8.2±1.0改善至终期随访时的2.1±2.4 （p < 0.001）。FAOS、FFI、EQ-5D、EQ-VAS均有显著改善。ROM从52.2±31.3°增加到95.9±23.3°（p < 0.001）。无症状胫骨骨赘5例（12.8%），软骨下囊肿3例（7.7%），包括2例轻度种植体沉淀。非常满意36例（92.3%），满意3例（7.7%）；所有人都将再次经历同样的过程。创伤后组踝关节僵硬，伴随手术较多，但改善程度相当。结论：使用纯钛假体治疗TTR短期疗效良好，疼痛明显缓解，功能恢复，满意度高。纯钛TTR是治疗原发性或创伤后距骨AVN可行有效的方法。临床证据等级：3级，回顾性队列研究。

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引用次数: 0

Evaluation of the relationship between plantar fascia and achilles tendon measurements in patients with plantar fasciitis 足底筋膜炎患者足底筋膜与跟腱测量关系的评价。

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.2025.11.006

Emre Emekli MD, PhD , M. Alperen Kılıç MD , Murat Tepe MD

Objective

This study aims to evaluate the relationship between plantar fascia (PFa) thickness and the morphology and paratenon measurements of the Achilles tendon (AT) in individuals diagnosed with plantar fasciitis (PF) based on magnetic resonance imaging (MRI) findings, and to investigate their role in PF development.

Methods

A total of 108 patients diagnosed with plantar fasciitis who underwent an ankle MRI between 2014 and 2024 were included in the study, along with a control group of 100 healthy individuals of similar age. In both groups, PFa thickness, AT anteroposterior (AP) and mediolateral (ML) diameters, and AT paratenon dimensions (diameters and area) were measured. The presence of retrocalcaneal bursitis and Achilles tendinopathy was also assessed. Measurements were repeated by two observers, and interobserver agreement was evaluated.

Results

PFa thickness and AT, AP and ML diameters were significantly higher in the PF group compared to controls (p < 0.05). Women had significantly greater PFa thickness than men. Retrocalcaneal bursitis and Achilles tendinopathy were also significantly more common in the PF group (p < 0.001). A weak positive correlation was observed between PFa thickness and AT diameters in the control group. Interobserver measurement agreement was high (ICC > 0.8).

Conclusion

Individuals diagnosed with PF showed increased morphometric characteristics of the AT, indicating a possible mechanical linkage between the plantar fascia and Achilles tendon. The findings support the role of the AT and associated structures in the pathophysiology of PF, emphasizing the importance of a comprehensive assessment of these structures in diagnosis and treatment.

目的：本研究旨在评估基于磁共振成像（MRI）诊断为足底筋膜炎（PF）的个体的足底筋膜（PFa）厚度与跟腱（AT）的形态和副腱测量之间的关系，并探讨它们在PF发展中的作用。方法：共有108名诊断为足底筋膜炎的患者在2014年至2024年期间接受了脚踝MRI检查，并纳入了研究，同时还有100名年龄相仿的健康个体作为对照组。在两组中，测量PFa厚度，AT正侧（AP）和中外侧（ML）直径，AT对atenon尺寸（直径和面积）。还评估了跟骨后滑囊炎和跟腱病的存在。由两名观测者重复测量，并评估观测者之间的一致性。结果：PF组PFa厚度及AT、AP、ML直径均显著高于对照组（p < 0.05）。女性的PFa厚度明显大于男性。跟骨后滑囊炎和跟腱病在PF组中也更为常见（p < 0.001）。对照组PFa厚度与AT直径呈弱正相关。观察者间测量一致性高（ICC > 0.8）。结论：诊断为PF的个体显示AT的形态特征增加，表明足底筋膜和跟腱之间可能存在机械联系。这些发现支持了AT和相关结构在PF病理生理中的作用，强调了对这些结构进行全面评估在诊断和治疗中的重要性。临床证据等级：3。

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引用次数: 0

The role of weightbearing computed tomography in assessing first metatarsal pronation in hallux valgus: A systematic review 负重计算机断层扫描在评估拇外翻第一跖骨前旋中的作用：一项系统综述。

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.2025.11.004

Sérgio Soares MD, PhD (Researcher) , Riccardo Garibaldi MD, PhD (Researcher PhD candidate) , Paolo Fiore MD , Xavier Martin Oliva MD, PhD (Researcher Full Professor)

Background

Hallux valgus is a multiplanar deformity often involving first metatarsal pronation. Weightbearing computed tomography may improve assessment compared to standard radiographs, which are limited to two-dimensional views.

Methods

A systematic review was conducted according to PRISMA guidelines. PubMed and Cochrane databases were searched for studies evaluating weightbearing computed tomography in assessing HV components, including metatarsal pronation and sesamoid position. Study quality was assessed using the Newcastle-Ottawa Scale.

Results

Fourteen studies (706 feet) were included. Weightbearing computed tomography consistently outperformed Weightbearing radiographs in detecting first metatarsal pronation and allowed more accurate differentiation between intrinsic torsion and joint malalignment. Pronation and sesamoid displacement were correlated, though thresholds and clinical significance varied. Nine studies were low risk of bias.

Conclusions

Weightbearing computed tomography provides a more accurate and reproducible assessment of metatarsal pronation and sesamoid alignment than weightbearing radiographs. However, its clinical impact remains uncertain. Future studies should standardize measurements and assess whether pronation correction improves surgical outcomes.

背景：拇外翻是一种多平面畸形，常累及第一跖骨前旋。与仅限于二维视图的标准x线片相比，负重计算机断层扫描可以改善评估。方法：根据PRISMA指南进行系统评价。检索PubMed和Cochrane数据库，以评估负重计算机断层扫描评估HV成分的研究，包括跖骨前旋和籽骨位置。使用纽卡斯尔-渥太华量表评估研究质量。结果：14项研究（706英尺）被纳入。负重计算机断层扫描在检测第一跖骨前旋方面一直优于负重x线片，并且可以更准确地区分内在扭转和关节错位。旋前和籽骨移位相关，但阈值和临床意义不同。9项研究为低偏倚风险。结论：与负重x线片相比，负重计算机断层扫描对跖骨前旋和籽骨对准的评估更为准确和可重复性。然而，其临床影响仍不确定。未来的研究应该标准化测量并评估旋前矫正是否能改善手术结果。

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