Pub Date : 2026-01-01DOI: 10.1053/j.jfas.2025.08.010
Jennifer A. Kipp DPM , Lindsay K. LeSavage DPM, AACFAS , Greg Russell MS , Kevin P. High MD, MS , Nicholas S. Powers DPM, FACFAS , Cody D. Blazek DPM, FACFAS
Background
The gold standard test for diagnosing osteomyelitis is bone biopsy, and IDSA 2023 guidelines recommend obtaining a “bone culture” for microbiological analysis in the setting of osteomyelitis. However, there is no consensus on the optimal method by which to obtain this bone sample.
Purpose
The purpose of this study was to retrospectively compare two intraoperative methods to obtain bone cultures: bone tissue cultures and bone swab cultures.
Study Design
A retrospective review was performed on one-hundred three patients who underwent 126 surgical procedures for concern of osteomyelitis in the lower extremity.
Methods
Intraoperatively, a bone swab culture and a bone tissue culture were obtained following debridement or amputation from the same operative site and submitted for microbiological analysis.
Results
Bone swab cultures yielded positive results in 40.5 % (51/126) of procedures, while bone tissue cultures were positive in 32 % (40/126)(p = 0.027). Complete agreement between both methods occurred in 80 % (101/126) cases. In cases of disagreement, bone swab cultures resulted positive more than bone tissue cultures (p = 0.028).
Conclusion
These findings suggest that the bone swab is more sensitive overall, and surgeons may even consider the use of both bone tissue and swabs for culture.
{"title":"A retrospective comparison of bone culture techniques","authors":"Jennifer A. Kipp DPM , Lindsay K. LeSavage DPM, AACFAS , Greg Russell MS , Kevin P. High MD, MS , Nicholas S. Powers DPM, FACFAS , Cody D. Blazek DPM, FACFAS","doi":"10.1053/j.jfas.2025.08.010","DOIUrl":"10.1053/j.jfas.2025.08.010","url":null,"abstract":"<div><h3>Background</h3><div>The gold standard test for diagnosing osteomyelitis is bone biopsy, and IDSA 2023 guidelines recommend obtaining a “bone culture” for microbiological analysis in the setting of osteomyelitis. However, there is no consensus on the optimal method by which to obtain this bone sample.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to retrospectively compare two intraoperative methods to obtain bone cultures: bone tissue cultures and bone swab cultures.</div></div><div><h3>Study Design</h3><div>A retrospective review was performed on one-hundred three patients who underwent 126 surgical procedures for concern of osteomyelitis in the lower extremity.</div></div><div><h3>Methods</h3><div>Intraoperatively, a bone swab culture and a bone tissue culture were obtained following debridement or amputation from the same operative site and submitted for microbiological analysis.</div></div><div><h3>Results</h3><div>Bone swab cultures yielded positive results in 40.5 % (51/126) of procedures, while bone tissue cultures were positive in 32 % (40/126)(<em>p</em> = 0.027). Complete agreement between both methods occurred in 80 % (101/126) cases. In cases of disagreement, bone swab cultures resulted positive more than bone tissue cultures (<em>p</em> = 0.028).</div></div><div><h3>Conclusion</h3><div>These findings suggest that the bone swab is more sensitive overall, and surgeons may even consider the use of both bone tissue and swabs for culture.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 21.e1-21.e4"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071129","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}
Pub Date : 2026-01-01DOI: 10.1053/j.jfas.2025.09.003
Ke Chen, Qiang Zhu, Wenping Huo, Jian Zhang, Shitao Wang
Objective
Compare clinical outcomes of elastic (Rigidloop) vs. rigid (screw) fixation for distal tibiofibular syndesmosis injury.
Methods
Eighty-eight patients were divided into an elastic fixation group (n = 43) and a rigid fixation group (n = 45) groups, with the elastic fixation group undergoing Rigidloop fixation and the rigid fixation group undergoing screw fixation. Clinical data (operation time, blood loss, weight-bearing/fracture healing time), radiographic parameters (talocalcaneal fusion site [TFCS], tibiofibular overlap [TFO], medial clear space [MCS]), American Orthopaedic Foot and Ankle Society (AOFAS) scores, plantar flexion range, and complications were analyzed.
Results
Preoperative and 12-month TFCS, TFO, and MCS were comparable (P > 0.05). The elastic fixation group had shorter operation time (60.23 ± 11.67 vs. 66.32 ± 12.28 min), reduced blood loss (151.05 ± 21.04 vs. 159.47 ± 22.11 mL), earlier weight-bearing (6.12 ± 1.06 vs. 7.75 ± 1.36 weeks), and faster wound/fracture healing compared with the rigid fixation group(P <0.05). At 3 months, the elastic fixation group showed superior plantar flexion (42.68 ± 4.00 vs. 40.18 ± 4.08°) and AOFAS scores (81.30 ± 5.23 vs. 77.98 ± 5.70 points, P < 0.05), but both groups tended to be consistent by 12 months (P > 0.05). Complications of the elastic fixation group (loosening, infection, re-separation) were lower (9.3 % vs. 24.4 %, P <0.05); satisfaction rates were similar (P > 0.05).
Conclusion
Rigidloop fixation is as effective as screw fixation in stabilizing syndesmosis injuries, and the Rigidloop system has the advantages of faster recovery, fewer complications, and early functional benefits, making it superior to screw fixation.
目的：比较弹性（Rigidloop）与刚性（螺钉）固定治疗胫腓联合远端损伤的临床效果。方法：88例患者分为弹性固定组（n=43）和刚性固定组（n=45），弹性固定组采用Rigidloop固定，刚性固定组采用螺钉固定。分析临床资料（手术时间、出血量、负重/骨折愈合时间）、影像学参数（距跟骨融合部位[TFCS]、胫腓骨重叠部位[TFO]、内侧间隙[MCS]）、美国矫形足踝学会（AOFAS）评分、足底屈曲范围及并发症。结果：术前和12个月TFCS、TFO、MCS具有可比性（P < 0.05）。弹性内固定组手术时间短（60.23±11.67 vs 66.32±12.28 min），出血量少（151.05±21.04 vs 159.47±22.11 mL），负重早（6.12±1.06 vs 7.75±1.36周），创面/骨折愈合快（P < 0.05）。弹性固定组并发症（松动、感染、再分离）发生率较低（9.3%比24.4%,P < 0.05）。结论：在稳定韧带联合损伤方面，Rigidloop固定与螺钉固定一样有效，且Rigidloop系统具有恢复快、并发症少、早期功能获益等优点，优于螺钉固定。
{"title":"Comparison of elastic fixation and rigid fixation in the treatment of distal tibiofibular syndesmosis injury","authors":"Ke Chen, Qiang Zhu, Wenping Huo, Jian Zhang, Shitao Wang","doi":"10.1053/j.jfas.2025.09.003","DOIUrl":"10.1053/j.jfas.2025.09.003","url":null,"abstract":"<div><h3>Objective</h3><div>Compare clinical outcomes of elastic (Rigidloop) vs. rigid (screw) fixation for distal tibiofibular syndesmosis injury.</div></div><div><h3>Methods</h3><div>Eighty-eight patients were divided into an elastic fixation group (n = 43) and a rigid fixation group (n = 45) groups, with the elastic fixation group undergoing Rigidloop fixation and the rigid fixation group undergoing screw fixation. Clinical data (operation time, blood loss, weight-bearing/fracture healing time), radiographic parameters (talocalcaneal fusion site [TFCS], tibiofibular overlap [TFO], medial clear space [MCS]), American Orthopaedic Foot and Ankle Society (AOFAS) scores, plantar flexion range, and complications were analyzed.</div></div><div><h3>Results</h3><div>Preoperative and 12-month TFCS, TFO, and MCS were comparable (P > 0.05). The elastic fixation group had shorter operation time (60.23 ± 11.67 vs. 66.32 ± 12.28 min), reduced blood loss (151.05 ± 21.04 vs. 159.47 ± 22.11 mL), earlier weight-bearing (6.12 ± 1.06 vs. 7.75 ± 1.36 weeks), and faster wound/fracture healing compared with the rigid fixation group(P <0.05). At 3 months, the elastic fixation group showed superior plantar flexion (42.68 ± 4.00 vs. 40.18 ± 4.08°) and AOFAS scores (81.30 ± 5.23 vs. 77.98 ± 5.70 points, P < 0.05), but both groups tended to be consistent by 12 months (P > 0.05). Complications of the elastic fixation group (loosening, infection, re-separation) were lower (9.3 % vs. 24.4 %, P <0.05); satisfaction rates were similar (P > 0.05).</div></div><div><h3>Conclusion</h3><div>Rigidloop fixation is as effective as screw fixation in stabilizing syndesmosis injuries, and the Rigidloop system has the advantages of faster recovery, fewer complications, and early functional benefits, making it superior to screw fixation.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 28.e1-28.e7"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193773","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}
Pub Date : 2026-01-01DOI: 10.1053/j.jfas.2025.08.005
Abdurrahman Aydın MD , Muhammed Bilal Kürk MD
Purpose
This study aimed to evaluate the clinical and radiological outcomes of parallel and non-parallel placements of a single syndesmotic screw relative to the ankle joint line in the coronal plane used to enhance tibiofibular stability after syndesmosis injuries in ankle trauma surgery.
Methods
Eighty-nine patients with isolated Weber B and C fractures treated from January 2021 to December 2024 were evaluated. They were divided into two groups based on the angulation of the syndesmotic screw: Group 1 (49 patients) had screws angled between −3° and +3° (parallel), while Group 2 (40 patients) had nonparallel screws. Comparisons were made on surgical duration, fluoroscopic shots needed for fixation, intraoperative fluoroscopic shots, postoperative medial clear space, ankle range of motion (ROM) at 3 and 6 months, American Orthopaedic Foot and Ankle Society (AOFAS) scores at those intervals, rates of implant fracture or failure, and radiolucencies around implants.
Results
The angulation of the syndesmotic screw was significantly different between the groups, measuring 1.87 ± 0.77 in Group 1 and 4.66 ± 1.68 in Group 2 (p < 0.001). Surgical duration averaged 51.32 ± 7.71 minutes in Group 1 compared to 40.62 ± 6.75 minutes in Group 2 (p = 0.027). At 3 months, ankle ROM was 32.95 ± 4.11 in Group 1 and 30.55 ± 3.44 in Group 2 (p = 0.026), but no significant difference was found at 6 months (p = 0.078). AOFAS scores showed significant differences at 3 months (p < 0.001) but not at 6 months (p = 0.862)
Conclusion
The study found that syndesmotic screws placed parallel or nonparallel to the joint in the coronal plane had similar clinical outcomes.
{"title":"Evaluation of the clinical and radiological outcomes of syndesmotic screws not parallel to the ankle joint","authors":"Abdurrahman Aydın MD , Muhammed Bilal Kürk MD","doi":"10.1053/j.jfas.2025.08.005","DOIUrl":"10.1053/j.jfas.2025.08.005","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to evaluate the clinical and radiological outcomes of parallel and non-parallel placements of a single syndesmotic screw relative to the ankle joint line in the coronal plane used to enhance tibiofibular stability after syndesmosis injuries in ankle trauma surgery.</div></div><div><h3>Methods</h3><div>Eighty-nine patients with isolated Weber B and C fractures treated from January 2021 to December 2024 were evaluated. They were divided into two groups based on the angulation of the syndesmotic screw: Group 1 (49 patients) had screws angled between −3° and +3° (parallel), while Group 2 (40 patients) had nonparallel screws. Comparisons were made on surgical duration, fluoroscopic shots needed for fixation, intraoperative fluoroscopic shots, postoperative medial clear space, ankle range of motion (ROM) at 3 and 6 months, American Orthopaedic Foot and Ankle Society (AOFAS) scores at those intervals, rates of implant fracture or failure, and radiolucencies around implants.</div></div><div><h3>Results</h3><div>The angulation of the syndesmotic screw was significantly different between the groups, measuring 1.87 ± 0.77 in Group 1 and 4.66 ± 1.68 in Group 2 (p < 0.001). Surgical duration averaged 51.32 ± 7.71 minutes in Group 1 compared to 40.62 ± 6.75 minutes in Group 2 (p = 0.027). At 3 months, ankle ROM was 32.95 ± 4.11 in Group 1 and 30.55 ± 3.44 in Group 2 (p = 0.026), but no significant difference was found at 6 months (p = 0.078). AOFAS scores showed significant differences at 3 months (p < 0.001) but not at 6 months (p = 0.862)</div></div><div><h3>Conclusion</h3><div>The study found that syndesmotic screws placed parallel or nonparallel to the joint in the coronal plane had similar clinical outcomes.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 18.e1-18.e6"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876550","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}
Pub Date : 2026-01-01DOI: 10.1053/j.jfas.2025.08.004
Andrea De Fazio MD , Giorgio Fravolini MD , Elena Gabrielli MD , Matteo Turchetta MD , Marianna Citro MS , Fabrizio Forconi MD , Giulio Maccauro Prof , Raffaele Vitiello Prof
Background
Lateral ankle sprains (LAS) are common injuries that may progress to chronic ankle instability (CAI), characterized by recurrent sprains, proprioceptive deficits, and neuromuscular impairments.
Purpose
This study evaluated the impact of rehabilitation on functional outcomes and electromyographic (EMG) parameters in patients with acute LAS and CAI.
Study Design
Prospective observational cohort study.
Methods
Between August 2022 and September 2023, 119 patients (73 with acute LAS, 46 with CAI) were assessed at baseline (T0) and after a three-months rehabilitation program (T1). Assessments included range of motion (ROM), muscle strength, surface EMG, balance tests (Y-Balance, Foot Lift, Side Hop, 6-m Hop), and the FAAM questionnaire. Rehabilitation consisted of individualized protocols integrating gym-based exercises and hydrotherapy, targeting ROM restoration, proprioceptive training, and muscle strengthening.
Results
LAS patients demonstrated significant baseline impairments in plantarflexion ROM (49.32 ± 13.37 vs. 61.76 ± 17.67; p = 0.01) and Foot Lift Test performance (168 ± 191.28 vs. 18.52 ± 58.38; p = 0.01). Post-rehabilitation, both groups showed improvements in ROM, strength, and functional scores. CAI patients achieved greater proprioceptive gains (Y-Balance, Side Hop), while LAS patients exhibited superior recovery in plantarflexion strength. However, EMG analysis revealed persistent neuromuscular deficits in both groups.
Conclusion
Despite clinical improvements, persistent EMG deficits, especially in CAI, indicate incomplete neuromuscular recovery. These findings highlight the limitations of standard rehabilitation protocols and underscore the need for personalized neuromuscular interventions and objective return-to-sport criteria. Future research should aim to refine diagnostic tools, standardize protocols, and incorporate technology-assisted rehabilitation to improve long-term outcomes.
背景：外侧踝关节扭伤（LAS）是一种常见的损伤，可发展为慢性踝关节不稳定（CAI），其特征是反复扭伤、本体感觉缺陷和神经肌肉损伤。目的：本研究评估康复对急性LAS和CAI患者功能结局和肌电图（EMG）参数的影响。研究设计：前瞻性观察队列研究方法：在2022年8月至2023年9月期间，对119例患者（73例急性LAS， 46例CAI）在基线（T0）和三个月康复计划（T1）后进行评估。评估包括活动范围（ROM）、肌肉力量、表面肌电图、平衡测试（Y-Balance、足举、侧跳、6米跳）和FAAM问卷。康复包括个体化方案，包括基于健身房的锻炼和水疗，目标是ROM恢复，本体感觉训练和肌肉强化。结果：LAS患者表现出明显的跖屈ROM基线损伤(49.32 ± 13.37 vs. 61.76 ± 17.67；p = 0.01)和足举试验性能(168 ± 191.28 vs. 18.52 ± 58.38； = 0.01页)。康复后，两组的ROM、力量和功能评分均有改善。CAI患者获得了更大的本体感觉（Y-Balance, Side Hop），而LAS患者在跖屈曲强度方面表现出更好的恢复。然而，肌电图分析显示两组患者均存在持续的神经肌肉缺陷。结论：尽管临床有所改善，但持续的肌电图缺损，特别是CAI，表明神经肌肉恢复不完全。这些发现强调了标准康复方案的局限性，并强调了个性化神经肌肉干预和客观回归运动标准的必要性。未来的研究应致力于完善诊断工具，规范治疗方案，并结合技术辅助康复来改善长期疗效。
{"title":"Functional and neuromuscular effects of rehabilitation in acute ankle sprain and chronic ankle instability","authors":"Andrea De Fazio MD , Giorgio Fravolini MD , Elena Gabrielli MD , Matteo Turchetta MD , Marianna Citro MS , Fabrizio Forconi MD , Giulio Maccauro Prof , Raffaele Vitiello Prof","doi":"10.1053/j.jfas.2025.08.004","DOIUrl":"10.1053/j.jfas.2025.08.004","url":null,"abstract":"<div><h3>Background</h3><div>Lateral ankle sprains (LAS) are common injuries that may progress to chronic ankle instability (CAI), characterized by recurrent sprains, proprioceptive deficits, and neuromuscular impairments.</div></div><div><h3>Purpose</h3><div>This study evaluated the impact of rehabilitation on functional outcomes and electromyographic (EMG) parameters in patients with acute LAS and CAI.</div></div><div><h3>Study Design</h3><div>Prospective observational cohort study.</div></div><div><h3>Methods</h3><div>Between August 2022 and September 2023, 119 patients (73 with acute LAS, 46 with CAI) were assessed at baseline (T0) and after a three-months rehabilitation program (T1). Assessments included range of motion (ROM), muscle strength, surface EMG, balance tests (Y-Balance, Foot Lift, Side Hop, 6-m Hop), and the FAAM questionnaire. Rehabilitation consisted of individualized protocols integrating gym-based exercises and hydrotherapy, targeting ROM restoration, proprioceptive training, and muscle strengthening.</div></div><div><h3>Results</h3><div>LAS patients demonstrated significant baseline impairments in plantarflexion ROM (49.32 ± 13.37 vs. 61.76 ± 17.67; <em>p</em> = 0.01) and Foot Lift Test performance (168 ± 191.28 vs. 18.52 ± 58.38; <em>p</em> = 0.01). Post-rehabilitation, both groups showed improvements in ROM, strength, and functional scores. CAI patients achieved greater proprioceptive gains (Y-Balance, Side Hop), while LAS patients exhibited superior recovery in plantarflexion strength. However, EMG analysis revealed persistent neuromuscular deficits in both groups.</div></div><div><h3>Conclusion</h3><div>Despite clinical improvements, persistent EMG deficits, especially in CAI, indicate incomplete neuromuscular recovery. These findings highlight the limitations of standard rehabilitation protocols and underscore the need for personalized neuromuscular interventions and objective return-to-sport criteria. Future research should aim to refine diagnostic tools, standardize protocols, and incorporate technology-assisted rehabilitation to improve long-term outcomes.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 17.e1-17.e6"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862552","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}
Pub Date : 2026-01-01DOI: 10.1053/j.jfas.2025.05.020
Jia Zheng MMed , Changgui Zhang MMed , Liu Yang MD , Xin Chen MA , Xiaojun Duan MD
Arthroscopic microfracture is a conventional technique for treating osteochondral lesions of the talus (OLT) that are less than 1.5 cm2 in area. Since the defects are filled with fibrocartilage after repair, some patients experience local pain postoperatively, subsequently affecting early rehabilitation. This study evaluates efficacy of combining microfracture with extracorporeal shock wave therapy (ESWT) and intra-articular hyaluronic acid (HA) injections for treating OLT and its impact on early rehabilitation. Patients were divided into Group A with patients experiencing walking pain at full weight-bearing 4-6 weeks after surgery, Group B with those experiencing pain 6-8 weeks after surgery. ESWT targeted the cartilage injury area and other pressure pain points, delivered weekly for five sessions. After each session, a 2.0-2.5 mL intra-articular injection of HA was administered to the ankle joint. Assessments were made before ESWT began, six weeks after the final treatment, and at the final follow-up. The primary outcome was the Visual Analogue Scale (VAS) pain score, and the secondary outcome was the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score. Forty-two patients were included, with a pre-treatment VAS score of 7.16 ± 1.54 decreasing to 2.11 ± 1.09 at the final follow-up, and the AOFAS score increasing from 67.78 ± 13.87 to 93.54 ± 4.10, showing significant differences (p < 0.05). Group A and B showed no significant differences in VAS and AOFAS scores across each time points (p > 0.05). ESWT synergizes with HA injections to significantly reduce post-microfracture weight-bearing pain and promote early joint function recovery.
关节镜下微骨折是治疗距骨软骨病变（OLT）面积小于1.5 cm²的常规技术。由于修复后缺损被纤维软骨填充，部分患者术后出现局部疼痛，影响早期康复。本研究评估微骨折联合体外冲击波治疗（ESWT）和关节内透明质酸（HA）注射治疗OLT的疗效及其对早期康复的影响。将术后4-6周出现完全负重行走疼痛的患者分为A组，术后6-8周出现疼痛的患者分为B组。ESWT针对软骨损伤区域和其他压力痛点，每周进行五次。每次疗程结束后，踝关节关节内注射2.0-2.5 mL HA。评估分别在ESWT开始前、最终治疗后6周和最终随访时进行。主要观察指标为视觉模拟评分（VAS）疼痛评分，次要观察指标为美国骨科足踝协会（AOFAS）踝关节-后足评分。纳入42例患者，治疗前VAS评分为7.16±1.54，最终随访时VAS评分为2.11±1.09，AOFAS评分由67.78±13.87上升至93.54±4.10，差异均有统计学意义（p < 0.05）。A、B组VAS、AOFAS评分各时间点差异无统计学意义（p < 0.05）。ESWT与HA注射协同作用，显著减轻微骨折后负重疼痛，促进早期关节功能恢复。临床证据等级：4级。
{"title":"The efficacy of microfracture combined with extracorporeal shock wave therapy and hyaluronic acid injections for treating osteochondral lesion of the talus and its impact on early rehabilitation: A retrospective case study","authors":"Jia Zheng MMed , Changgui Zhang MMed , Liu Yang MD , Xin Chen MA , Xiaojun Duan MD","doi":"10.1053/j.jfas.2025.05.020","DOIUrl":"10.1053/j.jfas.2025.05.020","url":null,"abstract":"<div><div>Arthroscopic microfracture is a conventional technique for treating osteochondral lesions of the talus (OLT) that are less than 1.5 cm<sup>2</sup> in area. Since the defects are filled with fibrocartilage after repair, some patients experience local pain postoperatively, subsequently affecting early rehabilitation. This study evaluates efficacy of combining microfracture with extracorporeal shock wave therapy (ESWT) and intra-articular hyaluronic acid (HA) injections for treating OLT and its impact on early rehabilitation. Patients were divided into Group A with patients experiencing walking pain at full weight-bearing 4-6 weeks after surgery, Group B with those experiencing pain 6-8 weeks after surgery. ESWT targeted the cartilage injury area and other pressure pain points, delivered weekly for five sessions. After each session, a 2.0-2.5 mL intra-articular injection of HA was administered to the ankle joint. Assessments were made before ESWT began, six weeks after the final treatment, and at the final follow-up. The primary outcome was the Visual Analogue Scale (VAS) pain score, and the secondary outcome was the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score. Forty-two patients were included, with a pre-treatment VAS score of 7.16 ± 1.54 decreasing to 2.11 ± 1.09 at the final follow-up, and the AOFAS score increasing from 67.78 ± 13.87 to 93.54 ± 4.10, showing significant differences (<em>p</em> < 0.05). Group A and B showed no significant differences in VAS and AOFAS scores across each time points (<em>p</em> > 0.05). ESWT synergizes with HA injections to significantly reduce post-microfracture weight-bearing pain and promote early joint function recovery.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 3.e1-3.e5"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585520","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}
Pub Date : 2026-01-01DOI: 10.1053/j.jfas.2025.07.003
Adam E. Fleischer DPM, MPH, FACFAS , Rachel H. Albright DPM, MPH, FACFAS , Khushiben Patel BS , Hector Santiago DPM , Jonathan Hook DPM, MHA, FACFAS , Dyane Tower DPM, MPH, MS, FACFAS , Lowell Weil Jr. DPM, MBA, FACFAS
Background
Total ankle arthroplasty (TAA) utilization has significantly increased in the US in recent years, and current studies examining surgeon specialty and TAA outcomes are limited.
Purpose
To explore the effect of surgeon specialty on long-term TAA survivorship and short-term postoperative complications
Study Design
Retrospective cohort study and time-to-event analysis
Methods
Using a large, national claims database (PearlDiver, Inc.) with more than 170 million patient files we examined the association of surgeon specialty (podiatric surgeon vs. other) on adverse patient outcomes from January 2010 to April 2023. Relevant covariates were adjusted for using multivariable Cox and logistic regression models.
Results
There were 16,485 people who underwent TAA for a cumulative rate of 9.7 per 100,000. Surgeon specialty was known for 13,514 TAA surgeries. There were 714 revisions corresponding to a revision rate of 0.053 (714/13,514) over the 13-year study period. Patients who underwent TAA by podiatric surgeons were no more likely to experience revision surgery than those undergoing TAA by other surgeon specialties (adjusted hazards ratio [HR] 0.84, 95 % CI 0.46 to 1.53, p = 0.57). Furthermore, the risk of readmission (adjusted odds ratio [OR] 1.0, 95 % CI 0.77 to 1.30), infection (adjusted OR 0.91, 95 % CI 0.77 to 1.07), and venous thromboembolism (adjusted OR 0.83, 95 % CI 0.61 to 1.09) within the first 90 days postoperatively did not differ among surgeon specialty.
Conclusion
This information may be of interest to third party payers, health administrators, and healthcare consumers.
背景：近年来，全踝关节置换术（TAA）的使用率在美国显著增加，目前关于外科医生专业和TAA结果的研究有限。目的：探讨外科专科对TAA远期生存率及术后短期并发症的影响。研究设计：回顾性队列研究和事件时间分析方法：使用一个拥有超过1.7亿患者档案的大型国家索赔数据库（PearlDiver, Inc.），我们检查了2010年1月至2023年4月外科医生专业（足部外科医生与其他外科医生）对不良患者结局的关联。采用多变量Cox和logistic回归模型对相关协变量进行校正。结果：16485人接受了TAA，累积率为9.7 / 10万。外科专业以13,514例TAA手术而闻名。在13年的研究期间，有714次修订，对应的修订率为0.053（714/13,514）。由足部外科医生进行TAA的患者与由其他专科外科医生进行TAA的患者相比，不太可能进行翻修手术（校正风险比[HR] 0.84, 95% CI 0.46 ~ 1.53, p = 0.57）。此外，术后90天内再入院（校正优势比[OR] 1.0, 95% CI 0.77 ~ 1.30）、感染（校正优势比[OR] 0.91, 95% CI 0.77 ~ 1.07）和静脉血栓栓塞（校正优势比[OR] 0.83, 95% CI 0.61 ~ 1.09）的风险在外科医生专业类型之间没有差异。结论：这些信息可能会引起第三方支付者、医疗管理人员和医疗保健消费者的兴趣。临床证据水平：3；
{"title":"Risk of revision and other complications in total ankle arthroplasty do not differ by surgeon specialty: Analysis of the PearlDiver healthcare claims database from 2010 to 2023","authors":"Adam E. Fleischer DPM, MPH, FACFAS , Rachel H. Albright DPM, MPH, FACFAS , Khushiben Patel BS , Hector Santiago DPM , Jonathan Hook DPM, MHA, FACFAS , Dyane Tower DPM, MPH, MS, FACFAS , Lowell Weil Jr. DPM, MBA, FACFAS","doi":"10.1053/j.jfas.2025.07.003","DOIUrl":"10.1053/j.jfas.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Total ankle arthroplasty (TAA) utilization has significantly increased in the US in recent years, and current studies examining surgeon specialty and TAA outcomes are limited.</div></div><div><h3>Purpose</h3><div>To explore the effect of surgeon specialty on long-term TAA survivorship and short-term postoperative complications</div></div><div><h3>Study Design</h3><div>Retrospective cohort study and time-to-event analysis</div></div><div><h3>Methods</h3><div>Using a large, national claims database (PearlDiver, Inc.) with more than 170 million patient files we examined the association of surgeon specialty (podiatric surgeon vs. other) on adverse patient outcomes from January 2010 to April 2023. Relevant covariates were adjusted for using multivariable Cox and logistic regression models.</div></div><div><h3>Results</h3><div>There were 16,485 people who underwent TAA for a cumulative rate of 9.7 per 100,000. Surgeon specialty was known for 13,514 TAA surgeries. There were 714 revisions corresponding to a revision rate of 0.053 (714/13,514) over the 13-year study period. Patients who underwent TAA by podiatric surgeons were no more likely to experience revision surgery than those undergoing TAA by other surgeon specialties (adjusted hazards ratio [HR] 0.84, 95 % CI 0.46 to 1.53, <em>p</em> = 0.57). Furthermore, the risk of readmission (adjusted odds ratio [OR] 1.0, 95 % CI 0.77 to 1.30), infection (adjusted OR 0.91, 95 % CI 0.77 to 1.07), and venous thromboembolism (adjusted OR 0.83, 95 % CI 0.61 to 1.09) within the first 90 days postoperatively did not differ among surgeon specialty.</div></div><div><h3>Conclusion</h3><div>This information may be of interest to third party payers, health administrators, and healthcare consumers.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 6.e1-6.e5"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610234","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}
Pub Date : 2026-01-01DOI: 10.1053/j.jfas.2025.07.011
Mehmet EKİCİ
Background
Ingrown toenail is a common condition, especially among young individuals, characterized by pain, swelling, redness, and infection. Surgical intervention is often required in stage II and III cases, with the Modified Winograd (MW) technique being the most widely used. Nevertheless, recurrence and infection remain notable concerns.
Purpose
To assess whether lateral edge inversion modification added to the MW technique reduces recurrence rates.
Study Design
Retrospective comparative observational study.
Methods
A total of 341 patients treated between January and November 2023 were analyzed. Group 1 (n = 96) underwent MW with lateral edge inversion, while Group 2 (n = 245) underwent MW alone. Demographics, surgical time, infection rates, recurrence, and recovery were compared.
Results
The mean age was 25.2 years, with 223 males and 118 females. Surgical time was comparable between groups. Early infection occurred in 4.16 % of Group 1 and 6.53 % of Group 2 (p > 0.05). Recurrence was observed in 10 patients in Group 2 but none in Group 1 (p < 0.05), indicating a significant reduction with lateral edge inversion.
Conclusion
Lateral edge inversion modification is a simple and effective addition to the MW technique, significantly reducing recurrence rates in the treatment of ingrown toenails.
{"title":"Results of ingrown toenails treated with modified Winograd technique using lateral edge inversion modification","authors":"Mehmet EKİCİ","doi":"10.1053/j.jfas.2025.07.011","DOIUrl":"10.1053/j.jfas.2025.07.011","url":null,"abstract":"<div><h3>Background</h3><div>Ingrown toenail is a common condition, especially among young individuals, characterized by pain, swelling, redness, and infection. Surgical intervention is often required in stage II and III cases, with the Modified Winograd (MW) technique being the most widely used. Nevertheless, recurrence and infection remain notable concerns.</div></div><div><h3>Purpose</h3><div>To assess whether lateral edge inversion modification added to the MW technique reduces recurrence rates.</div></div><div><h3>Study Design</h3><div>Retrospective comparative observational study.</div></div><div><h3>Methods</h3><div>A total of 341 patients treated between January and November 2023 were analyzed. Group 1 (<em>n</em> = 96) underwent MW with lateral edge inversion, while Group 2 (<em>n</em> = 245) underwent MW alone. Demographics, surgical time, infection rates, recurrence, and recovery were compared.</div></div><div><h3>Results</h3><div>The mean age was 25.2 years, with 223 males and 118 females. Surgical time was comparable between groups. Early infection occurred in 4.16 % of Group 1 and 6.53 % of Group 2 (<em>p</em> > 0.05). Recurrence was observed in 10 patients in Group 2 but none in Group 1 (<em>p</em> < 0.05), indicating a significant reduction with lateral edge inversion.</div></div><div><h3>Conclusion</h3><div>Lateral edge inversion modification is a simple and effective addition to the MW technique, significantly reducing recurrence rates in the treatment of ingrown toenails.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 13.e1-13.e4"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719045","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}
The flexor hallucis longus (FHL) tendon is used as a medial landmark for posterior ankle arthroscopy. However, some posterior ankle pathologies require working medial to the FHL. The safe distance beyond the FHL to the neurovascular bundle has never been established.
Purpose
To report the safe distances beyond the FHL and neurovascular bundle and the incidence of neurovascular injury after using “safe arthroscopic approach”.
Methods
The 63 MRIs with posterior ankle pathologies were included. Measurements were the FHL-tibial nerve (TN) and FHL-posterior tibial artery (PTA) distances at the level of fibular tip, 1.2 cm above and 1.2 cm below. Twenty FHL tenosynovitis patients underwent arthroscopic debridement utilizing a safe arthroscopic approach developed by the authors based on the MRI findings. The incidence of neurovascular injury and clinical outcomes were assessed.
Results
The closest mean (standard deviation, SD) distances of FHL-TN and FHL-PTA were 2.14 (0.81) mm and 5.23 (2.11) mm. The incidence of neurovascular injury after using “safe arthroscopic approach” was 1/20. The NRS for pain during activity daily living (ADL) and FAAM for ADL were statistically improved at 6-month follow-up from 6.36 (1.50) to 1.14 (1.29) and 72.4 (5.78) to 89.4 (7.96), p<0.001.
Conclusion
This study demonstrated close margins between the FHL and the TN and PTA of 2.14 mm and 5.23 mm. The “safe arthroscopic approach” for arthroscopic FHL debridement had a TN injury incidence of 1/20 which was equivalent to previous reported incidences of the arthroscopic surgery which did not go beyond FHL.
{"title":"A magnetic resonance imaging safe distance beyond the flexor hallucis longus tendon and the application of the safe arthroscopic approach to prevent neurovascular injury in posterior ankle arthroscopy","authors":"Penpun Lertwattanachai MD , Thos Harnroongroj MD MSc , Bavornrit Chuckpaiwong MD , Theerawoot Tharmviboonsri MD , Nuntich Singsumpun MD , Ishthayapong Kanjanakeereewong MD","doi":"10.1053/j.jfas.2025.09.006","DOIUrl":"10.1053/j.jfas.2025.09.006","url":null,"abstract":"<div><h3>Background</h3><div>The flexor hallucis longus (FHL) tendon is used as a medial landmark for posterior ankle arthroscopy. However, some posterior ankle pathologies require working medial to the FHL. The safe distance beyond the FHL to the neurovascular bundle has never been established.</div></div><div><h3>Purpose</h3><div>To report the safe distances beyond the FHL and neurovascular bundle and the incidence of neurovascular injury after using “safe arthroscopic approach”.</div></div><div><h3>Methods</h3><div>The 63 MRIs with posterior ankle pathologies were included. Measurements were the FHL-tibial nerve (TN) and FHL-posterior tibial artery (PTA) distances at the level of fibular tip, 1.2 cm above and 1.2 cm below. Twenty FHL tenosynovitis patients underwent arthroscopic debridement utilizing a safe arthroscopic approach developed by the authors based on the MRI findings. The incidence of neurovascular injury and clinical outcomes were assessed.</div></div><div><h3>Results</h3><div>The closest mean (standard deviation, SD) distances of FHL-TN and FHL-PTA were 2.14 (0.81) mm and 5.23 (2.11) mm. The incidence of neurovascular injury after using “safe arthroscopic approach” was 1/20. The NRS for pain during activity daily living (ADL) and FAAM for ADL were statistically improved at 6-month follow-up from 6.36 (1.50) to 1.14 (1.29) and 72.4 (5.78) to 89.4 (7.96), p<0.001.</div></div><div><h3>Conclusion</h3><div>This study demonstrated close margins between the FHL and the TN and PTA of 2.14 mm and 5.23 mm. The “safe arthroscopic approach” for arthroscopic FHL debridement had a TN injury incidence of 1/20 which was equivalent to previous reported incidences of the arthroscopic surgery which did not go beyond FHL.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 31.e1-31.e5"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182389","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}
Pub Date : 2026-01-01DOI: 10.1053/j.jfas.2025.07.006
Héctor José Masaragian M.D. (Foot and Ankle Surgeon), Leonel Rega M.D. (Foot and ankle Surgeon) , Fernando Perin M.D. (Foot and ankle Surgeon) , Lucas de Allende M.D. (Foot and ankle Surgeon) , César Miguel Fabrego M.D. (Foot and ankle Surgeon) , Johann Luis Veizaga Velasco M.D. (Foot and ankle Surgeon)
Background
Hallux rigidus is a degenerative condition of the first metatarsophalangeal joint, more frequently affecting females and individuals over 40 years. Various surgical options exist, but no prior studies have reported outcomes for distal shortening chevron osteotomy combined with extensive dorsal cheilectomy.
Purpose
To evaluate the clinical and functional outcomes of patients with hallux rigidus treated with distal shortening chevron osteotomy and extensive dorsal cheilectomy.
Study Design
Retrospective case series.
Methods
A total of 50 patients (51 feet) underwent surgery between 2015 and 2022. One patient had bilateral involvement. The mean age was 49.37 years; 46 % were male and 54 % female. Mean follow-up was 46.57 months (range, 6–81 months). Patients were assessed preoperatively and after surgery using the American Orthopaedic Foot & Ankle Society (AOFAS) score, range of motion (ROM), Visual Analogue Scale (VAS), and Foot and Ankle Ability Measure (FAAM).
Results
Postoperative scores demonstrated statistically significant improvements across all measures. Patients reported decreased pain, improved joint mobility, and enhanced function. The majority expressed satisfaction and indicated a willingness to undergo the procedure again.
Conclusion
Distal shortening chevron osteotomy with extensive dorsal cheilectomy is a safe and effective surgical option for Coughlin grades I–III hallux rigidus. This technique yields consistent improvements in pain, mobility, and function, with high patient satisfaction.
{"title":"Joint preservation in hallux rigidus: evaluating the efficacy of modified chevron osteotomy with extensive cheilectomy","authors":"Héctor José Masaragian M.D. (Foot and Ankle Surgeon), Leonel Rega M.D. (Foot and ankle Surgeon) , Fernando Perin M.D. (Foot and ankle Surgeon) , Lucas de Allende M.D. (Foot and ankle Surgeon) , César Miguel Fabrego M.D. (Foot and ankle Surgeon) , Johann Luis Veizaga Velasco M.D. (Foot and ankle Surgeon)","doi":"10.1053/j.jfas.2025.07.006","DOIUrl":"10.1053/j.jfas.2025.07.006","url":null,"abstract":"<div><h3>Background</h3><div>Hallux rigidus is a degenerative condition of the first metatarsophalangeal joint, more frequently affecting females and individuals over 40 years. Various surgical options exist, but no prior studies have reported outcomes for distal shortening chevron osteotomy combined with extensive dorsal cheilectomy.</div></div><div><h3>Purpose</h3><div>To evaluate the clinical and functional outcomes of patients with hallux rigidus treated with distal shortening chevron osteotomy and extensive dorsal cheilectomy.</div></div><div><h3>Study Design</h3><div>Retrospective case series.</div></div><div><h3>Methods</h3><div>A total of 50 patients (51 feet) underwent surgery between 2015 and 2022. One patient had bilateral involvement. The mean age was 49.37 years; 46 % were male and 54 % female. Mean follow-up was 46.57 months (range, 6–81 months). Patients were assessed preoperatively and after surgery using the American Orthopaedic Foot & Ankle Society (AOFAS) score, range of motion (ROM), Visual Analogue Scale (VAS), and Foot and Ankle Ability Measure (FAAM).</div></div><div><h3>Results</h3><div>Postoperative scores demonstrated statistically significant improvements across all measures. Patients reported decreased pain, improved joint mobility, and enhanced function. The majority expressed satisfaction and indicated a willingness to undergo the procedure again.</div></div><div><h3>Conclusion</h3><div>Distal shortening chevron osteotomy with extensive dorsal cheilectomy is a safe and effective surgical option for Coughlin grades I–III hallux rigidus. This technique yields consistent improvements in pain, mobility, and function, with high patient satisfaction.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 9.e1-9.e9"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719044","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}
Pub Date : 2026-01-01DOI: 10.1053/j.jfas.2025.09.005
Lijun Shi MD , Jun Wu MD , Ruihong Cao BD , Dong Chen MD , Yang Zhang MD , Yan Huang MD
Background
Chronic lateral ankle instability (CLAI) with concomitant Grade I inferior tibiofibular syndesmosis injury (ITSI) is frequently overlooked, leading to residual symptoms after isolated ligament repair.
Purpose
To compare outcomes of arthroscopic modified Broström procedure (AMBP) alone versus AMBP plus syndesmotic fixation for CLAI with Grade I ITSI.
Study Design
Retrospective comparative cohort study.
Methods
From January 2021 to December 2022, 24 patients with chronic lateral ankle instability concomitant with Grade I inferior tibiofibular syndesmosis injury were assigned to either isolated AMBP (Group A, n = 13) or AMBP with elastic syndesmotic fixation (Group B, n = 11).Functional outcomes including the American Orthopedic Foot and Ankle Society score, Karlsson ankle joint function score, and pain visual analog scale score were assessed at final follow-up. Comparative analysis was conducted and the incidence of residual instability or recurrence was statistically analyzed.
Results
All patients in groups A and B were followed up until the last visit, with an average follow-up time of 25.7 ± 5 months (range: 18–37 months). There was a significant difference in functional scores between pre- and post-surgery for more than 1 year (P < 0.05). Arthroscopic modified Broström procedure combined with inferior tibiofibular syndesmosis fixation achieved higher scores compared with the two different treatment methods, and the difference was statistically significant (P < 0.05).
Conclusion
When lateral ankle instability and Grade I inferior tibiofibular syndesmosis injury coexist, simultaneous repair of both injuries is more effective than isolated repair of the ATFL.
{"title":"Research on the treatment of chronic lateral ankle instability combined with grade 1 inferior tibiofibular syndesmosis injury","authors":"Lijun Shi MD , Jun Wu MD , Ruihong Cao BD , Dong Chen MD , Yang Zhang MD , Yan Huang MD","doi":"10.1053/j.jfas.2025.09.005","DOIUrl":"10.1053/j.jfas.2025.09.005","url":null,"abstract":"<div><h3>Background</h3><div>Chronic lateral ankle instability (CLAI) with concomitant Grade I inferior tibiofibular syndesmosis injury (ITSI) is frequently overlooked, leading to residual symptoms after isolated ligament repair.</div></div><div><h3>Purpose</h3><div>To compare outcomes of arthroscopic modified Broström procedure (AMBP) alone versus AMBP plus syndesmotic fixation for CLAI with Grade I ITSI.</div></div><div><h3>Study Design</h3><div>Retrospective comparative cohort study.</div></div><div><h3>Methods</h3><div>From January 2021 to December 2022, 24 patients with chronic lateral ankle instability concomitant with Grade I inferior tibiofibular syndesmosis injury were assigned to either isolated AMBP (Group A, <em>n</em> = 13) or AMBP with elastic syndesmotic fixation (Group B, <em>n</em> = 11).Functional outcomes including the American Orthopedic Foot and Ankle Society score, Karlsson ankle joint function score, and pain visual analog scale score were assessed at final follow-up. Comparative analysis was conducted and the incidence of residual instability or recurrence was statistically analyzed.</div></div><div><h3>Results</h3><div>All patients in groups A and B were followed up until the last visit, with an average follow-up time of 25.7 ± 5 months (range: 18–37 months). There was a significant difference in functional scores between pre- and post-surgery for more than 1 year (<em>P</em> < 0.05). Arthroscopic modified Broström procedure combined with inferior tibiofibular syndesmosis fixation achieved higher scores compared with the two different treatment methods, and the difference was statistically significant (<em>P</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>When lateral ankle instability and Grade I inferior tibiofibular syndesmosis injury coexist, simultaneous repair of both injuries is more effective than isolated repair of the ATFL.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 30.e1-30.e4"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253291","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}
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