Pub Date : 2025-01-27DOI: 10.1016/j.fastrc.2025.100475
Madison Leyk DPM , Scott Jorgensen DPM, FACFAS , Kristen Brett DPM, AACFAS
Limited literature exists regarding the treatment for symptomatic osteoarthritis of the fourth and fifth tarsometatarsal joints. Reports regarding joint sparing procedures describe the use of interpositional autologous grafts from the peroneus brevis and peroneus tertius tendons, tendon allografts, and ceramic spherical implants, while arthrodesis remains cautiously reserved. This case study demonstrates an innovative surgical technique that displays the use of an autologous gastrocnemius aponeurosis graft between January 2016 and December 2020 for the treatment of symptomatic osteoarthritis of the fourth and fifth tarsometatarsal joint. Fifteen patients were included in the case study, no patients were lost to follow up. The average follow-up was 30 months with 40 % of patients returning greater than 3 years after their surgery date for unrelated complaints. The reported surgical technique can be performed as an isolated procedure; however, additional procedures can be performed as necessary depending on patient pathology. One postoperative complication was encountered secondary to non-compliance, but no patients required revision or re-operation. The surgical technique allows for preservation of adjacent normal anatomy without the use of a foreign body implant and provides a powerful advantage compared to other reported surgical techniques.
{"title":"Interpositional arthroplasty of the fourth and fifth tarsometatarsal joint with an autologous gastrocnemius aponeurosis graft: A surgical technique guide and case series","authors":"Madison Leyk DPM , Scott Jorgensen DPM, FACFAS , Kristen Brett DPM, AACFAS","doi":"10.1016/j.fastrc.2025.100475","DOIUrl":"10.1016/j.fastrc.2025.100475","url":null,"abstract":"<div><div>Limited literature exists regarding the treatment for symptomatic osteoarthritis of the fourth and fifth tarsometatarsal joints. Reports regarding joint sparing procedures describe the use of interpositional autologous grafts from the peroneus brevis and peroneus tertius tendons, tendon allografts, and ceramic spherical implants, while arthrodesis remains cautiously reserved. This case study demonstrates an innovative surgical technique that displays the use of an autologous gastrocnemius aponeurosis graft between January 2016 and December 2020 for the treatment of symptomatic osteoarthritis of the fourth and fifth tarsometatarsal joint. Fifteen patients were included in the case study, no patients were lost to follow up. The average follow-up was 30 months with 40 % of patients returning greater than 3 years after their surgery date for unrelated complaints. The reported surgical technique can be performed as an isolated procedure; however, additional procedures can be performed as necessary depending on patient pathology. One postoperative complication was encountered secondary to non-compliance, but no patients required revision or re-operation. The surgical technique allows for preservation of adjacent normal anatomy without the use of a foreign body implant and provides a powerful advantage compared to other reported surgical techniques.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100475"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-14DOI: 10.1016/j.fastrc.2025.100468
Juan T. Ceja-Solorio DPM , Christopher Sullivan DPM , Ashley Ward MD , John M. Giurini DPM (Chief Division of Podiatric Surgery)
The current case report describes the rare complication of acrometastasis of lung cancer and to raise the index of suspicion in patients with a localized, painful mass of the foot and a prior history of cancer. This is a case report of a 60-year old diabetic woman who initially presented with a painful lump of the distal hallux that had been present for 6 months. She had a known diagnosis of adenosquamous carcinoma of the lung with sarcomatoid component with a recently diagnosed metastasis to the brain. The patient initially underwent excision of the mass in toto only to develop local recurrence 6 months later. She subsequently underwent a formal hallux amputation. The patient passed away 2.5 years following her amputation.
{"title":"Adenocarcinoma of the lung with metastasis to the foot: A case report","authors":"Juan T. Ceja-Solorio DPM , Christopher Sullivan DPM , Ashley Ward MD , John M. Giurini DPM (Chief Division of Podiatric Surgery)","doi":"10.1016/j.fastrc.2025.100468","DOIUrl":"10.1016/j.fastrc.2025.100468","url":null,"abstract":"<div><div>The current case report describes the rare complication of acrometastasis of lung cancer and to raise the index of suspicion in patients with a localized, painful mass of the foot and a prior history of cancer. This is a case report of a 60-year old diabetic woman who initially presented with a painful lump of the distal hallux that had been present for 6 months. She had a known diagnosis of adenosquamous carcinoma of the lung with sarcomatoid component with a recently diagnosed metastasis to the brain. The patient initially underwent excision of the mass in toto only to develop local recurrence 6 months later. She subsequently underwent a formal hallux amputation. The patient passed away 2.5 years following her amputation.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100468"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-09DOI: 10.1016/j.fastrc.2024.100463
Claudia Radek-Ziffra DPM , Howard A. Stone DPM, FACFAS
Achilles tendinosis has numerous possible etiologies including overuse, decreased tendon blood supply and tensile strength due to aging, muscle imbalance or weakness, and excessive pronation of the foot. The pathology of tendonosis is not completely understood yet there are many theories described throughout literature. If conservative therapy fails, surgical intervention is indicated. Open surgical debridement of the damaged areas of the Achilles tendon with or without tissue graft and tendon transfers has been the standard of care for many years. Within several studies, there has been reported TOPAZ radiofrequency ablation as a successful and effective method for the treatment of chronic Achilles tendinopathy similar to its use for plantar fasciitis in the lower extremity. This case study focuses on the comparing MRI findings of the Achilles tendon prior to radiofrequency ablation versus 13 months postoperatively. A VAS analog pain score was used pre-operatively and post-operatively for an accurate measurement of pain reduction. The objective measurement of pain was based on pain on palpation along the watershed area of the Achilles tendon on physical examination as well as return to daily life activities. Utilizing this treatment modality described below, no signal intensity changes were not present on follow up MRI within the Achilles tendon. Following surgery, there was reduced thickening of the Achilles tendon at the watershed area on physical exam. The patients pre-operative pain symptoms completely resolved. TOPAZ radiofrequency ablation is an effective method for the treatment of Achilles tendonosis and should be considered prior to performing a more invasive surgical procedure.
{"title":"MRI findings one year post-radio frequency ablation for chronic Achilles tendonosis: A case report","authors":"Claudia Radek-Ziffra DPM , Howard A. Stone DPM, FACFAS","doi":"10.1016/j.fastrc.2024.100463","DOIUrl":"10.1016/j.fastrc.2024.100463","url":null,"abstract":"<div><div>Achilles tendinosis has numerous possible etiologies including overuse, decreased tendon blood supply and tensile strength due to aging, muscle imbalance or weakness, and excessive pronation of the foot. The pathology of tendonosis is not completely understood yet there are many theories described throughout literature. If conservative therapy fails, surgical intervention is indicated<strong>.</strong> Open surgical debridement of the damaged areas of the Achilles tendon with or without tissue graft and tendon transfers has been the standard of care for many years. Within several studies, there has been reported TOPAZ radiofrequency ablation as a successful and effective method for the treatment of chronic Achilles tendinopathy similar to its use for plantar fasciitis in the lower extremity. This case study focuses on the comparing MRI findings of the Achilles tendon prior to radiofrequency ablation versus 13 months postoperatively. A VAS analog pain score was used pre-operatively and post-operatively for an accurate measurement of pain reduction. The objective measurement of pain was based on pain on palpation along the watershed area of the Achilles tendon on physical examination as well as return to daily life activities. Utilizing this treatment modality described below, no signal intensity changes were not present on follow up MRI within the Achilles tendon. Following surgery, there was reduced thickening of the Achilles tendon at the watershed area on physical exam. The patients pre-operative pain symptoms completely resolved. TOPAZ radiofrequency ablation is an effective method for the treatment of Achilles tendonosis and should be considered prior to performing a more invasive surgical procedure.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100463"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-08DOI: 10.1016/j.fastrc.2025.100467
Woo Y. Chun D.P.M , April Wong D.P.M , Lee tiberi D.P.M , Alexander Trottier D.P.M , Don C. Yoo M.D , Glod Douglas D.P.M
Charcot neuroarthropathy is a degenerative disorder that compromises the structural integrity of bones and joints in neuropathic limbs, particularly affecting the foot. Patients often have concomitant ulcers making it difficult to distinguish acute charcot neuroarthropathy from underlying acute osteomyelitis (OM). This case report details a 52-year-old patient who presented to clinic with charcot neuroarthropathy with chronic ulcer. Our team utilized a sequence of 3 phases of bone scan — Technetium-99 m methyl diphosphonate (Tc-99 m MDP), Technetium-99 m sulfur colloid (Tc-99 m SC), and Indium-111 white blood cell (WBC) imaging — combined with single-photon emission computed tomography scan with a computed tomography (SPECT-CT) to delineate acute Charcot changes from acute osteomyelitis (OM). Imaging revealed soft tissue infection in the left plantar midfoot without evidence of osteomyelitis (OM), allowing patient to undergo successful staged reconstructive surgery with combination hindfoot and midfoot arthrodesis with subsequent external fixator application. This innovative imaging approach enhances the ability to differentiate acute osteomyelitis (OM) from acute charcot neuroarthropathy in presence of ulcer, guiding surgical planning prior to reconstruction.
{"title":"Novel advanced imaging method to differentiate acute osteomyelitis from acute charcot neuroarthropathy in presence of chronic ulcer: A case report","authors":"Woo Y. Chun D.P.M , April Wong D.P.M , Lee tiberi D.P.M , Alexander Trottier D.P.M , Don C. Yoo M.D , Glod Douglas D.P.M","doi":"10.1016/j.fastrc.2025.100467","DOIUrl":"10.1016/j.fastrc.2025.100467","url":null,"abstract":"<div><div>Charcot neuroarthropathy is a degenerative disorder that compromises the structural integrity of bones and joints in neuropathic limbs, particularly affecting the foot. Patients often have concomitant ulcers making it difficult to distinguish acute charcot neuroarthropathy from underlying acute osteomyelitis (OM). This case report details a 52-year-old patient who presented to clinic with charcot neuroarthropathy with chronic ulcer. Our team utilized a sequence of 3 phases of bone scan — Technetium-99 m methyl diphosphonate (Tc-99 m MDP), Technetium-99 m sulfur colloid (Tc-99 m SC), and Indium-111 white blood cell (WBC) imaging — combined with single-photon emission computed tomography scan with a computed tomography (SPECT-CT) to delineate acute Charcot changes from acute osteomyelitis (OM). Imaging revealed soft tissue infection in the left plantar midfoot without evidence of osteomyelitis (OM), allowing patient to undergo successful staged reconstructive surgery with combination hindfoot and midfoot arthrodesis with subsequent external fixator application. This innovative imaging approach enhances the ability to differentiate acute osteomyelitis (OM) from acute charcot neuroarthropathy in presence of ulcer, guiding surgical planning prior to reconstruction.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100467"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143164171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-08DOI: 10.1016/j.fastrc.2025.100466
Madison Leyk DPM (Chief Resident) , Scott Jorgensen DPM, FACFAS (Attending Physician) , Kristen Brett DPM, AACFAS (Attending Physician)
The current literature offers reconstruction options after a failed Brostrom-Gould but fails to demonstrate a durable option with multiple points of fixation in more than one anatomic plane without compromising adjacent soft tissue. This new and innovative surgical technique guide displays the use of semitendinosus tendon allograft in 22 ankles between January 2016 and December 2020 for treatment of recurrent lateral ankle instability after Brostrom-Gould failure. The average follow up time was 30 months and three patients were lost to follow up. Patients returned to regular shoe gear on average by 11 weeks. Three postoperative complications required return to the operating room for incision dehiscence or revision reconstruction. Eleven patients required advanced imaging postoperatively due to a new injury and only one patient compromised their reconstruction. In conclusion, our results demonstrate a new, reproducible lateral ankle ligament reconstruction technique that has been able to withstand repeat inversion.
{"title":"Anatomic lateral ankle reconstruction with tendon allograft after failed brostrom. A case series and surgical technique guide","authors":"Madison Leyk DPM (Chief Resident) , Scott Jorgensen DPM, FACFAS (Attending Physician) , Kristen Brett DPM, AACFAS (Attending Physician)","doi":"10.1016/j.fastrc.2025.100466","DOIUrl":"10.1016/j.fastrc.2025.100466","url":null,"abstract":"<div><div>The current literature offers reconstruction options after a failed Brostrom-Gould but fails to demonstrate a durable option with multiple points of fixation in more than one anatomic plane without compromising adjacent soft tissue. This new and innovative surgical technique guide displays the use of semitendinosus tendon allograft in 22 ankles between January 2016 and December 2020 for treatment of recurrent lateral ankle instability after Brostrom-Gould failure. The average follow up time was 30 months and three patients were lost to follow up. Patients returned to regular shoe gear on average by 11 weeks. Three postoperative complications required return to the operating room for incision dehiscence or revision reconstruction. Eleven patients required advanced imaging postoperatively due to a new injury and only one patient compromised their reconstruction. In conclusion, our results demonstrate a new, reproducible lateral ankle ligament reconstruction technique that has been able to withstand repeat inversion.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100466"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-06DOI: 10.1016/j.fastrc.2024.100464
Gregory Rose DPM MPH , Gabrielle Uptegraph DPM , Anthony Schwab DPM MS , Rebecca Varney DPM , Corine Creech DPM FACFAS
Osteochondral defects of the talus are insidious yet common post operative sequela of ankle trauma. Nondisplaced osteochondral lesions are first treated conservatively. If this option fails, surgical intervention is often warranted. In larger lesions, uncontained shoulder lesions, or lesions that have failed arthroscopic intervention, an open enbloc osteochondral bone graft treatment may be indicated. Conventional anterior and medial malleolar osteotomy approaches do not allow access to the posterolateral talus for bulk allograft procedures. This case report provides the first known in vivo description of a transligamentous approach for lesions of the lateral and posterolateral talar dome. A 31-year-old male presented to our institution with a sizable osteochondral fracture along the mid to posterolateral margin of the talar dome. A single incision, lateral transligamentous approach was utilized to visualize the lesion which was resected in its entirety with a sagittal saw. A size matched fresh talar allograft was then cut with a sagittal saw to obtain a size matched bony allograft. This was then press fit into the defect within the patient's talar dome and fixed with a partially threaded, headless 3.0 screw buried deep to the cartilage. The patient remained non weight bearing for 12 weeks followed by protected weightbearing in a removal cast boot for 2 weeks and then full weight bearing in a shoe at 14 weeks post op. At final follow up 15 months post-operative the patient remained pain free. Final radiographs reveal a well incorporated bulk talar allograft with physical exam demonstrating a stable ligamentous complex and full range of tibiotalar motion without pain.
Level of clinical evidence
IV-Case Report
{"title":"A transligamentous approach for lateral osteochondral defect: A case report","authors":"Gregory Rose DPM MPH , Gabrielle Uptegraph DPM , Anthony Schwab DPM MS , Rebecca Varney DPM , Corine Creech DPM FACFAS","doi":"10.1016/j.fastrc.2024.100464","DOIUrl":"10.1016/j.fastrc.2024.100464","url":null,"abstract":"<div><div>Osteochondral defects of the talus are insidious yet common post operative sequela of ankle trauma. Nondisplaced osteochondral lesions are first treated conservatively. If this option fails, surgical intervention is often warranted. In larger lesions, uncontained shoulder lesions, or lesions that have failed arthroscopic intervention, an open enbloc osteochondral bone graft treatment may be indicated. Conventional anterior and medial malleolar osteotomy approaches do not allow access to the posterolateral talus for bulk allograft procedures. This case report provides the first known in vivo description of a transligamentous approach for lesions of the lateral and posterolateral talar dome. A 31-year-old male presented to our institution with a sizable osteochondral fracture along the mid to posterolateral margin of the talar dome. A single incision, lateral transligamentous approach was utilized to visualize the lesion which was resected in its entirety with a sagittal saw. A size matched fresh talar allograft was then cut with a sagittal saw to obtain a size matched bony allograft. This was then press fit into the defect within the patient's talar dome and fixed with a partially threaded, headless 3.0 screw buried deep to the cartilage. The patient remained non weight bearing for 12 weeks followed by protected weightbearing in a removal cast boot for 2 weeks and then full weight bearing in a shoe at 14 weeks post op. At final follow up 15 months post-operative the patient remained pain free. Final radiographs reveal a well incorporated bulk talar allograft with physical exam demonstrating a stable ligamentous complex and full range of tibiotalar motion without pain.</div></div><div><h3>Level of clinical evidence</h3><div>IV-Case Report</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100464"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.fastrc.2024.100462
Besim Becoja DPM , Lawrence M. Fallat DPM, FACFAS
The presentation of a hypertrophic nonunion of the ankle after repeated failed surgeries presents a unique set of challenges that necessitate extensive surgical planning and preparation. Three-dimensional (3D) printing technology enables the creation of patient-specific surgical implants, offering tailored solutions for complex cases such as hypertrophic nonunion following repeated surgical failures. We present two cases that used customized 3D implantation devices to treat hypertrophic nonunion after a history of repeated failed surgical interventions. One patient underwent surgical correction of the distal tibial metaphysis nonunion and another patient underwent surgical correction of a distal fibula nonunion. After 3 years of follow-up, both patients demonstrated radiographic evidence of complete bone union, an 90 % reduction in pain Visual Analog Scale (VAS), restoration of functional mobility, 85 % improvement of AOFAS Ankle-Hindfoot scale, and corrected anatomic limb alignment. The use of patient-specific 3D implant devices in the case of hypertrophic nonunion is a successful integration of innovative technology in medicine. The technology of customizable implantation devices is a valuable tool in the surgical treatment of pathologies of the foot and ankle.
{"title":"Innovative management of hypertrophic tibia and fibula nonunions: Outcomes of custom 3D-printed implants","authors":"Besim Becoja DPM , Lawrence M. Fallat DPM, FACFAS","doi":"10.1016/j.fastrc.2024.100462","DOIUrl":"10.1016/j.fastrc.2024.100462","url":null,"abstract":"<div><div>The presentation of a hypertrophic nonunion of the ankle after repeated failed surgeries presents a unique set of challenges that necessitate extensive surgical planning and preparation. Three-dimensional (3D) printing technology enables the creation of patient-specific surgical implants, offering tailored solutions for complex cases such as hypertrophic nonunion following repeated surgical failures. We present two cases that used customized 3D implantation devices to treat hypertrophic nonunion after a history of repeated failed surgical interventions. One patient underwent surgical correction of the distal tibial metaphysis nonunion and another patient underwent surgical correction of a distal fibula nonunion. After 3 years of follow-up, both patients demonstrated radiographic evidence of complete bone union, an 90 % reduction in pain Visual Analog Scale (VAS), restoration of functional mobility, 85 % improvement of AOFAS Ankle-Hindfoot scale, and corrected anatomic limb alignment. The use of patient-specific 3D implant devices in the case of hypertrophic nonunion is a successful integration of innovative technology in medicine. The technology of customizable implantation devices is a valuable tool in the surgical treatment of pathologies of the foot and ankle.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100462"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143164169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.fastrc.2024.100465
Joseph R. Brown DPM (Chief Resident Physician) , Nevin Joseph DPM (Resident Physician) , Bryan R. Blacka BS (Medical Student) , Ian Barron DPM, FACFAS (Assistant Professor)
Metatarsus adductus (MA) deformity adds to the complexity of hallux abductovalgus (HAV) correction. Scant literature exists on the outcomes of HAV correction with concomitant MA. The purpose of this study was to evaluate the literature on the outcomes, complications, and treatment strategies of HAV with concomitant MA deformity. A comprehensive systematic review was performed. Mean radiographic outcomes, patient reported outcome measure scores, and complication rates were calculated. A total of 279 articles were initially identified. 8 articles met the inclusion criteria, for a total of 237 feet. Procedures undertaken exhibited substantial heterogeneity across studies, revealing the lack of a standardized surgical approach. Studies were divided into two separate groups based on procedural selection: A) Isolated 1st ray procedures; B) Combined 1st and lesser ray procedures. The intermetatarsal, hallux valgus, and metatarsus adductus angles were all significantly improved. There was no significant difference in final radiographic angles between the two groups. Recurrence occurred in 12.2 % of patients, necessitating revision in 1.7 %. The total complication rate was 7.2 %, with nonunion as the primary complication at 1.7 %. The overall mean AOFAS score improved from 53.4 preoperatively to 88.8 postoperatively (p < 0.00001). The overall mean postoperative VAS score was 1.4. There was no significant difference in complication rates or AOFAS scores between the groups. No “gold standard” treatment exists for surgical management of HAV with MA. However, favorable functional outcomes with a low reoperation rate can be expected with a combination of arthrodesis and osteotomy procedures.
{"title":"Outcomes of surgical management of hallux abductovalgus with concomitant metatarsus adductus deformity: A systematic review","authors":"Joseph R. Brown DPM (Chief Resident Physician) , Nevin Joseph DPM (Resident Physician) , Bryan R. Blacka BS (Medical Student) , Ian Barron DPM, FACFAS (Assistant Professor)","doi":"10.1016/j.fastrc.2024.100465","DOIUrl":"10.1016/j.fastrc.2024.100465","url":null,"abstract":"<div><div>Metatarsus adductus (MA) deformity adds to the complexity of hallux abductovalgus (HAV) correction. Scant literature exists on the outcomes of HAV correction with concomitant MA. The purpose of this study was to evaluate the literature on the outcomes, complications, and treatment strategies of HAV with concomitant MA deformity. A comprehensive systematic review was performed. Mean radiographic outcomes, patient reported outcome measure scores, and complication rates were calculated. A total of 279 articles were initially identified. 8 articles met the inclusion criteria, for a total of 237 feet. Procedures undertaken exhibited substantial heterogeneity across studies, revealing the lack of a standardized surgical approach. Studies were divided into two separate groups based on procedural selection: A) Isolated 1st ray procedures; B) Combined 1st and lesser ray procedures. The intermetatarsal, hallux valgus, and metatarsus adductus angles were all significantly improved. There was no significant difference in final radiographic angles between the two groups. Recurrence occurred in 12.2 % of patients, necessitating revision in 1.7 %. The total complication rate was 7.2 %, with nonunion as the primary complication at 1.7 %. The overall mean AOFAS score improved from 53.4 preoperatively to 88.8 postoperatively (<em>p</em> < 0.00001). The overall mean postoperative VAS score was 1.4. There was no significant difference in complication rates or AOFAS scores between the groups. No “gold standard” treatment exists for surgical management of HAV with MA. However, favorable functional outcomes with a low reoperation rate can be expected with a combination of arthrodesis and osteotomy procedures.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100465"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143164170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Calcaneal tuberosity avulsion fractures, although uncommon, pose significant challenges due to their complexity and high rates of complications. This systematic review evaluates the effectiveness of various surgical fixation techniques for these fractures. Analyzing data from 31 studies involving 214 patients, we found that cannulated lag screws and tension band wiring were the most frequently used methods. The overall complication rate was 34.1 %, with fixation failure and wound issues being the most common problems. While several innovative techniques have been proposed to improve stability and outcomes, no consensus on the optimal fixation method has been established. This review highlights the need for individualized treatment approaches and further research to optimize surgical management of these challenging injuries.
{"title":"Calcaneal tuberosity avulsion fractures: A systematic review & meta-analysis of fixation methods","authors":"Karissa Badillo DPM , Emily Zink DPM , Jeffrey Manway DPM, FACFAS","doi":"10.1016/j.fastrc.2024.100459","DOIUrl":"10.1016/j.fastrc.2024.100459","url":null,"abstract":"<div><div>Calcaneal tuberosity avulsion fractures, although uncommon, pose significant challenges due to their complexity and high rates of complications. This systematic review evaluates the effectiveness of various surgical fixation techniques for these fractures. Analyzing data from 31 studies involving 214 patients, we found that cannulated lag screws and tension band wiring were the most frequently used methods. The overall complication rate was 34.1 %, with fixation failure and wound issues being the most common problems. While several innovative techniques have been proposed to improve stability and outcomes, no consensus on the optimal fixation method has been established. This review highlights the need for individualized treatment approaches and further research to optimize surgical management of these challenging injuries.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100459"},"PeriodicalIF":0.0,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the editor regarding “Periarticular open wedge osteotomy for severe valgus deformity and associated rearfoot talar coalitions”","authors":"Balachandar Gopalan DNB Orth, ChM Tr & Orth (Consultant Orthopaedic Surgeon)","doi":"10.1016/j.fastrc.2024.100457","DOIUrl":"10.1016/j.fastrc.2024.100457","url":null,"abstract":"","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100457"},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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