Pub Date : 2025-11-20DOI: 10.1016/j.fastrc.2025.100589
Marque Allen DPM FACFAS , Chris Bibbo DPM, DO , Jacob J. Riddle DPM , Seth Ashraf DPM
{"title":"Fasciodesis of the deep crural fascia for tendoachilles repair and reconstruction: A case series for a novel surgical technique to prevent wound complications","authors":"Marque Allen DPM FACFAS , Chris Bibbo DPM, DO , Jacob J. Riddle DPM , Seth Ashraf DPM","doi":"10.1016/j.fastrc.2025.100589","DOIUrl":"10.1016/j.fastrc.2025.100589","url":null,"abstract":"","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100589"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Syndesmotic instability occurs in up to 20 % of ankle fractures and may lead to asymmetric tibiotalar loading and early arthrosis if inadequately reduced. Traditional metallic fixation techniques, though effective, are associated with hardware removal rates exceeding 40 % and malreduction rates approaching 35 %. Bio-integrative fixation composed of continuous mineral fibers within a PLDLA matrix provides strength retention during healing while eliminating permanent hardware. We describe a reproducible technique utilizing OSSIOfiber® bio-integrative suture anchors for dynamic syndesmotic fixation. Under fluoroscopic guidance, a 2.5 mm tibial anchor is deployed through a 4.75 mm fibular tunnel, tensioned, and secured with a second anchor to achieve physiologic syndesmotic stabilization. Technical pearls, reduction verification, and postoperative assessment are outlined. This technique provides a minimally invasive, dynamic alternative for syndesmotic stabilization with the potential to reduce implant removal and malreduction risk. Early results and comparative evidence suggest equivalent fixation strength and radiographic outcomes to metallic devices, supporting bio-integrative fixation as a viable option for surgeons seeking a non-metallic solution.
{"title":"Dynamic syndesmotic stabilization with non-metallic bio-integrative fixation: A novel technique guide","authors":"Anthony Schwab DPM, MS, AACFAS , Garrett Wireman DPM, ATC, AACFAS , Jason Nowak DPM, FACFAS , Garret Strand DPM, FACFAS","doi":"10.1016/j.fastrc.2025.100587","DOIUrl":"10.1016/j.fastrc.2025.100587","url":null,"abstract":"<div><div>Syndesmotic instability occurs in up to 20 % of ankle fractures and may lead to asymmetric tibiotalar loading and early arthrosis if inadequately reduced. Traditional metallic fixation techniques, though effective, are associated with hardware removal rates exceeding 40 % and malreduction rates approaching 35 %. Bio-integrative fixation composed of continuous mineral fibers within a PLDLA matrix provides strength retention during healing while eliminating permanent hardware. We describe a reproducible technique utilizing OSSIOfiber® bio-integrative suture anchors for dynamic syndesmotic fixation. Under fluoroscopic guidance, a 2.5 mm tibial anchor is deployed through a 4.75 mm fibular tunnel, tensioned, and secured with a second anchor to achieve physiologic syndesmotic stabilization. Technical pearls, reduction verification, and postoperative assessment are outlined. This technique provides a minimally invasive, dynamic alternative for syndesmotic stabilization with the potential to reduce implant removal and malreduction risk. Early results and comparative evidence suggest equivalent fixation strength and radiographic outcomes to metallic devices, supporting bio-integrative fixation as a viable option for surgeons seeking a non-metallic solution.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100587"},"PeriodicalIF":0.0,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-07DOI: 10.1016/j.fastrc.2025.100586
Neil L. Bernard DPM , Brianna Lach DPM , Eyad Rasoul DPM, MPH , James C. Connors DPM, FACFAS , Mark Hardy DPM, FACFAS , Dustin C. Huntsman DPM, AACFAS
Central metatarsal fractures are common injuries encountered in foot and ankle trauma. Management depends on multiple factors, including fracture pattern, position, age, bone quality, and body mass index (BMI). While these injuries are often managed conservatively, outcomes vary according to individual risk factors. Operative treatment typically involves retrograde percutaneous pinning or small plate fixation. Oblique central metatarsal fractures may accommodate small-diameter screws; however, transverse fractures near the metatarsal neck remain challenging due to limited bone stock for secure hardware placement. Percutaneous Kirshner wire (K-wire) fixation offers temporary stabilization but may not adequately resist pistoning or rotational forces, particularly in distal metatarsal neck fractures. This report presents a novel technique employing extramedullary fixation to supplement intramedullary K-wire stabilization in two such cases. Both patients underwent open reduction and internal fixation using this hybrid method. At follow-up, both demonstrated complete radiographic union and a return to pre-injury activity without complications. These findings suggest that extramedullary fixation may serve as a low-profile and effective option for managing difficult distal metatarsal fractures when traditional fixation methods are limited.
{"title":"A combined intramedullary–extramedullary fixation strategy for distal central metatarsal fractures: Clinical outcomes in two cases","authors":"Neil L. Bernard DPM , Brianna Lach DPM , Eyad Rasoul DPM, MPH , James C. Connors DPM, FACFAS , Mark Hardy DPM, FACFAS , Dustin C. Huntsman DPM, AACFAS","doi":"10.1016/j.fastrc.2025.100586","DOIUrl":"10.1016/j.fastrc.2025.100586","url":null,"abstract":"<div><div>Central metatarsal fractures are common injuries encountered in foot and ankle trauma. Management depends on multiple factors, including fracture pattern, position, age, bone quality, and body mass index (BMI). While these injuries are often managed conservatively, outcomes vary according to individual risk factors. Operative treatment typically involves retrograde percutaneous pinning or small plate fixation. Oblique central metatarsal fractures may accommodate small-diameter screws; however, transverse fractures near the metatarsal neck remain challenging due to limited bone stock for secure hardware placement. Percutaneous Kirshner wire (K-wire) fixation offers temporary stabilization but may not adequately resist pistoning or rotational forces, particularly in distal metatarsal neck fractures. This report presents a novel technique employing extramedullary fixation to supplement intramedullary K-wire stabilization in two such cases. Both patients underwent open reduction and internal fixation using this hybrid method. At follow-up, both demonstrated complete radiographic union and a return to pre-injury activity without complications. These findings suggest that extramedullary fixation may serve as a low-profile and effective option for managing difficult distal metatarsal fractures when traditional fixation methods are limited.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100586"},"PeriodicalIF":0.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-04DOI: 10.1016/j.fastrc.2025.100585
Kenneth M Dupont PhD CCRP , James W Johnson PhD , Chance H McClure BS , David L Safranski PhD
{"title":"Letter to the editor regarding “Clinical and biomechanical analysis of a dynamic compression intramedullary nail for hindfoot and ankle arthrodesis\"","authors":"Kenneth M Dupont PhD CCRP , James W Johnson PhD , Chance H McClure BS , David L Safranski PhD","doi":"10.1016/j.fastrc.2025.100585","DOIUrl":"10.1016/j.fastrc.2025.100585","url":null,"abstract":"","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100585"},"PeriodicalIF":0.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-28DOI: 10.1016/j.fastrc.2025.100584
William Stallings , Fernando Pinero
Background
Subtalar dislocations are uncommon, high-energy injuries that frequently occur with associated fractures and significant soft tissue compromise. Prompt closed reduction is essential to prevent avascular necrosis of the talus, neurovascular injury, and post-traumatic arthritis.
Purpose
Traditional reduction methods are technically demanding, dependent on operator strength, and may endanger already compromised soft tissues. The Quigley method, which applies traction through the toes, can exacerbate deformity and doesn’t provide sufficient force to achieve reduction safely, increasing the risk of injury to the toes and forefoot. Similarly, Charnley’s technique requires exaggeration of the deformity, which raises the risk of neurovascular damage and conversion of closed to open dislocation, while also relying on operator grip strength that may not always be feasible.
Method
We present the case with displaced comminuted fractures of the lesser metatarsals and combined subtalar and talonavicular dislocation to support the use of novel technique conceptualized by the authors. This method uses a padded ankle distraction strap secured with kerlix gauze to the surgeon’s hips, allowing body weight to generate steady, high force in line traction. With traction maintained, the surgeon’s hands are free to correct deformity and apply splinting without loss of distraction.
Result
Reduction was achieved on the first attempt, achieving reduction on the first attempt reduces the risk of further soft tissue injury, limits the need for repeat sedation and radiation, and decreases the likelihood of requiring urgent operative intervention.
Conclusion
This Method represents a safe, reproducible, and cost-effective option for closed reduction in both emergency and operative settings.
{"title":"Closed reduction of subtalar and talonavicular dislocation: Novel technique description","authors":"William Stallings , Fernando Pinero","doi":"10.1016/j.fastrc.2025.100584","DOIUrl":"10.1016/j.fastrc.2025.100584","url":null,"abstract":"<div><h3>Background</h3><div>Subtalar dislocations are uncommon, high-energy injuries that frequently occur with associated fractures and significant soft tissue compromise. Prompt closed reduction is essential to prevent avascular necrosis of the talus, neurovascular injury, and post-traumatic arthritis.</div></div><div><h3>Purpose</h3><div>Traditional reduction methods are technically demanding, dependent on operator strength, and may endanger already compromised soft tissues. The Quigley method, which applies traction through the toes, can exacerbate deformity and doesn’t provide sufficient force to achieve reduction safely, increasing the risk of injury to the toes and forefoot. Similarly, Charnley’s technique requires exaggeration of the deformity, which raises the risk of neurovascular damage and conversion of closed to open dislocation, while also relying on operator grip strength that may not always be feasible.</div></div><div><h3>Method</h3><div>We present the case with displaced comminuted fractures of the lesser metatarsals and combined subtalar and talonavicular dislocation to support the use of novel technique conceptualized by the authors. This method uses a padded ankle distraction strap secured with kerlix gauze to the surgeon’s hips, allowing body weight to generate steady, high force in line traction. With traction maintained, the surgeon’s hands are free to correct deformity and apply splinting without loss of distraction.</div></div><div><h3>Result</h3><div>Reduction was achieved on the first attempt, achieving reduction on the first attempt reduces the risk of further soft tissue injury, limits the need for repeat sedation and radiation, and decreases the likelihood of requiring urgent operative intervention.</div></div><div><h3>Conclusion</h3><div>This Method represents a safe, reproducible, and cost-effective option for closed reduction in both emergency and operative settings.</div></div><div><h3>Level of Clinical Evidence</h3><div>IV</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100584"},"PeriodicalIF":0.0,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-22DOI: 10.1016/j.fastrc.2025.100583
Wen Po Jonathan Tan , Omkar Mahadevan , Muhammed Yaser Hasan
Background
Checkrein syndrome is a rare condition characterized by dynamic flexion contracture of the hallux interphalangeal joint (IPJ) and extension contracture of the metatarsophalangeal joint (MTPJ) during ankle dorsiflexion. It most often arises secondary to trauma or iatrogenic injury along the course of the flexor hallucis longus (FHL) tendon. Multiple surgical approaches have been described but no consensus exists regarding the optimal technique
Methods
We report the case of a 36-year-old male who developed a painful Checkrein deformity of the hallux following fibular free flap harvest. Conservative measures were unsuccessful. Surgical management consisted of FHL tendon lengthening performed via a medio-plantar forefoot approach. A review of the literature was also performed to summarize available surgical strategies, approaches, and outcomes.
Results
The medio-plantar forefoot approach provided direct access to the FHL tendon proximal to the sesamoid sulcus, enabling precise Z-lengthening under intraoperative dynamic assessment. Postoperative recovery was uneventful, with resolution of big toe deformity and motion. Review of published cases demonstrated that Checkrein deformity most frequently follows post-traumatic and iatrogenic causes involving the leg, ankle, or hindfoot. The predominant surgical technique was FHL Z-lengthening, most often performed through a retro-malleolar approach, followed by midfoot and fracture-site–specific exposures. Overall, outcomes across all techniques were favorable, with high rates of deformity correction, motion restoration, and low recurrence.
Conclusion
The medio-plantar forefoot approach is a safe and effective surgical option in the management of Checkrein deformity. Its advantage is the targeted exposure and avoidance of extensive dissection but does limit associated lesser toe correction. A review of reported cases indicates that favorable outcomes can be achieved across all surgical techniques when appropriately selected.
{"title":"Medio-plantar forefoot approach for distal flexor hallucis longus exposure in checkrein syndrome: Case experience and literature review","authors":"Wen Po Jonathan Tan , Omkar Mahadevan , Muhammed Yaser Hasan","doi":"10.1016/j.fastrc.2025.100583","DOIUrl":"10.1016/j.fastrc.2025.100583","url":null,"abstract":"<div><h3>Background</h3><div>Checkrein syndrome is a rare condition characterized by dynamic flexion contracture of the hallux interphalangeal joint (IPJ) and extension contracture of the metatarsophalangeal joint (MTPJ) during ankle dorsiflexion. It most often arises secondary to trauma or iatrogenic injury along the course of the flexor hallucis longus (FHL) tendon. Multiple surgical approaches have been described but no consensus exists regarding the optimal technique</div></div><div><h3>Methods</h3><div>We report the case of a 36-year-old male who developed a painful Checkrein deformity of the hallux following fibular free flap harvest. Conservative measures were unsuccessful. Surgical management consisted of FHL tendon lengthening performed via a medio-plantar forefoot approach. A review of the literature was also performed to summarize available surgical strategies, approaches, and outcomes.</div></div><div><h3>Results</h3><div>The medio-plantar forefoot approach provided direct access to the FHL tendon proximal to the sesamoid sulcus, enabling precise Z-lengthening under intraoperative dynamic assessment. Postoperative recovery was uneventful, with resolution of big toe deformity and motion. Review of published cases demonstrated that Checkrein deformity most frequently follows post-traumatic and iatrogenic causes involving the leg, ankle, or hindfoot. The predominant surgical technique was FHL Z-lengthening<strong>,</strong> most often performed through a retro-malleolar approach<strong>,</strong> followed by midfoot and fracture-site–specific exposures. Overall, outcomes across all techniques were favorable, with high rates of deformity correction, motion restoration, and low recurrence.</div></div><div><h3>Conclusion</h3><div>The medio-plantar forefoot approach is a safe and effective surgical option in the management of Checkrein deformity. Its advantage is the targeted exposure and avoidance of extensive dissection but does limit associated lesser toe correction. A review of reported cases indicates that favorable outcomes can be achieved across all surgical techniques when appropriately selected.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100583"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Necrotizing fasciitis is a life threatening, rapidly progressive infection requiring emergent surgical debridement. As a result of the extensive debridement patients are often left with large soft tissue defects, which may have considerable implications on morbidity. As a means to reduce patient morbidity and more rapidly cover large defects, the “spare parts” technique may serve as a viable option for reconstruction. The goal of this surgical technique is to utilize repurposed tissue from non-salvageable areas as a tool to cover critical structures expeditiously. Presented here is a case of utilizing the spare parts technique for a patient after debridement due to necrotizing fasciitis. A hallux digital fillet flap was harvested as a full thickness skin graft and inset over a soft tissue defect of the anterior ankle. This was done in an attempt to decrease the amount of wound contracture across the joint and provide rapid soft tissue coverage of a critical area.
{"title":"Utilizing the spare parts technique to aid in complex wound reconstruction for a necrotizing soft tissue infection: A case report","authors":"Zoe Dolcimascolo DPM , Suhail Masadeh DPM , Michael Liette DPM","doi":"10.1016/j.fastrc.2025.100582","DOIUrl":"10.1016/j.fastrc.2025.100582","url":null,"abstract":"<div><div>Necrotizing fasciitis is a life threatening, rapidly progressive infection requiring emergent surgical debridement. As a result of the extensive debridement patients are often left with large soft tissue defects, which may have considerable implications on morbidity. As a means to reduce patient morbidity and more rapidly cover large defects, the “spare parts” technique may serve as a viable option for reconstruction. The goal of this surgical technique is to utilize repurposed tissue from non-salvageable areas as a tool to cover critical structures expeditiously. Presented here is a case of utilizing the spare parts technique for a patient after debridement due to necrotizing fasciitis. A hallux digital fillet flap was harvested as a full thickness skin graft and inset over a soft tissue defect of the anterior ankle. This was done in an attempt to decrease the amount of wound contracture across the joint and provide rapid soft tissue coverage of a critical area.</div></div><div><h3>Level of Clinical Evidence</h3><div>Level 4 Case Study</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100582"},"PeriodicalIF":0.0,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-15DOI: 10.1016/j.fastrc.2025.100580
{"title":"Erratum regarding missing “Declaration of Competing Interest” statements in previously published articles","authors":"","doi":"10.1016/j.fastrc.2025.100580","DOIUrl":"10.1016/j.fastrc.2025.100580","url":null,"abstract":"","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 4","pages":"Article 100580"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-11DOI: 10.1016/j.fastrc.2025.100577
Mohammed Yusuf Aslam DPM , Katherine Dux DPM, FACFAS , Bryn Laubacher DPM, FACFAS , Emad Allam MD
Background
Plantar plate injuries are a common cause of forefoot pain and can lead to functional instability. These injuries may be classified as a low-grade (<50 % thickness) or high-grade (>50 % thickness) tear on ultrasound. This study evaluates plantar plate tear severity based on ultrasound and its correlation with surgical intervention.
Methods
A retrospective review was performed on patients with ultrasound-confirmed lesser metatarsophalangeal joint plantar plate tears between 2011 and 2024. Patients were categorized by ultrasound grade of tear and whether they underwent nonsurgical or surgical treatment. A Chi-square test assessed the association between grade of plantar plate tear (low and high) and treatment (nonsurgical and surgical).
Results
Fifty-four patients were included in the study. Of the 23 patients with low-grade tears, 4 required surgery. Of the 31 patients with high-grade tears, 11 required surgery. Statistical analysis revealed no statistically significant difference between plantar plate tear grade and treatment type (χ² = 1.35, p = 0.246).
Conclusion
The severity of plantar plate tear as determined by ultrasound does not independently predict the need for surgical treatment. Treatment strategies appear to be more strongly influenced by patient-reported pain, functional limitation, and patient preference rather than imaging findings alone.
{"title":"Ultrasound grading of plantar plate injuries and correlation with surgical intervention","authors":"Mohammed Yusuf Aslam DPM , Katherine Dux DPM, FACFAS , Bryn Laubacher DPM, FACFAS , Emad Allam MD","doi":"10.1016/j.fastrc.2025.100577","DOIUrl":"10.1016/j.fastrc.2025.100577","url":null,"abstract":"<div><h3>Background</h3><div>Plantar plate injuries are a common cause of forefoot pain and can lead to functional instability. These injuries may be classified as a low-grade (<50 % thickness) or high-grade (>50 % thickness) tear on ultrasound. This study evaluates plantar plate tear severity based on ultrasound and its correlation with surgical intervention.</div></div><div><h3>Methods</h3><div>A retrospective review was performed on patients with ultrasound-confirmed lesser metatarsophalangeal joint plantar plate tears between 2011 and 2024. Patients were categorized by ultrasound grade of tear and whether they underwent nonsurgical or surgical treatment. A Chi-square test assessed the association between grade of plantar plate tear (low and high) and treatment (nonsurgical and surgical).</div></div><div><h3>Results</h3><div>Fifty-four patients were included in the study. Of the 23 patients with low-grade tears, 4 required surgery. Of the 31 patients with high-grade tears, 11 required surgery. Statistical analysis revealed no statistically significant difference between plantar plate tear grade and treatment type (χ² = 1.35, <em>p</em> = 0.246).</div></div><div><h3>Conclusion</h3><div>The severity of plantar plate tear as determined by ultrasound does not independently predict the need for surgical treatment. Treatment strategies appear to be more strongly influenced by patient-reported pain, functional limitation, and patient preference rather than imaging findings alone.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"6 1","pages":"Article 100577"},"PeriodicalIF":0.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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