Foot & ankle surgery (New York, N.Y.)最新文献

英文中文

Adjuvant hydrolyzed collagen powder in high-risk patients with large soft tissue defects undergoing orthoplastic limb preservation surgery 佐剂水解胶原蛋白粉在高危大面积软组织缺损矫形肢体保留手术中的应用

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2025-09-10 DOI: 10.1016/j.fastrc.2025.100567

Christopher Bibbo , Sara Mateen , Suhail Masadeh

Limb preservation in the multi-morbid patient remains a significant challenge. The combination of orthopedic and plastic reconstructive techniques (“Orthoplastics”) is well known to result in limb preservation (“limb salvage”) even in extremely high-risk patients. Despite advances, adjunctive healing techniques remain desirable.

In this case series, we examined the use of hydrolyzed collagen powder in limb salvage in multi-morbid patients undergoing limb preservation surgery. The medical records of ten high-risk patients with multiple co-morbidities undergoing limb preservation reconstruction, who would otherwise have required a major level amputation, were reviewed retrospectively. Of these patients, there was an average of nine varying risk factors, including the presence of infection, diabetes mellitus, renal impairment, vascular disease, smoking, illicit drug or alcohol abuse, or nicotine use. The case review data included patient demographics, risk factors, specific pathophysiology, Orthoplastic procedure, and the volume of adjunctive hydrolyzed collagen during the reconstructive procedures.

All patients achieved limb preservation or the prevention of an anticipated higher-level amputation. On average, two hydrolyzed collagen applications were used per patient with a mean volume of 1.8 g (range 2-4 g). Notably, the presence of an actively treated infection did not appear to diminish the efficacy of hydrolyzed collagen. Additionally, no adverse reactions were identified with the use of hydrolyzed collagen. These findings suggest that use of hydrolyzed collagen is a safe, valuable adjunct in Orthoplastic limb preservation surgery for patients at extreme risk for limb loss.

多病患者的肢体保存仍然是一个重大挑战。骨科和整形重建技术的结合（“Orthoplastics”）是众所周知的结果肢体保存（“肢体抢救”），即使在极端高风险的患者。尽管取得了进步，但辅助治疗技术仍然是可取的。在这个病例系列中，我们研究了水解胶原蛋白粉在进行肢体保留手术的多病患者的肢体保留中的应用。回顾性分析了10例合并多种合并症的高危患者进行肢体保留重建的医疗记录，否则他们将需要进行大节段截肢。在这些患者中，平均有九种不同的风险因素，包括感染、糖尿病、肾脏损害、血管疾病、吸烟、非法药物或酒精滥用或尼古丁使用。病例回顾数据包括患者人口统计学、危险因素、特定病理生理、矫形手术和重建过程中辅助水解胶原蛋白的体积。所有患者均实现了肢体保留或预防了预期的更高级别截肢。平均每位患者使用两种水解胶原蛋白，平均体积为1.8 g（范围为2-4 g）。值得注意的是，积极治疗的感染并不会降低水解胶原蛋白的疗效。此外，未发现使用水解胶原蛋白的不良反应。这些研究结果表明，对于极度危险的肢体丧失患者，在Orthoplastic肢体保留手术中使用水解胶原蛋白是一种安全、有价值的辅助手段。

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引用次数: 0

About the Journal 关于华尔街日报

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2025-09-01 DOI: 10.1016/S2667-3967(25)00098-9

引用次数: 0

Right foot acute pediatric extensor hallucis longus end to end repair with semitendinosus graft application: A case report 应用半腱肌移植修复小儿右足急性长拇伸肌1例

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2025-08-31 DOI: 10.1016/j.fastrc.2025.100562

Emanoil Shafik DPM, MPH, MS, Max Sanginario DPM, Stephen Trimnell DPM, MS, Joseph D. Cuomo DPM, MS, Abdelhafid El Akri MD, DPM, Sagar Shah DPM, Henry Habib DPM, DABPM

A 11 year old female was referred to Podiatric Surgeon by Plastic Surgeon for right foot lacerations and lateral fibular fracture that had occurred one month prior. Patient had no known past medical history and states that she is a very active dancer. Patient states she was on vacation with her family on a Caribbean island where while rough housing with her sibling, she stepped on a broken glass bottle leading to inverting her ankle. Patient sustained multiple lacerations to her foot and ankle. A plastic surgeon on holiday at the same Caribbean resort was able to provide immediate medical attention to the patient. The right hallux upon physical examination was noted to be in fixed plantarflexion and lacked the ability to manually extend her right hallux upon command. Magnetic Resonance Imaging was done to evaluate the integrity of the long extensor tendon. Imaging of the right foot showing a 4 cm tear of the extensor hallucis longus tendon at the level of the proximal first metatarsal. Patient underwent a procedure for extensor hallucis longus repair with semitendinosus graft application.

一位11岁的女性，因一个月前发生的右脚撕裂和外侧腓骨骨折，由整形外科医生转介给足科外科医生。病人没有已知的既往病史，并表示她是一个非常活跃的舞者。病人说，她和家人在加勒比海的一个岛上度假，在和她的兄弟姐妹住简陋的房子时，她踩到了一个破碎的玻璃瓶，导致脚踝倒转。病人的脚和脚踝有多处撕裂伤。在同一加勒比度假胜地度假的一名整形外科医生能够立即为病人提供医疗照顾。体格检查发现右拇趾处于固定跖屈，缺乏按指令手动伸展右拇趾的能力。磁共振成像评估长伸肌腱的完整性。右脚影像学显示在第一跖近端处长拇伸肌腱撕裂4厘米。病人接受半腱肌移植修复拇长伸肌的手术。

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引用次数: 0

Ipsilateral achilles tendon rupture and medial malleolar fracture in an elderly patient: A rare case report and review 老年患者同侧跟腱断裂及内踝骨折1例：罕见病例报告及回顾

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2025-08-28 DOI: 10.1016/j.fastrc.2025.100561

Emanoil Shafik DPM, MPH, MS, Stephen Trimnell DPM, MS, Joseph D. Cuomo DPM, MS, Max Sanginario DPM, Abdelhafid El Akri MD, DPM, Sagar Shah DPM, Michael Piccarelli DPM, AACFAS

A 77-year-old male presented with a left Achilles tendon rupture and an ipsilateral medial malleolus fracture sustained after a misstep. This combination of injuries is rare, with only eight cases previously reported in the literature. Magnetic resonance imaging (MRI) confirmed a complete rupture of the Achilles tendon approximately 7 cm proximal to its calcaneal insertion. Intraoperative evaluation using an Arthroscopy procedure demonstrated no intra-articular step-off of the medial malleolus fracture. A positive Thompson test further confirmed the tendon rupture. The medial malleolus was stabilized with two 4 × 40 mm Arthrex cannulated screws, and the Achilles tendon was repaired using the Percutaneous Achilles Repair System.

一个77岁的男性提出了一个左跟腱断裂和同侧内踝骨折后持续失足。这种合并损伤是罕见的，文献中只有8例报道。磁共振成像（MRI）证实跟腱在距跟骨止点近7厘米处完全断裂。术中关节镜检查显示，内踝骨折未发生关节内移位。汤普森测试呈阳性进一步证实了肌腱断裂。使用2枚4 × 40 mm Arthrex空心螺钉固定内踝，使用经皮跟腱修复系统修复跟腱。

引用次数: 0

The intramedullary anatomy of the distal fibula as it pertains to current fibular nail offerings: A CT scan analysis 腓骨远端髓内解剖与当前腓骨钉置入的关系：CT扫描分析

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2025-08-21 DOI: 10.1016/j.fastrc.2025.100559

Brian Burgess DPM FACFAS , Ross Groeschl DPM AACFAS

There has been recent increased interest in intramedullary fibular nails for the treatment of fibular fractures. While most publications highlight the clinical outcomes and decreased complication rates associated with fibular nails in comparison to their plate and screw counterparts, no studies to date have discussed the intramedually anatomy of the distal fibula as it pertains to fibular nailing. We retrospectively reviewed 197 tibial/fibular CT scans. Measurements of the intramedullary canal were taken at set points (180 mm, 130 mm from the fibular tip, the isthmus, and the widest portion of the fibula) in both the coronal and sagittal planes. 43 CT scans met inclusion criteria. The average width of the isthmus was 4.21 ± 1.08 mm (range, 2.19–7.33 mm) in the coronal plane and 5.27 ± 1.40 mm (range, 1.7–7.91 mm) in the sagittal plane. The average width of the fibula at 130 mm from the distal tip of the fibula was 5.18 ± 1.15 mm (range, 2.46–8.31 mm) in the coronal plane and 6.41 ± 1.45 mm (range, 2.88–9.89 mm) in the sagittal plane. 180 mm from the distal tip of the fibula, the average diameter was 5.77 ± 1.49 mm (range, 3.02–10.2 mm) and 7.18 ± 1.66 mm (range, 2.42–10.42 mm), for the coronal and sagittal planes, respectively. This is the first study of its kind to provide important insight into the distal fibula’s intramedullary anatomy, specifically as it pertains to fibular nails.

Level of Evidence

近年来，人们对用髓内钉治疗腓骨骨折越来越感兴趣。虽然大多数出版物强调与钢板和螺钉相比，与腓骨钉相关的临床结果和并发症发生率降低，但迄今为止还没有研究讨论腓骨远端髓内解剖与腓骨钉的关系。我们回顾了197个胫骨/腓骨CT扫描。在冠状面和矢状面分别测量髓内管的定点（距腓骨尖端180 mm、130 mm、峡部和腓骨最宽处）。43例CT扫描符合纳入标准。峡部冠状面平均宽度为4.21±1.08 mm（范围2.19 ~ 7.33 mm），矢状面平均宽度为5.27±1.40 mm（范围1.7 ~ 7.91 mm）。距腓骨远端130 mm处，冠状面平均宽度为5.18±1.15 mm（范围2.46 ~ 8.31 mm），矢状面平均宽度为6.41±1.45 mm（范围2.88 ~ 9.89 mm）。距腓骨远端180 mm处，冠状面和矢状面平均直径分别为5.77±1.49 mm（范围3.02-10.2 mm）和7.18±1.66 mm（范围2.42-10.42 mm）。这是同类研究中首次提供了对腓骨远端髓内解剖的重要见解，特别是因为它与腓骨钉有关。证据水平

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引用次数: 0

An anomaly of the medial process of the cuboid mimicking pseudo-calcaneonavicular coalition: A case report 模拟假跟棘关节联合的长方体内侧突异常：1例报告

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2025-08-20 DOI: 10.1016/j.fastrc.2025.100560

Paris Elio , De Marco Giacomo MD , Vazquez Oscar MD , Steiger Christina MD, PhD , Dayer Romain MD , Boudabbous Sana MD , Ceroni Dimitri MD

Calcaneonavicular coalition is well recognised as a malformation that restricts movement of the midfoot, and it can be responsible for sinus tarsi pain and ankle instability. Local calcaneal morphology anomalies, such as a protrusive anterior process of the calcaneus or calcaneus secundarius, can also alter the hindfoot’s biomechanics and exhibit clinical effects similar to a calcaneonavicular coalition.

This case report examines a previously undescribed hypertrophic medial process of the cuboid, which can limit the range of motion of the subtalar joint, mimicking calcaneonavicular coalition. We also explain the clinical approach used to reach our diagnosis.

跟舟关节联合是一种限制足中部活动的畸形，可导致跗骨窦疼痛和踝关节不稳定。局部跟骨形态异常，如跟骨前突或跟骨第二突，也可以改变后足的生物力学，并表现出与跟骨棘关节联合相似的临床效果。本病例报告检查了先前未描述的长方体内侧增厚过程，它可以限制距下关节的活动范围，模拟跟舟关节联合。我们还解释了用于达到我们诊断的临床方法。

引用次数: 0

Circumferential ankle leiomyoma with intratendinous involvement: A case report 伴肌腱内受累的踝关节周围平滑肌瘤1例

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2025-08-20 DOI: 10.1016/j.fastrc.2025.100557

Lauren Simon DPM , David Gelbmann DPM , Marsha A Apushkin MD

Leiomyomas are mostly benign soft tissue neoplasms arising from smooth muscle. These neoplasms are infrequent in the lower extremity accounting for about 1.7 % of all benign soft tissue tumors. In the literature, rare case reports of the foot and ankle have presented the leiomyomas with average size of 2 cm. We present a case report of a leiomyoma of the ankle with the size exceeding the reported.

平滑肌瘤多为良性软组织肿瘤，起源于平滑肌。这些肿瘤在下肢并不常见，约占所有良性软组织肿瘤的1.7%。在文献中，罕见的足部和踝关节平滑肌瘤的报告，平均大小为2厘米。我们报告一例踝关节平滑肌瘤的大小超过报告。

引用次数: 0

Digital arthroplasty using double K-wire technique for hammertoe correction 双k针技术用于锤状趾矫正的指关节成形术

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2025-08-14 DOI: 10.1016/j.fastrc.2025.100558

Dr. Kwanoo Lee DPM, AACFAS (Fellow) , Dr. McKayla Seymour DPM, AACFAS (Fellow) , Dr. Jonathon Srour DPM, AACFAS (Physician) , Dr. Israel Santander DPM, AACFAS (Physician) , Dr. Scott T. Vantre DPM, FACFAS (Director of Research) , Dr. Laurence G. Rubin DPM, FACFAS (Fellowship Director)

Digital arthroplasty is a standard surgical treatment for hammertoe correction. To date, no study has been performed to evaluate a double K-wire technique for digital arthroplasty. This study examined radiographic correction for digital arthroplasty using a double K-wire technique. A retrospective chart review was performed on consecutive patients undergoing digital arthroplasty through a foot and ankle surgery private practice between December of 2020 to September 2022. A total of 30 patients with 53 hammertoe corrections were included in the study with a minimum of a 1-year follow up. The average transverse and sagittal plane angle improvement postoperatively was 5.2° and 27.2°, respectively with a statistically significant difference. Based on our study, arthroplasty with double K-wire fixation corrects hammertoe deformity as confirmed by radiographic measurements.

指关节成形术是锤状趾矫正的标准手术治疗方法。到目前为止，还没有研究评估双k针技术在指关节成形术中的应用。本研究探讨了双k线技术在指关节成形术中的x线矫正。对2020年12月至2022年9月期间通过私人诊所进行足踝手术的连续患者进行回顾性图表回顾。总共有30名患者接受了53例锤状趾矫正，并进行了至少1年的随访。术后横切面和矢状面平均角度改善分别为5.2°和27.2°，差异有统计学意义。根据我们的研究，经x线测量证实，双k针固定关节置换术可矫正锤状趾畸形。

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引用次数: 0

Ankle arthritis in the setting of distal tibial and calcaneal cysts: A case report of a novel staged treatment with bone graft substitute and total ankle arthroplasty 胫骨远端囊肿和跟骨囊肿并发踝关节关节炎：一种新的分期治疗骨移植替代和全踝关节置换术的病例报告

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2025-08-05 DOI: 10.1016/j.fastrc.2025.100556

Michael A. Thomas DPM, MS, FACFAS , Priya D. Patel DPM, AACFAS , Hinal K. Patel DPM, AACFAS , Mansi N. Patel DPM, AACFAS , Aryan N. Bhagat , Nitesh N. Bhagat MD , Matthew K. Brant DPM, FACFAS

Total ankle arthroplasty is a selective procedure that can be highly advantageous for the appropriate candidate. A primary indicator for a positive outcome of the procedure is adequate bone stock, and there is limited literature regarding total ankle arthroplasty in the setting of inadequate bone stock. Most literature refers to periprosthetic bone cysts after a total ankle replacement. This case study documents a 52-year-old male with long-standing ankle arthritis and distal tibial (2.5 × 2.5 × 1.3 cm, volume: 8.13 cm³) and calcaneal (3.8 × 3.5 × 3.0 cm, volume: 39.9 cm³) cysts. Here, a novel treatment was performed utilizing a staged procedure of bone graft substitute in the setting of distal tibial and calcaneal cysts before a total ankle arthroplasty. Preoperative CT imaging was used to evaluate the severity and size of the cysts prior to bone graft substitute implementation. CT imaging was also used postoperatively to confirm consolidation of the cysts. The patient was subsequently followed for two years after the final procedure and was noted to have a stable distal tibial plafond with sufficient ankle joint range of motion with the Wright Medical Inbone Total Ankle Replacement system® (Memphis, Tennessee, USA) by primarily using bone graft substitute for the tibial and calcaneal cysts and later performing a total ankle replacement. The patient had a follow-up period of 24 months after the final procedure with a preoperative AOFAS score of 34, which progressed to 79 postoperatively. As total ankle replacements are increasing in popularity, this novel staged treatment appears to be a safe and viable option to prevent ankle arthrodesis in patients with tibial and calcaneal cysts.

Level of Clinical Evidence

全踝关节置换术是一种选择性手术，对合适的候选人非常有利。手术积极结果的一个主要指标是足够的骨储备，关于骨储备不足情况下全踝关节置换术的文献有限。大多数文献涉及全踝关节置换术后假体周围骨囊肿。本病例报告一名52岁男性，患有长期踝关节关节炎和胫骨远端（2.5 × 2.5 × 1.3 cm，体积：8.13 cm3）和跟骨（3.8 × 3.5 × 3.0 cm，体积：39.9 cm3）囊肿。在这里，一种新的治疗方法是在全踝关节置换术之前，在胫骨远端和跟骨囊肿的设置中使用骨移植替代物进行分阶段的治疗。术前CT成像用于评估囊肿的严重程度和大小，然后进行骨移植替代实施。术后也用CT成像确认囊肿的实变。患者在最终手术后随访了两年，使用Wright Medical Inbone全踝关节置换系统®（Memphis, Tennessee， USA），主要使用骨移植替代胫骨和跟骨囊肿，随后进行全踝关节置换，结果发现患者胫骨远端平台稳定，踝关节活动范围足够大。患者最终手术后随访24个月，术前AOFAS评分为34，术后AOFAS评分为79。随着全踝关节置换术越来越受欢迎，这种新的分期治疗似乎是一种安全可行的选择，可以预防胫骨和跟骨囊肿患者的踝关节融合术。临床证据水平

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引用次数: 0

The pull-through technique: Surgical augmentation for debriding diabetic infections of the mid- and forefoot 拉通技术：手术增强清除糖尿病感染的中、前脚

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2025-07-30 DOI: 10.1016/j.fastrc.2025.100555

Dolfi Herscovici Jr DO, FAAOS , Alexander D. Selsky DO

Aggressive, mechanical debridement is the preferred treatment for the management of chronic infected diabetic foot ulcers. The Pull-Through technique is a low-tech approach that does not require specialized equipment. What makes this approach attractive is that, combined with standard irrigation and debridement, this approach is low-cost, produces a smaller dorsal incision, allows for adequate debridement of the plantar wound, and may help debride biofilms present in the dorsum of the chronic plantar-based wound that could not be addressed by simply debriding the plantar wounds.

积极的机械清创是治疗慢性感染糖尿病足溃疡的首选方法。拉通技术是一种低技术含量的方法，不需要专门的设备。这种方法吸引人的地方在于，与标准的冲洗和清创相结合，这种方法成本低，产生更小的背部切口，允许足底伤口充分清创，并可能有助于清除存在于慢性足底伤口背部的生物膜，这些生物膜无法通过简单的足底伤口清创来解决。

引用次数: 0

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