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

{"title":"Pseudobunion: A new unfortunate result after new minimally invasive bunion surgery. A retrospective radiographic review and case series of 17 feet","authors":"Bogdan Grecea DPM, AACFAS ,&nbsp;Neal M. Blitz DPM, FACFAS","doi":"10.1016/j.fastrc.2025.100521","DOIUrl":"10.1016/j.fastrc.2025.100521","url":null,"abstract":"<div><div>Minimally invasive bunion surgery (MIBS) techniques may produce a new painful, bunion-like complication caused by the residual medial ledge of bone. This “pseudobunion” has not been previously studied and the focus was on patients requiring revision surgery for hardware removal and/or metatarsal exostectomy.</div><div>A 7-year case review was performed between January 2018 to December 2024 and we identified 17 feet (16 patients) with pseudobunion requiring surgery. Data collected included age, sex, laterality, intermetatarsal angle (IMA), hallux valgus angle (HVA), bunion severity, first metatarsal regeneration (FMR) type and number of screws used during the index surgery. Radiographic evaluation included a newly defined metatarsal ledge resection angle (MLRA).</div><div>The mean age was 46.6 years and 100 % were females. One patient had bilateral pseudobunion. The mean interval between the index surgery and revision was 366.7 ± 132.2 days. A 2-screw construct was used in 10 feet (58.8 %) and a 1-screw construct in 7 feet (41.2 %). Index MIBS had a mean preoperative IMA of 17.1° ± 2.4° and postoperative 4.3° ± 1.4° (<em>p</em> &lt; 0.0001), and mean preoperative HVA of 33.5° ± 8.4° and postoperative of 4.3° ± 4.3° (<em>p</em> &lt; 0.0001). Pseudobunion did not occur in mild bunions. At revision, the mean MLRA improved from 56.0° ± 15.9° at the index to 24.4° ± 3.2° post-revision, reaching statistical significance (<em>p</em> &lt; 0.0001).</div><div>Two-screw constructs were associated with a higher incidence of Type I FMR (80 %), whereas one-screw constructs demonstrated predominantly Type II/III FMR (85.7 %), demonstrating a statistically significant association between number of screws and FMR healing type (<em>p</em> = 0.015). Year-over-year analysis, demonstrated a statistically significant downward trend in pseudobunion revisions (R² = 0.86, <em>p</em> = 0.008). While the relative distribution of number of screws did not significantly differ by year (<em>p</em> = 0.176), no pseudobunion revisions with 1-screw constructs have occurred since 2021, coinciding with the development of a 1-screw construct and resection technique allowing for full ledge removal.</div><div>Pseudobunion is a new complication that can be effectively addressed with revision surgery. However, it may be preventable during the index bunion procedure through careful selection MIBS generation, screw construct choice and adequately resecting the medial ledge.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100521"},"PeriodicalIF":0.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297522","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}

{"title":"Surgical excision of symptomatic nonunions of the fifth metatarsal base fractures: A systematic review of outcomes and complications","authors":"Zack Hill DPM, AACFAS ,&nbsp;Ceclina Cao PMS-3 ,&nbsp;Patcharathorn Pookun PMS-2 ,&nbsp;Fely Jhae D. Ebanculla PMS-2 ,&nbsp;Guanjin Chen PMS-3","doi":"10.1016/j.fastrc.2025.100514","DOIUrl":"10.1016/j.fastrc.2025.100514","url":null,"abstract":"<div><h3>Background</h3><div>Symptomatic non-unions of the fifth metatarsal base, particularly in Zones 1 and 2, pose significant treatment challenges. Surgical management includes open reduction internal fixation (ORIF) or excision of the non-union fragment. Though less technically demanding, excision procedures risk disrupting important tendon and ligamentous attachments, potentially affecting foot function.</div></div><div><h3>Methods</h3><div>This review synthesizes available data on surgical excision as a definitive treatment, addressing outcomes and complications. A systematic review of PubMed, Embase, Cochrane Library, and Google Scholar was performed to identify studies reporting on the excision of nonunion fragments at the proximal fifth metatarsal. Inclusion criteria required studies to present functional outcomes and complications following excision in Zones 1 and 2. Of 156 studies reviewed, 4 met the criteria, encompassing 18 patient cases.</div></div><div><h3>Results</h3><div>All 18 patients underwent excision of the proximal fragment, with various techniques used to preserve peroneal tendon function. Twelve patients were high-level athletes, and all returned to sport without pain or functional limitations. One study reported a significant improvement in AOFAS forefoot scores (from 58.6 to 95; <em>p</em> = 0.024) and VAS scores (from 8.0 to 1.6; <em>p</em> = 0.023). At an average follow-up of 18.3 months, 100 % of patients were pain-free, and no complications were reported.</div></div><div><h3>Conclusion</h3><div>Excision of symptomatic non-unions of the fifth metatarsal base, particularly in Zone 1 and selective cases for Zone 2, appears to be a safe and effective treatment option, allowing for significant pain relief and return to activity in high-level athletes. Further research is needed to validate long-term outcomes and optimal surgical techniques.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100514"},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470806","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}

{"title":"Can AI outperform professional writers in summarizing foot and ankle literature?","authors":"Seth L. Warren DPM ,&nbsp;Steven R. Cooperman DPM, MBA, AACFAS","doi":"10.1016/j.fastrc.2025.100522","DOIUrl":"10.1016/j.fastrc.2025.100522","url":null,"abstract":"<div><div>This study evaluates the performance of an advanced large language model in summarizing scientific literature within the specialized field of foot and ankle surgery. Building upon prior work that demonstrated ChatGPT-3.5′s comparability to podiatric residents, this investigation compares ChatGPT-4.5 directly against paid, professionally written summaries sourced from Foot and Ankle Quarterly. Ten original research articles were summarized by ChatGPT-4.5 and matched with corresponding professionally written summaries. Quantitative analysis using BLEU and ROUGE metrics assessed textual similarity, while Flesch Reading Ease and Flesch-Kincaid Grade Level scores evaluated readability. A qualitative preference survey was conducted among three blinded, fellowship-trained foot and ankle surgeons. Results showed that AI-generated summaries were preferred in 73.33 % of comparisons and demonstrated no factual inaccuracies. Although professionally written summaries were quantitatively more readable, AI-generated summaries maintained higher consistency in language complexity. ROUGE scores suggested substantial content overlap between AI-generated and reference summaries, whereas BLEU scores reflected differences, which may be attributable to shorter AI summary lengths. These findings suggest ChatGPT-4.5 can reliably and efficiently produce accurate, high-quality summaries, potentially surpassing paid academic writers in certain domains. Broader implications include improved efficiency in academic research and literature review. Continued investigation and oversight are necessary to guide the responsible integration of AI tools into clinical and scholarly workflows.</div></div><div><h3>Level of evidence</h3><div>III, comparative study</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100522"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321833","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}

{"title":"A novel technique for surgical treatment of diabetic calcaneal osteomyelitis: Trabecular calcaneal instillation technique","authors":"Alper Erkin ,&nbsp;Hande Cengiz Açıl ,&nbsp;Taner Demirci ,&nbsp;Dilek Aygin ,&nbsp;Thomas Eberlein","doi":"10.1016/j.fastrc.2025.100517","DOIUrl":"10.1016/j.fastrc.2025.100517","url":null,"abstract":"<div><div>Negative Pressure Wound Therapy with instillation (NPWTi) is widely used for managing various wound types, including acute and chronic infections, soft tissue injuries and surgical wounds. However, there is a lack of large-scale, controlled studies specifically assessing the efficacy and safety of NPWTi in diabetic calcaneal osteomyelitis. This study aims to evaluate the effectiveness of the Trabecular Calcaneal Instillation technique, a novel surgical approach utilizing NPWTi for the management of diabetic calcaneal osteomyelitis. We implemented the Trabecular Calcaneal Instillation technique, which involves creating deep tubular cavities within the calcaneus and applying NPWTi. This approach was assessed in a cohort of 15 patients with diabetic calcaneal osteomyelitis. Key outcomes measured included wound healing rates, patient comfort and incidence of amputation. Preliminary findings indicate that the Trabecular Calcaneal Instillation technique significantly improved wound healing rates and patient comfort compared to traditional methods. It further allowed for the avoidance of amputation in 13 patients. The Trabecular Calcaneal Instillation technique shows advantages over traditional treatments for diabetic calcaneal osteomyelitis. Further research is necessary to confirm these findings and establish the technique's efficacy and safety in broader clinical practice.</div></div><div><h3>Level of evidence</h3><div>Level 4</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100517"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665800","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}

{"title":"Tibial cortex transverse transport: Historical evolution, clinical applications, and future directions","authors":"Quinn M. Schroeder DPM, AACFAS ,&nbsp;Dalon U. Paredes DPM ,&nbsp;Miranda Montion BS, MA ,&nbsp;Elizabeth R. Powell BS ,&nbsp;Dakota R.C. Topp BS ,&nbsp;Gan Golshteyn MS, DPM, FACFAS ,&nbsp;Emmy Oji DPM, FACFAS ,&nbsp;Khase A. Wilkinson DPM, FACFAS ,&nbsp;David V. Tran DPM, FACFAS ,&nbsp;Kyle M. Smith DPM, FACFAS","doi":"10.1016/j.fastrc.2025.100513","DOIUrl":"10.1016/j.fastrc.2025.100513","url":null,"abstract":"<div><div>Diabetic foot ulcers are among the most severe complications of diabetes mellitus, often leading to high morbidity, major amputations, and premature mortality. Despite advancements in wound care and limb salvage techniques, treatment failures remain prevalent. Tibial cortex transverse transport (TCT), leveraging principles of distraction osteogenesis, offers a unique approach by directly stimulating microvascular perfusion and tissue regeneration in ischemic limbs, addressing limitations of conventional therapies. Despite its potential and documented use elsewhere, TCT remains underutilized and less studied within Western healthcare systems, representing a significant knowledge gap. This paper provides a comprehensive review of the historical evolution of tibial cortex transverse transport, its underlying biomechanics, surgical methodology, and clinical applications. By tracing the origins of this procedure, detailing its mechanism of action, and discussing modern adaptations and future utilities, we aim to provide a foundation for wide adoption and refinement of this technique, particularly in Western medicine.</div><div>Level of clinical evidence: V</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100513"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270814","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}

{"title":"Defining the topography of the common peroneal nerve and surgical approaches for nerve transfers and neurolysis","authors":"Edgardo Rodriguez-Collazo DPM ,&nbsp;Alieu Kanu DPM ,&nbsp;Sitong Chen DPM","doi":"10.1016/j.fastrc.2025.100503","DOIUrl":"10.1016/j.fastrc.2025.100503","url":null,"abstract":"<div><div>As one of the most common mononeuropathy in the lower extremity, common peroneal nerve neuropathy requires concise and complete understanding by any specialist of the lower extremity. The causes of common peroneal nerve injuries vary including trauma, iatrogenic injury and chronic compression or traction but can have debilitating effects. Conservative treatment for motor symptoms can include bracing and orthotics whereas neuropathic pain is often managed with analgesics such as narcotics. Surgical intervention is recommended if no improvements are noted after 4 months. Common entrapment sites for the common peroneal nerve have not been well described in the literature. This article discusses the topography of the common peroneal nerve and its branches, sites of entrapment, appropriate diagnosis, and surgical approaches for treatment of common peroneal nerve pathologies. Defining the topography of the common peroneal nerve allows for precise anatomical identification and improved surgical techniques for treatment. Studies have shown that patients with significant injuries can suffer from socioeconomic debilitation and narcotic abuse. Therefore, this precise anatomic identification is of utmost importance for reproducible, and effective surgical techniques when addressing these issues as symptoms can persist if an inadequate intervention is performed.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 2","pages":"Article 100503"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196367","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}

{"title":"About the Journal","authors":"","doi":"10.1016/S2667-3967(25)00053-9","DOIUrl":"10.1016/S2667-3967(25)00053-9","url":null,"abstract":"","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 2","pages":"Article 100518"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490119","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}

{"title":"Staple fixation for first metatarsophalangeal joint fusion: A case series with surgical and clinical outcomes","authors":"Adam Ferguson DPM,&nbsp;Makenzie Kerns DPM,&nbsp;Matthew Gorski DPM, AACFAS","doi":"10.1016/j.fastrc.2025.100515","DOIUrl":"10.1016/j.fastrc.2025.100515","url":null,"abstract":"<div><div>This is a case series of 5 patients, 6 total feet who underwent first metatarsophalangeal (MTP) joint fusion using staples. The objective of this case series is to demonstrate the ease of application of staples in MTP joint fusion procedures, and their ability to provide stable fixation to achieve successful fusion. The primary outcome evaluated was successful fusion with use of this alternative hardware. Historically plate and screw constructs have been utilized extensively for successful first MTP joint fusion. While staple constructs are more novel, this study aims to show that they are a viable alternative while they may or may not be superior. This collection of data is small and further studies are needed to compare their efficacy, longevity and complications as compared to other fixation methods. The patients' demographics, surgical techniques, postoperative outcomes, and compatibility with adjunctive therapies are discussed.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100515"},"PeriodicalIF":0.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253426","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}

{"title":"Gutter impingement following total ankle arthroplasty: A systematic review of management and surgical approaches,","authors":"Karissa Badillo ,&nbsp;Julia Tolin ,&nbsp;Jarrett D. Cain ,&nbsp;Jeffrey Manway","doi":"10.1016/j.fastrc.2025.100508","DOIUrl":"10.1016/j.fastrc.2025.100508","url":null,"abstract":"<div><div>Total ankle arthroplasty (TAA) has become an increasingly common surgical option for patients with end stage ankle arthritis. Gutter impingement is a common yet largely underreported complication following total ankle arthroplasty (TAA). As the use of TAA exponentially increases, an understanding of how to both recognize and manage gutter impingement is vital to the optimization of post-operative care. Narrowing of the medial and lateral ankle gutters can arise from a variety of causes, including implant malalignment, scar tissue formation and hypertrophic bone formation, ultimately leading to residual pain following surgery. The incidence of this pathology and its respective management varies greatly within the available literature. The purpose of this study is to review the incidence, treatment approaches and outcomes of gutter impingement following TAA. Eight studies were analyzed which included 1456 patients, of which 130 were treated for gutter impingement at an average of 18 months following index TAA. The mean age of patients across all studies was 62.9 years, with an average follow up period of 40.6 ± 23.1 months. Open debridement was noted to be the most common surgical approach (50.8 %) followed by arthroscopic debridement (37.7 %). Conservative treatment was only used in 9.2 % of cases. This review demonstrates the underreporting of gutter impingement following total ankle arthroplasty and highlights the of lack of standardized treatment. Future prospective studies are warranted in efforts to optimize patient outcomes in the management of gutter impingement.</div></div><div><h3>Level of Evidence</h3><div>Level III Systematic Review</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100508"},"PeriodicalIF":0.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860728","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}

{"title":"Medial brostrom repair to resolve anterior medial rotary laxity in Weber B ankle fracture: A case report","authors":"Lauren Simon DPM ,&nbsp;Michael Mancano DPM ,&nbsp;Kendall O'Steen ,&nbsp;Mitchell L. Goldflies MD ,&nbsp;Edgardo Rodriguez-Collazo DPM","doi":"10.1016/j.fastrc.2025.100509","DOIUrl":"10.1016/j.fastrc.2025.100509","url":null,"abstract":"<div><div>The ankle is one of the most commonly injured joints in the lower extremity. In the United States, there are over 2 million ankle injuries annually (1). Historically, the treatment of bimalleolar equivalent fractures includes the fibular fracture, and use of a syndesmotic fixation if syndesmotic laxity and medial widening are observed. This article argues that deltoid ligament repair should be done concomitantly with anterior medial capsule repair in order to fully address rotary laxity. The centerpiece of deltoid injury with capsule injury diagnosis is the widening of the medial clear space &gt;4 mm and/or &gt;1 mm difference than the contralateral limb on AP radiographs (1–7). We suggest that anterior medial capsule repair must be done with the deltoid ligament repair. We present a case of a Weber B fracture with uncertain deltoid involvement on pre-operative radiographs, for which a deltoid rupture with capsule involvement was determined intraoperatively with appropriate stress radiographs taken under general anesthesia. Repair of the deltoid using a low cost, non-intraarticular implant with concomitant repair of the anterior-medial capsule of the ankle joint was utilized. This medial ankle repair, in addition to ORIF of the fibula resulted in a satisfactory clinical and radiographic outcome.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100509"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253425","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}