Foot typology, dynamic and static weight distribution and radiographic changes after subtalar arthroereisis in juvenile symptomatic flexible flat feet
This study describes the dynamic and static correction effects of subtalar arthroereisis in adolescents with flexible symptomatic flatfeet in comparison to normal subjects as well as to results before and after removal of metal. Eighteen adolescents with 25 symptomatic flexible flatfeet were treated surgically with a subtalar arthroereisis at a mean of 12.5 (10-16) years. At follow-up (mean 3.9 years, range 0.4-8), patients filled out the American Orthopaedic Foot and Ankle Society questionnaire, received radiographs and were examined using dynamic and static pedobarography as well as static hindfoot axis examination. (Sou...
Source: Journal of Foot and Ankle Surgery - July 28, 2021 Category: Orthopaedics Authors: Lara O. Eysel, Katja A. L üders, Lena Braunschweig, Heiko M. Lorenz, Jochen Dörner, Anna K. Hell, Hartmut Stinus Source Type: research

Phosphaturic Mesenchymal Tumor of the Ankle: A Case Report and Review of the Literature
We report the case of a phosphaturic mesenchymal tumour (PMT) of the ankle; an extremely rare lesion that causes osteomalacia via paraneoplastic renal phosphate wasting. A 41-year-old man was referred to plastic surgery with a swelling over the anterior ankle, which had been increasing in size for one year. Focused ultrasound assessment was inconclusive, but excision biopsy demonstrated features in keeping with a phosphaturic mesenchymal tumour. Evidence of tumour-induced osteomalacia was subsequently identified on review of historical biochemistry. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 26, 2021 Category: Orthopaedics Authors: Oliver Jones, Suzanne H. Murphy, Kenneth E.S. Poole, A. James Watkins, Amer J. Durrani Source Type: research

Risk Factors and Outcomes after Surgical Reconstruction of Charcot Neuroarthropathy in Fracture versus Dislocation Patterns
The primary aim of this study is to compare the preoperative risk factors and postoperative outcomes between Charcot neuroarthropathy patients with dislocation versus purely fracture pattern breakdown. The secondary aim is to compare the same factors between Charcot neuroarthropathy patients with dislocation versus fracture-dislocation pattern breakdown. A total of 55 patients with forefoot, midfoot, or hindfoot Charcot Neuroarthopathy were assessed at a mean follow up of 2.99 years. Bivariate analysis compared preoperative risk factors and postoperative outcomes, and segmented multivariable regression analysis was perform...
Source: Journal of Foot and Ankle Surgery - July 25, 2021 Category: Orthopaedics Authors: Nicole K. Cates, Jonathan Furmanek, Korey S. Dubois, Jacob Wynes Source Type: research

Iatrogenic Damage to Neurovascular and Soft Tissue Structures during Lateral Release of Hallux Valgus: A Comparative Anatomical Study of Minimally Invasive versus Open Surgical Techniques
Lateral release is often an integral step in surgical correction of hallux valgus and can be performed using open or minimally invasive techniques. We investigated whether these techniques cause iatrogenic damage to arteries, nerves, tendons, or joint capsules. In this cadaver study, lateral release was performed on nine pairs of specimens by a specialized foot surgeon. The specimens were randomly assigned to each group. The operations were followed by anatomical preparation, data collection, photo documentation, and statistical analysis. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 22, 2021 Category: Orthopaedics Authors: Kajetan Klos, Mark Lenz, Gunther O. Hofmann, Wiebke Schubert, Matthias Knobe, Klaus Edgar Roth, Paul Simons, Matthias Aurich Source Type: research

Comparison of Fixation Techniques in Oblique and Biplanar Chevron Medial Malleolar Osteotomies; a Finite Element Analysis
This study aimed to evaluate different fixation techniques and implants in oblique and biplanar chevron medial malleolar osteotomies using finite element analysis. Both oblique and biplanar chevron osteotomy models were created, and each osteotomy was fixed with two different screws (3.5 mm cortical screw and 4.0 mm malleolar screw) in two different configurations; (1) two perpendicular screws, and (2) an additional third transverse screw. Nine simulation scenarios were set up, including eight osteotomy fixations and the intact ankle. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 22, 2021 Category: Orthopaedics Authors: Ali Levent, Metin Yapti, H. Kursat Celik, Ozkan Kose, O. Faruk Kilicaslan, Allan E.W. Rennie Tags: Original Research Source Type: research

The Impact of Hospitalization for Diabetic Foot Infection on Health-Related Quality of Life: Utilizing PROMIS
Diabetic foot infections (DFI) are an increasingly common cause of hospitalizations. Once hospitalized with DFI, many patients require some level of amputation, often undergoing multiple operations. With increasing importance on patient-centered metrics, self-reported health-related quality of life (HRQOL) tools have been developed. This prospective cohort study aimed assessed the impact of DFI on HRQOL. Two hundred twenty-four patients completed the 29-item Patient-Reported Outcome Measurement Information System (PROMIS) and 12-Item Short Form (SF-12) survey. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 22, 2021 Category: Orthopaedics Authors: Matthew J. Johnson, Dane K. Wukich, Paul A. Nakonezny, Lawrence A. Lavery, Javier La Fontaine, Junho Ahn, David H. Truong, George Tye Liu, Michael VanPelt, Paul J. Kim, Katherine M. Raspovic Tags: Original Research Source Type: research

Open Ankle Arthrodesis: A Retrospective Analysis Comparing Different Fixation Methods
A wide variation of surgical options, complications and union raters are reported in the treatment of end-stage ankle arthritis. However, open ankle arthrodesis remains the golden standard for ankle arthritis. The purpose of this study was to evaluate the union rate and complication rate as well as identify potential risk factors for different methods of fixation in patients with end-stage ankle arthritis of different etiology. In total, 42 ankles of 41 patients with ankle osteoarthritis were included for this single-center retrospective study. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 22, 2021 Category: Orthopaedics Authors: Stein B.M. van den Heuvel, Diederick Penning, Tim Schepers Source Type: research

Complex Foot Infection Treated with Surgical Debridement and Antibiotic Loaded Calcium Sulfate - A Retrospective Cohort Study of 137 Cases
Complex foot infections involving bone and soft tissue in patients with co-morbidities such as diabetes and peripheral arterial disease (PAD) are a cause of significant hospital admission. They are associated with substantial economic costs to health services worldwide. Historically, severe foot infection has been treated with surgical debridement and prolonged courses of systemic antibiotics. Prolonged systemic antibiotic use increases the risk of drug side effects, antimicrobial resistance and Clostridium difficile infection. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 22, 2021 Category: Orthopaedics Authors: Robert Morley, Matt Rothwell, Dr John Stephenson, Liza McIlvenny, Frank Webb, Aaron Barber Tags: Original Research Source Type: research

Outcome Assessment Performance of the SF-36, Manchester-Oxford Foot Questionnaire and AOFAS in Forefoot Reconstruction Surgery
The purpose of this study was to investigate the measurement properties of the Short Form 36 (SF-36) to detect real change after forefoot reconstruction surgery. Responsiveness and minimally important change estimates were compared with those from the Manchester-Oxford Foot Questionnaire (MOXFQ) and the American Orthopaedic Foot and Ankle Society (AOFAS) measures. Eighty-three patients awaiting surgery were recruited. Patients completed pre and 12 months postoperative the SF-36 and the MOXFQ. A surgeon assessed the AOFAS scores. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 22, 2021 Category: Orthopaedics Authors: Daniel N. Bianco Adames, Gemma Gonz ález-Lucena, Juan I. Stacey Ruales, Berta Gasol Cudos, Albert Ginés-Cespedosa Tags: Original Research Source Type: research

Do arch height and arch stiffness relate to physical performance in adult men?
Foot arch plays an important role in bearing body weight, absorbing ground reaction forces and maintaining balance, and its structure and function are bound to have a profound effect on physical activities and sports. Arch height and arch stiffness are two factors that represent the structure and function of the arch. Therefore, the purpose of this study was to explore the associations of arch height and arch stiffness with physical performance. A total of 56 men (aged 49.00 ± 7.95 years, mean BMI 26.80 ± 3.75 kg/m2) participated in this study. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 22, 2021 Category: Orthopaedics Authors: Xiaoguang Zhao, Yaodong Gu, Jiabin Yu, Ye Ma, Zhexiao Zhou Source Type: research

Description of a Revision Technique for Failed Polyvinyl Alcohol Hydrogel Implant in Patient with Freiberg's Disease
We report a case with recurrence of symptoms within six weeks and required revision for fracture of the implant. We describe a revision technique with modified osteochondral bone graft to deal with the variables of revision surgery namely: the bone loss, collateral ligament insufficiency and changes to the proximal phalanx articular surface. We describe a post-operative plan, recovery and a good outcome achieved in 12 Month follow-up. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 21, 2021 Category: Orthopaedics Authors: Dafalla Elamin, George Chami Tags: Case Reports and Series Source Type: research

Retrocalcaneal Enthesophyte Resection with Functional Lengthening of the Achilles Tendon and Buried Knot Technique: A Case Series
Retrocalcaneal exostosis can be debilitating and in severe cases, surgical resection is indicated. Complications can arise from surgical resection of the exostosis and reattachment of the Achilles tendon, including irritation of the suture knot, recurrence of the bony prominence, and dehiscence. The use of a buried knot technique with functional lengthening of the Achilles tendon and gastroc-soleal muscle complex can minimize these complications. Complete detachment of the Achilles tendon allows for aggressive and thorough resection of the exostosis and functional lengthening with reattachment. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 21, 2021 Category: Orthopaedics Authors: Nicole K. Cates, Emily C. Wagler, Shirley Chen, Laurence G. Rubin Tags: Case Reports and Series Source Type: research

Sesamoidectomy in athletes: outcomes from two-centers
Sesamoid pain can arise from avascular necrosis, fracture, osteochondrosis, and advanced degeneration. Disorders of the sesamoids in athletes can be debilitating. Total sesamoidectomy of the involved sesamoid is considered an effective surgical treatment when conservative measures have failed. There is limited literature evaluating the outcome of sesamoidectomy in athletically active patients. Our two- center study reports on 68 patients (70 procedures; 2 male patients were operated on both feet in separate procedures approximately 3 years apart; 41 (58.6%) tibial and 29 (41.4%) fibular sesamoidectomies; 24 males and 44 fe...
Source: Journal of Foot and Ankle Surgery - July 20, 2021 Category: Orthopaedics Authors: Amol Saxena, Magali Fournier, Parth Patel, Nicola Maffulli Source Type: research

Sesamoidectomy in athletes: outcome from two-center
Sesamoid pain can arise from avascular necrosis, fracture, osteochondrosis, and advanced degeneration. Disorders of the sesamoids in athletes can be debilitating. Total sesamoidectomy of the involved sesamoid is considered an effective surgical treatment when conservative measures have failed. There is limited literature evaluating the outcome of sesamoidectomy in athletically active patients. Our two- center study reports on 68 patients (70 procedures; 2 male patients were operated on both feet in separate procedures approximately 3 years apart; 41 (58.6%) tibial and 29 (41.4%) fibular sesamoidectomies; 24 males and 44 fe...
Source: Journal of Foot and Ankle Surgery - July 20, 2021 Category: Orthopaedics Authors: Amol Saxena, Magali Fournier, Parth Patel, Nicola Maffuli Source Type: research

Accelerated rehabilitation in non-operative management of acute Achilles tendon ruptures – a systematic review and meta-analysis
We examined the treatment effect of accelerated functional rehabilitation in non-operative management of acute Achilles tendon ruptures.A systematic search of PubMed, EMBASE and Web of Science databases for articles comparing accelerated versus delayed rehabilitation in the non-operative management of acute Achilles tendon rupture was performed. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 20, 2021 Category: Orthopaedics Authors: Laurens Coopmans, Jorge Amaya Aliaga, Willem-Jan Metsemakers, An Sermon, Dominique Misselyn, Stefaan Nijs, Harm Hoekstra Tags: Review Article Source Type: research

Delayed Onset of Infectious Foreign Body Granuloma for Non-absorbable Sutures after Open Achilles Tendon Repair: A Case Report
We present a patient with systemic lupus erythematosus who developed an infectious suture granuloma that extended to the entire Achilles tendon and was induced by non-absorbable sutures that were used for open Achilles tendon repair 20 years before. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 19, 2021 Category: Orthopaedics Authors: Ryo Itoga, Masatake Matsuoka, Tomohiro Onodera, Ai Shimizu, Koji Iwasaki, Shinji Matsubara, Ryosuke Hishimura, Eiji Kondo, Norimasa Iwasaki Source Type: research

Are Readmission and Reoperation Rates for Lower Extremity Necrotizing Fasciitis Different between Patients with and without Diabetes Mellitus?
This study aims to understand the hospital course of diabetic and nondiabetic patients managed for lower-extremity necrotizing fasciitis by identifying factors contributing to readmissions and reoperations. 562 patients treated for lower-extremity necrotizing fasciitis were selected from the American College of Surgeons-National Surgical Quality Improvement Program database between 2012 —2017. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 19, 2021 Category: Orthopaedics Authors: Junho Ahn, Farzam Farahani, Katherine M. Raspovic, George T. Liu, Trapper A. Lalli, Michael D. VanPelt, Paul A. Nakonezny, Dane K. Wukich Tags: Original Research Source Type: research

The Sliding Hindfoot Osteotomy for the treatment of talus body defects - Results of a new technique in tibiotalocalcaneal arthrodesis
This study reports the early results of a sliding oblique hindfoot osteotomy for salvage procedures combined with tibiotalar arthrodesis to achieve a well-aligned, painless, plantigrade foot. All patients presenting to our institution with severe talus body defects requiring corrective surgery between January 2016 - August 2020 were included. An oblique osteotomy of the diseased talus was performed to correct anterior talus subluxation and prevent excessive loss of height at the tibiotalar apposition and to correct varus-valgus deformity. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 19, 2021 Category: Orthopaedics Authors: Abdul-Rasheed Rabiu, Jean-Pierre St Mart, Ines LH Reichert, Raju Ahluwalia Tags: Case Reports and Series Source Type: research

The Clinical Efficacy of Suture-button Fixation and Trans-syndesmotic Screw Fixation in the Treatment of Ankle Fracture Combined with Distal Tibiofibular Syndesmosis Injury: A Retrospective Study
Twenty percent of ankle fractures present with concomitant syndesmosis injury which results in poor clinical outcomes. Surgical stabilization of the syndesmosis can be achieved with either trans-syndesmotic screws or a suture-button device. The aim of this study is to investigate the clinical efficacy of suture-button fixation and trans-syndesmotic screw fixation in the treatment of ankle fracture combined with distal tibiofibular syndesmosis injury. A retrospective analysis was conducted by enrolling 76 patients with ankle fractures combined with distal tibiofibular syndesmosis  injury who were admitted in our trauma...
Source: Journal of Foot and Ankle Surgery - July 19, 2021 Category: Orthopaedics Authors: Yibo Xu, Ran Kang, Ming Li, Zhong Li, Teng Ma, Cheng Ren, Qian Wang, Yao Lu, Kun Zhang Tags: Original Research Source Type: research

Longitudinal Validity and Minimal Important Change for the Modified Lower Extremity Functional Scale (LEFS) in Orthopedic Foot and Ankle Patients
The Lower extremity functional scale (LEFS) is a patient-reported outcome measure for lower extremity disorders. Aim of this study was to assess the longitudinal validity including responsiveness and test-retest reliability of the revised 15-item version, and to define the minimal important change (MIC) of the modified LEFS in a generic sample of orthopedic foot and ankle patients who underwent surgery. Responsiveness, effect size and standardized response mean were measured by determining the score change between the baseline and 6-months administration of the LEFS from 156 patients. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 16, 2021 Category: Orthopaedics Authors: Antti J. Saarinen, Anton S. Bondfolk, Jussi P. Repo, Henrik Sandelin, Mikko M. Uimonen Tags: Original Research Source Type: research

The Safety Profile of Same Day Outpatient Total Ankle Arthroplasty
There has been significant change in the health care policy in the United States in recent years with an increasing focus on health care costs and patient satisfaction. One strategy of cost containment is to transition outpatient surgery away from high cost hospital environments. Total ankle arthroplasty has begun the evolution to outpatient settings however, there is limited published literature on the results of outpatient total ankle arthroplasty (TAA). The purpose of the present study was to review the safety profile of same day outpatient TAA at an ambulatory surgery center. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 16, 2021 Category: Orthopaedics Authors: Travis M. Langan, Calvin J. Rushing, Bryon J. McKenna, Gregory C. Berlet, Christopher F. Hyer Tags: Original Research Source Type: research

One To Remember...
During my undergraduate studies I worked as a CNA on the surgical floor at the hospital. One evening I mustered up the courage to ask an old prestigious surgeon who had just finished a long day in the operating room a question. He personally held over 70 surgical patents and he exuded authority and was highly respected. I explained my desire to pursue medicine and asked him if all the hard work to get there was really worth it? He instantly stopped what he was doing, looked right at me, and said, “Anything worth doing in life takes hard work.” With that, he walked away. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 10, 2021 Category: Orthopaedics Authors: Ryan Rigby Tags: Editorial Source Type: research

Outcomes of Tibial Nerve Repair and Transfer: A Structured Evidence-Based Systematic Review and Meta-Analysis
The objective of our study is to conduct a systematic review of the effectiveness of end-to-end repair, neurolysis, nerve grafting, and nerve transfer in improving motor function after tibial nerve injury.PubMed, Cochrane, Medline, and Embase libraries were queried according to the PRISMA guidelines for articles that present functional outcomes after tibial nerve injury in humans treated with nerve transfer or repair. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 6, 2021 Category: Orthopaedics Authors: Stuti P. Garg, Abbas M. Hassan, Anooj A. Patel, Megan M. Perez, Jenna R. Stoehr, Suvethavarshini Ketheeswaran, Ava G. Chappell, Robert D. Galiano, Jason H. Ko Source Type: research

Early Clinical, Functional, and Mortality Outcomes for Heel Ulcers Treated with a Vertical Contour Calcanectomy
Heel ulcerations are common complications seen in patients suffering from chronic conditions such as diabetes mellitus, peripheral vascular disease, and in bed ridden patients. When these systemic pathologies lead to heel ulcers, an increased risk of calcaneal osteomyelitis often significantly limits the benefits of conventional therapeutic interventions and increases risk of major lower extremity amputation. The Vertical Contour Calcanectomy (VCC) is a novel surgical procedure specific for the surgical management of these complex and often recalcitrant heel ulcerations. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 3, 2021 Category: Orthopaedics Authors: Helene Cook, Christopher Kennedy, Kevin Delijani, Daniel Popovsky, Tammer Elmarsafi, Caitlin Zarick, Christopher Attinger, Professor John Steinberg Tags: Original Research Source Type: research

The Role of Secondary Imaging Techniques for Assessing Bone Mineral Density in Elderly Ankle Fractures
Elderly ankle fractures in the elderly represent a substantial health-care burden. Dual-energy x-ray absorptiometry (DXA) is the gold standard for diagnosis of osteoporosis. However, there is emerging research regarding secondary imaging techniques to evaluate bone mineral density (BMD). The purpose of this systematic review was to summarize the role of secondary imaging techniques for measuring BMD in elderly ankle fractures. A literature search was undertaken using relevant search terms. Articles were screened for suitability and data extracted where studies met inclusion criteria and were of sufficient quality. (Source:...
Source: Journal of Foot and Ankle Surgery - July 3, 2021 Category: Orthopaedics Authors: Eric So, Calvin Rushing, Mark A. Prissel, Gregory C. Berlet Source Type: research

Cover 1 -- cover prints black and PMS 261
(Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 1, 2021 Category: Orthopaedics Source Type: research

Subscription Information
(Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 1, 2021 Category: Orthopaedics Source Type: research

Editorial Board
(Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 1, 2021 Category: Orthopaedics Source Type: research

Table of Contents
(Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - July 1, 2021 Category: Orthopaedics Source Type: research

Why My Patient Chose Not Wear a Face Mask
A few months ago, when my office manager informed me that one of my long-time patients was in our waiting room, and refusing to wear a face mask, I initially thought how selfish my patient was acting because I was concerned, like many of the other patients in our waiting room, and my staff members, that this particular patient could potentially inoculate others with the SARS-CoV-2 virus, or even contract the virus herself. So, masked up like I had been since early in 2020, I went out to talk with this patient, and to ask her to accompany me to a treatment room where I could further explain our concern and our institution's...
Source: Journal of Foot and Ankle Surgery - July 1, 2021 Category: Orthopaedics Authors: D. Scot Malay Source Type: research

Augmented Microfracture Technique Versus Microfracture in Talar Cartilage Restoration: A Systematic Review and Meta-analysis
The aim of this meta-analysis was to compare the efficacy and safety between the microfracture (MFx) and augmented microfracture (MFx+) techniques for articular cartilage defects of the talus (OLTs). PubMed and EMBASE were searched from January 1950 to October 2020. Only randomized controlled trials, quasi-randomized controlled trials, and observational studies (retrospective and prospective) applying MFx and MFx+ techniques to treat talar cartilage defects were selected. Ten trials with 492 patients were included. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 29, 2021 Category: Orthopaedics Authors: Hong-Jie Wen, Shou-Yan Zhu, Hong-Bo Tan, Yong-Qing Xu Tags: Review Article Source Type: research

Functional Gains Using Radial and Combined Shockwave Therapy in the Management of Achilles Tendinopathy
Achilles tendinopathy is a common condition and many patients have functional limitations after initial conservative treatment. Shockwave therapy has been shown to improve function within patients; however comparative outcomes for different forms of shockwave is poorly described. In this retrospective cohort study, we describe findings from a quality improvement initiative evaluating safety and functional outcomes after treatment with radial shockwave therapy (n  = 58) or combined radial and focused shockwave therapy (n = 29) for patients with Achilles tendinopathy refractory to exercise therapy. (Source: Journal o...
Source: Journal of Foot and Ankle Surgery - June 23, 2021 Category: Orthopaedics Authors: Resident David M Robinson, Assistant Professor Can O Tan, Assistant Professor Adam S Tenforde Source Type: research

Posterior Locking Plate Fixation of Barton íček Type IV Posterior Malleolar Fracture: A Focus on Die-Punch Fragment Size
Die-punch fragments refer to articular cartilage and subchondral bone embedded in cancellous bone as part of an intra-articular fracture. Barton íček type IV posterior malleolar fractures with associated die-punch fragments are rare, and the appropriate surgical approach remains unclear. We determined outcomes, and the effect of die-punch fragment size on outcomes, for 32 patients with Bartoníček type IV posterior malleolar fractures wit h die-punch fragments between January 2015 and December 2017. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 22, 2021 Category: Orthopaedics Authors: Chunguang Sun, Zhengguo Fei, Xiaoqiang Peng, Cheng Li, Qijia Zhou, Qirong Dong, Wei Xu Source Type: research

A Novel Manipulation Technique for Lapidus Fusion in Correction of Hallux Valgus Deformity with Underlying Metatarsus Adductus: A Case Series
Underlying metatarsus adductus (MA) is commonly seen in patients with hallux valgus (HV) deformity, with implications regarding procedure selection and hallux valgus recurrence. Lapidus, or 1st tarsometatarsal fusion, is commonly performed allowing reduction in intermetatarsal angle (IMA) but this procedure has not been established as an approach to provide partial correction of MA deformity.Retrospective assessment of preoperative and postoperative metatarsus adductus angle (MAA), IMA and hallux abductus angle (HAA) in patients treated with Lapidus fusion for HV. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 21, 2021 Category: Orthopaedics Authors: Troy J. Boffeli, Catlea Gorman, Tyler K. Sorensen, Collin Messerly, Howard C. Chang Tags: Original Research Source Type: research

‘Functional Capabilities after First Metatarsal Phalangeal Joint Arthrodesis Using a Locking Plate and Compression Screw Construct.’
This study aims to explore the functional limitations following first MTPJ arthrodesis, overall satisfaction and patient's abilities to achieve activities of daily living (ADL). This prospective cohort study assessed functional limitations as well as footwear and lifestyle restrictions using several questionnaires. One hundred and three participants who had a first MTPJ arthrodesis under the care of a single surgeon were recruited. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 21, 2021 Category: Orthopaedics Authors: Michael G Curran, Evelyn P Murphy, Fiona M Murphy, Christopher G Fenelon, Stephen R Kearns Tags: Original Research Source Type: research

Temporary screw lateral hemiepiphysiodesis of the first metatarsal for juvenile hallux valgus deformity: A case series of 23 feet.
This study aims to evaluate the outcomes of temporary screw lateral hemiepiphysiodesis of the base of the first metatarsal. A chart review of patients who underwent temporary screw lateral hemiepiphysiodesis of the first metatarsal at a tertiary care paediatric orthopaedic centre was done. A total of 23 feet of 14 patients were included. The mean age of the patients was 10.6 ± 1.8 years, while the bone age was 11.1 ± 1.8 years. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 21, 2021 Category: Orthopaedics Authors: Humaid Al Farii, Yousef Marwan, Nizar Algarni, Abdullah Addar, Reggie C. Hamdy, Chantal Janelle Source Type: research

Effect of Bone Quality and Leg Depth on the Biomechanical Performance of a Nitinol Staple
The use of Nitinol compression staples has increased in foot and ankle procedures due to their ease of delivery and ability to offer sustained, dynamic compression. Prior biomechanical studies have predominantly examined mechanical performance in healthy bone models without investigating the effect of unicortical versus bicortical fixation. The purpose of this study was to examine the effect of bone quality and staple leg depth on the biomechanical performance of Nitinol staples in a bicortical bone model. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 21, 2021 Category: Orthopaedics Authors: David L. Safranski, Savita C. Chapman, Zong-Rui Wee, Craig R. Lareau, Zachary T. Ritter, Jeffrey D. Seybold, John Y. Kwon Source Type: research

Medical Malpractice Trends in Foot and Ankle Surgery
Medical malpractice lawsuits can place significant economic and psychologic burden on a provider. Orthopaedic surgery is one of the most common subspecialties involved in malpractice claims. There is currently no study examining malpractice lawsuits within foot and ankle surgery. Accordingly, the purpose of this work is to examine trends in malpractice claims in foot and ankle surgery. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 21, 2021 Category: Orthopaedics Authors: Rishin J. Kadakia, Keith J. Orland, Akhil Sharma, Craig C. Akoh, Jie Chen, Selene G. Parekh Tags: Original Research Source Type: research

Assessment of Hindfoot Alignment: Intraoperative Fluoroscopy Versus Standing Radiograph
Few intraoperative assessments are available for hindfoot alignment. In the current study, we demonstrated the feasibility of hindfoot alignment via intraoperative fluoroscopy. We retrospectively compared measurements of heel alignment obtained via intraoperative fluoroscopy with those acquired using standard radiographs. Two observers compared the heel alignment ratios and angles derived from 100 pairs of images. The effects of age, sex, laterality, and body mass index on the discrepancy between fluoroscopic images and radiographs were analyzed. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 20, 2021 Category: Orthopaedics Authors: Jiyoung Jeon, Joo-Hak Kim, Sang-Heon Song, Hyung-In Cho, Jongwoong Lee Source Type: research

Flexor Hallucis Longus Tenolysis/Tenosynovectomy in Dancers
This study is a retrospective case series of 58 dancers and 63 ankles who underwent FHL tenolysis/tenosynovectomy via an open posteromedial approach by a single surgeon between 1993 to 2017. All patients were interviewed and charts reviewed. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 20, 2021 Category: Orthopaedics Authors: Elizabeth I. Barchi, Stephanie Swensen, Oscar E. Dimant, Tracy Espiritu-McKay, Donald J. Rose Source Type: research

Clinical outcomes after first metatarsophalangeal joint arthrodesis by flat cut joint preparation with individual adjustment for sagittal alignment
Sagittal misalignment is a major cause of patient dissatisfaction and re-operation after first metatarsophalangeal (MTP) joint arthrodesis. The stereotypical application of the fixed angle would be undesirable, especially in cases of flat or cavus foot. We retrospectively reviewed 31 cases (27 patients) in which first MTP joint arthrodesis was performed using the flat cut joint preparation technique with reference to the plantar clearance beneath the pulp of the toe while simulating weight-bearing by pushing a board against the sole. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 19, 2021 Category: Orthopaedics Authors: Takumi Matsumoto, Ryutaro Takeda, Taro Kasai, Song Ho Chang, Naohiro Izawa, Jun Hirose, Juji Takuo, Sakae Tanaka Tags: Original research Source Type: research

A comparison of adverse short-term outcomes following forefoot amputation performed on an inpatient versus outpatient basis.
The objective of this investigation was to evaluate short-term adverse outcomes following forefoot amputation with a specific comparison between those procedures performed on an inpatient versus outpatient basis. The 2018 American College of Surgeons National Surgical Quality Improvement Program database was interrogated to select those subjects with a 28805 CPT code (amputation, foot; transmetatarsal) that underwent the procedure with “all layers of incision (deep and superficial) fully closed.” This resulted in 326 subjects who underwent the procedure on an inpatient basis and 72 subjects who underwent the pr...
Source: Journal of Foot and Ankle Surgery - June 19, 2021 Category: Orthopaedics Authors: Andrew J. Meyr, Jennifer Skolnik, Sara Mateen, Laura E. Sansosti Source Type: research

An evaluation of patient characteristics associated with medical disposition in the surgical treatment of ankle fractures
The objective of this investigation was to evaluate patient characteristics associated with medical disposition in treatment of ankle fractures. The 2018 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was interrogated with data extracted related to the 6 CPT codes available pertaining to ankle fractures: 27766, 27769, 27792, 27814, 27822, and 27823. The primary outcome analysis involved a comparison of patient characteristics and short-term adverse outcomes between those fractures repaired on an inpatient basis versus outpatient basis. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 19, 2021 Category: Orthopaedics Authors: Andrew J. Meyr, Matthew Dougherty, Kwasi Y. Kwaadu Source Type: research

Outcomes of talar osteochondral and transchondral lesions using an algorithmic approach based on size, location and subchondral plate integrity: a 10-year study on 204 lesions
The management of transchondral and osteochondral talar lesions has evolved, with microfracturing originally considered the best initial treatment. Despite talar lesions being a tri-dimensional defect, most studies use two-dimensional parameters to grade them. We propose in this study that tri-dimensional sizing may be more appropriate in evaluation for treatment. The present study evaluated the outcomes of treatment of talar lesions performed by a single surgeon, creating and using an algorithm based on volume, location, and integrity of the subchondral plate. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 19, 2021 Category: Orthopaedics Authors: Amol Saxena, Nicola Maffulli, Anqi Jin, Eghosa Isa, Jessica Jaswal, Ryan Allen Tags: Original Research Source Type: research

Subjective and Objective Outcomes of Surgery for Rheumatoid Forefoot Deformities under the Current Treatment Paradigm
We investigated the clinical outcomes of surgical procedures for the treatment of forefoot deformities in patients with rheumatoid arthritis. Twenty feet in 16 women (mean age 62.1 years) underwent corrective osteotomy of the first metatarsal bone with shortening oblique osteotomy of the lesser metatarsophalangeal joints (joint-preservation group), while 13 feet in 12 women (mean age 67.4 years) underwent arthrodesis of the first metatarsophalangeal joint with resection arthroplasty of the lesser metatarsophalangeal joints (joint-sacrifice group); mean follow-up for each group was 25.8 and 23.8 months, respectively. (Sourc...
Source: Journal of Foot and Ankle Surgery - June 19, 2021 Category: Orthopaedics Authors: Masahiro Horita, Keiichiro Nishida, Daisuke Kaneda, Kenzo Hashizume, Yoshihisa Nasu, Ryuichi Nakahara, Kenta Saiga, Hideki Ohashi, Masahito Watanabe, Toshifumi Ozaki Tags: Original Research Source Type: research

Comparison of Ultrasound-Guided Prolotherapy Versus Extracorporeal Shock Wave Therapy in the Treatment of Chronic Plantar Fasciitis: A Randomized Clinical Trial
This study aimed to compare the effectiveness of extracorporeal shockwave therapy (ESWT) versus dextrose prolotherapy on pain and foot functions in patients with chronic plantar fasciitis with a prospective randomized-controlled trial. A total of 29 patients in whom conservative care failed were enrolled for the study after the clinical and ultrasonographic assessment. The patients were randomly assigned to receive ESWT (ESWT group, n  = 15) or dextrose prolotherapy (dextrose prolotherapy group, n = 14). (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 18, 2021 Category: Orthopaedics Authors: Serdar Kesikburun, Ayca Uran Şan, Bilge Kesikburun, Berke Aras, Evren Yaşar, Arif Kenan Tan Tags: Original Research Source Type: research

Predictive Factors and Amputation Level for Reamputation in Patients with Diabetic Foot: A Retrospective Case-Control Study
The aim of this study was to assess the rate and level of reamputation in patients who had a previous amputation from diabetic foot. We retrospectively analyzed patients who underwent amputation and reamputation due to diabetic foot in our clinic between 2011 and 2019. 59 were evaluated as the healed group after the first amputation and 55 were evaluated as the reamputation group. Given 55 patients who needed reamputation: there were 13 finger or ray, 23 transmetatarsal (TMM) or Syme, 18 transtibial, and 1 transfemoral in the first operation. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 18, 2021 Category: Orthopaedics Authors: Mustafa Faik Se çkin, Çagrı Özcan, Savaş Çamur, Ömer Polat, Suat Batar Source Type: research

Effectiveness of Flexor Tenotomy with a Transpositional Skin Flap for the Treatment of Severe Claw Toe Deformity with Mild-to-moderate Joint Contracture
Flexor tenotomy is the most effective for achieving healing and for the prevention of toe ulcer resulting from claw toe deformity. Although flexor tenotomy might be effective for a flexible claw toe, it might not provide benefits for severe claw toe deformity involving joint contracture. We devised a method involving the transfer of a flap to the skin defect caused by tenotomy, as severe claw toe deformity is associated with skin contracture. Although transpositional skin flap might increase the postoperative complication risks, it can be effectively used for severe claw toe deformity involving mild-to-moderate joint contr...
Source: Journal of Foot and Ankle Surgery - June 18, 2021 Category: Orthopaedics Authors: Keisuke Shimbo, Yukako Okuhara, Kazunori Yokota Tags: Tips, Quips, and Pearls Source Type: research

Treatment of recurrent peroneal tendon dislocation by peroneal retinaculum reattachment without fibular groove deepening
Peroneal tendon dislocation is an uncommon injury that usually occurs while playing sports [12-15]. This injury typically occurs when there is a forceful contraction of the peroneal musculature while the foot is dorsiflexed [1, 2]. The risk factors for peroneal tendon dislocation are hindfoot malalignment [16], peroneus muscle anomalies [17], and the morphologic shape of the malleolar groove. (Source: Journal of Foot and Ankle Surgery)
Source: Journal of Foot and Ankle Surgery - June 18, 2021 Category: Orthopaedics Authors: Seung-Hwan Park, Young Rak Choi, Jaehyung Lee, Jaehyeon Seo, Ho Seong Lee Source Type: research

Comparison of Ultrasound-Guided Prolotherapy vs Extracorporeal Shock Wave Therapy in The Treatment of Chronic Plantar Fasciitis: A Randomized Clinical Trial
Plantar fasciitis is a common disorder which occurs as a result of a localized inflammation and degeneration of the proximal plantar aponeurosis [1]. It is one of the most common causes of foot pain affecting approximately 10% of the population over the course of a lifetime [2,3]. Treatment of chronic plantar fasciitis is challenging. Non-steroidal anti-inflammatory drugs (NSAIDs) are generally the first medical option in the management. However, chronic cases may not response to anti-inflammatory therapy and there are long haul utilization of NSAIDs is restricted because of extreme unfavorable impacts as dyspepsia, unstab...
Source: Journal of Foot and Ankle Surgery - June 18, 2021 Category: Orthopaedics Authors: Serdar Kesikburun, Ayca Uran Şan, Bilge Kesikburun, Berke Aras, Evren Yaşar, rif Kenan Tan Tags: Original Research Source Type: research