Radiological safety atlas of minimally invasive midfoot fusion: A cadaver study.

Purpose: The popularity of minimally invasive (MIS) foot surgery continues to grow. However, it comes with certain limitations that present notable challenges. One significant hurdle is the absence of direct visualization of neurovascular structures and tendons.

Use of Bio-integrative Screws for Fixation of Lisfranc Instability; Pros and Cons from Surgeons' Point of View in a Cadaver Study.

Objectives: Majority of Lisfranc fracture-dislocations require anatomic reduction and rigid internal fixation to prevent debilitating sequelae. Current methods include solid screws and flexible fixations which have been in use for many years. Biointegrative screw is a newer option that has not yet been thoroughly investigated for its effectiveness for Lisfranc injuries.

Takedown of Ankle Fusions and Conversion to Total Ankle Replacements.

Background: With ankle replacements gaining credibility, there is a small subset of patients who might benefit from a conversion of an ankle fusion to a replacement. The objective of this study is to present clinical and radiographic results of patients who had their ankle fusion converted to total ankle arthroplasty (TAA).

Methods: Patients presented to the senior author with ongoing ankle pain following fusion or increasing pain after a period of relative comfort after an ankle fusion.

Medial and Lateral Combined Ligament Arthroscopic Repair for Multidirectional Ankle Instability.

Background: The high prevalence of ankle sprains in the population produces a significant number of patients with lateral instability. Persistence of this condition may lead to the progressive involvement of medial structures, causing a multidirectional rotational instability.

Methods: This is a retrospective study with patients diagnosed with multidirectional instability who underwent ankle arthroscopy with medial (arthroscopic tensioning) and lateral repair (arthroscopic Bröstrom) between January 2018 and January 2020.

Deltoid ligament arthroscopic repair in ankle fractures: Case series.

Introduction: Diagnosis and treatment of ankle medial ligament lesions in malleolar fractures has always been a matter of controversy. Even when deltoid involvement is clear, the direct repair of this structure is not a consensus. Recently, deltoid repair through an arthroscopic technique was described aiming to potentialize better clinical results and minimize complications.

Converting Ankle Arthrodesis to a Total Ankle Arthroplasty.

Several articles in the literature discuss the positive results of converting a painful ankle fusion to an ankle replacement. Our results confirm that in well-selected cases a conversion to a total ankle replacement is not only possible, but also significantly improves quality of life and reduces pain. The outcome of a total ankle replacement after an ankle fusion depends to a degree on the method of fusion.

Combined Spring and Deltoid Ligament Repair in Adult-Acquired Flatfoot.

Background: Adult-acquired flatfoot deformity (AAFD) is usually due to a combination of mechanical failure of the osteoligamentous complex that maintains the medial longitudinal arch of the foot and attenuation or complete tear of the posterior tibial tendon. Magnetic resonance imaging studies in patients with flatfoot deformities have reported the posterior tibial tendon to be pathologic in up to 100% of patients, the spring ligament in up to 87%, and the deltoid ligament in 33%. Many studies in the literature describe reconstruction of the spring ligament or the deltoid ligament associated with AAFD, but there is no study in which both (spring and deltoid) ligaments are reconstructed at the same time.

Prospective study of the " Inside-Out" arthroscopic ankle ligament technique: Preliminary result.

Background: Lateral ankle ligament injury is among the most common orthopedic injuries. The objective of this study is to present the preliminary prospective results of treatment using the "Inside-Out" variant of the fully arthroscopic Broström-Gould technique.

Methods: Twenty six patients were included: 20 male and 6 female, aged 19-60 years, mean 41 years.

Endoscopic Flexor Halluces Longus transfer for Chronic Achilles Tendon rupture - technique description and early post-operative results.

Background: Achilles tendon ruptures may lead to proximal retraction of the stump if not treated acutely, increasing the chances of poorer functional outcomes. The flexor halluces longus transfer is a well-established treatment option, usually performed as an open procedure. The aim of this paper is to report the preliminary results and describe the technique of endoscopic flexor halluces longus transfer.

Searching for consensus in the approach to patients with chronic lateral ankle instability: ask the expert.

Purpose: The purpose of this study is to propose recommendations for the treatment of patients with chronic lateral ankle instability (CAI) based on expert opinions.

Methods: A questionnaire was sent to 32 orthopaedic surgeons with clinical and scientific experience in the treatment of CAI. The questions were related to preoperative imaging, indications and timing of surgery, technical choices, and the influence of patient-related aspects.

Reliability of Baropodometry on the Evaluation of Plantar Load Distribution: A Transversal Study.

. Baropodometry is used to measure the load distribution on feet during rest and walking. The aim of this study was to evaluate changes in plantar foot pressures distribution due to period of working and due to stretching exercises of the posterior muscular chain.

Does Foot Position and Location of Measurement Influence Ankle Medial Clear Space?

Purpose: There is still controversy regarding normal and abnormal values of the medial clear space (MCS) of the ankle. The aim of this study was to assess how much different degrees of plantar flexion, with and without stress, influenced the MCS.

Methods: We submitted 30 volunteers to 6 different anteroposterior ankle radiographs in the following positions: neutral, neutral with external rotation stress, physiologic plantar flexion (FPF), physiologic plantar flexion with external rotation stress, maximum plantar flexion (MPF), and maximum plantar flexion with external rotation stress.

Diagnosis and treatment of osteochondral lesions of the ankle: current concepts.

We conducted a wide-ranging review of the literature regarding osteochondral lesions of the ankle, with the aim of presenting the current concepts, treatment options, trends and future perspectives relating to this topic.

Foot and Ankle Injuries in Professional Soccer Players: Diagnosis, Treatment, and Expectations.

Soccer is one of the most popular sports in the world. It has undergone many changes in recent years, mainly because of increased physical demands, and this has led to an increased injury risk. Direct contact accounts for half of all injuries in both indoor and outdoor soccer and ankle sprains are the most common foot and ankle injury.

How to classify plantar plate injuries: parameters from history and physical examination.

Objective: To find the best clinical parameters for defining and classifying the degree of plantar plate injuries.

Method: Sixty-eight patients (100 metatarsophalangeal joints) were classified in accordance with the Arthroscopic Anatomical Classification for plantar plate injuries and were divided into five groups (0 to IV). Their medical files were reviewed and the incidence of each parameter for the respective group was correlated.

Presence of a long accessory flexor tendon of the toes in surgical treatment for tendinopathy of the insertion of the calcaneal tendon: case report.

The presence of accessory tendons in the foot and ankle needs to be recognized, given that depending on their location, they may cause disorders relating either to pain processes or to handling of the surgical findings. We describe the presence of an accessory flexor tendon of the toes, seen in surgical exposure for transferring the long flexor tendon of the hallux to the calcaneus, due to the presence of a disorder of tendinopathy of the insertion of the calcaneal tendon in association with Haglund's syndrome.

Joint-sparing Corrections in Malunited Lisfranc Joint Injuries.

Lisfranc fracture-dislocations are very serious and potentially disabling injuries. Unfortunately, they are often misdiagnosed. Multiplanar midfoot deformities that result from these fracture-dislocations are precursors of joint degeneration and significant functional disabilities.

Plantar plate radiofrequency and Weil osteotomy for subtle metatarsophalangeal joint instablity.

Background: To the present day, literature has only discussed how to treat extensive plantar plate and collateral ligament lesions, with gross joint subluxation and obvious clinical instability. The treatment options for early stages of the disease with minor injuries and subtle instabilities have not been described. The main purpose of this prospective study is to evaluate the efficacy of the combination of the arthroscopic radiofrequency shrinkage and distal Weil osteotomy in the treatment of subtle metatarsophalangeal joint instability.

Shoe heel abrasion and its possible biomechanical cause: a transversal study with infantry recruits.

Background: Excessive shoe heel abrasion is of concern to patients and shoe manufacturers, but little scientific information is available about this feature and its possible causes. The purpose of this study was to relate this phenomenon with biomechanical factors that could predispose to shoe heel abrasion.

Methods: Ninety-seven recruits (median age 25) were enrolled in this study.

Prospective evaluation of protocol for surgical treatment of lesser MTP joint plantar plate tears.

Background: Instability of the lesser metatarsophalangeal (MTP) joints is a common cause of deformity and pain. The purpose of this study was to prospectively evaluate the surgical outcomes for the different grades of plantar plate tears and propose a treatment protocol.

Methods: Sixty-eight patients (100 MTP joints) were prospectively enrolled and graded according to the anatomical grade system for plantar plate tears.

Lesser metatarsal phalangeal joint arthroscopy: anatomic description and comparative dissection.

Purpose: The aim of this article is to describe the normal arthroscopic anatomy of the lesser metatarsophalangeal (MTP) joints and compare it with that seen in open dissection in cadaveric models.

Methods: We performed arthroscopic examination of 18 MTP joints of 6 normal fresh frozen feet. The second, third, and fourth MTP joints were studied because of the higher incidence of pathologic conditions found in these joints.

Classification of metatarsophalangeal joint plantar plate injuries: history and physical examination variables.

Although metatarsophalangeal (MTP) plantar plate tears are common, they are still often missed. The purpose of this study is to find the best clinical variables to define and grade the plantar plate injuries. Sixty-eight patients (100 MTP joints) were graded arthroscopically and divided into five groups (0 to IV) according to the anatomical classification.

Endoscopic approach for plantar fasciopathy: a long-term retrospective study.

Purpose: The purpose of this study was to report the long term effectiveness of endoscopic plantar fascia release for recalcitrant plantar fasciopathy.

Materials: Twenty-three consecutive patients underwent endoscopically-assisted plantar fascia release for symptomatic plantar fasciopathy unresponsive to nonoperative measures. The clinical diagnosis was supported by imaging (plain radiographs and magnetic resonance imaging [MRI]) and the American Orthopaedic Foot & Ankle Society (AOFAS) score was administered to all patients.

Plantar Approach for a Morton Neuroma: Surgical Technique.

Introduction: The plantar approach for management of a Morton neuroma allows the transverse metatarsal ligament to be spared, decreases the risk of damage to the dorsal cutaneous nerve branches, and has a low rate of complications with results comparable with those of other approaches.

Step 1 Incision: Make a transverse plantar skin incision distal to the metatarsal weight-bearing area.

Step 2 Exposure: Excise the connective tissues around the neuroma and expose the common digital nerve as far proximally as possible.

Plantar approach for excision of a Morton neuroma: a long-term follow-up study.

Background: When nonsurgical treatment of a Morton neuroma is unsuccessful, neurectomy is indicated. The purpose of the present retrospective study was to evaluate the long-term outcomes, complications, and adverse events following a distal plantar transverse incision for the excision of an intermetatarsal neuroma.

Methods: We conducted a retrospective review of 168 consecutive patients who underwent surgical excision of a Morton neuroma that had been unresponsive to nonsurgical treatment.