Diversity in Medical School, Orthopaedic Surgery Residency, and ACGME-Accredited Foot and Ankle Orthopaedic Surgery Fellowship Training by Gender, Race, and Ethnicity.

Introduction: Increasing diversity in the US health care workforce is a topic of increasing scrutiny and interest. This study analyzes the pipeline of demographic diversity for Accreditation Council for Graduate Medical Education (ACGME)-accredited foot and ankle orthopaedic surgery fellowship training.

Methods: This was a cross-sectional study of medical students, orthopaedic surgery residents, and orthopaedic foot and ankle fellows at US-accredited training programs from 2013 to 2022.

Rhabdomyosarcoma With EWSR1::NF2 Gene Fusion: A Case Report Potentially Expanding Its Genetic Spectrum.

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children, presenting with heterogeneous clinical and molecular subtypes. While gene fusions are predominantly associated with alveolar RMS, spindle cell RMS, especially congenital and intraosseous variants, are also linked to specific gene fusions. Furthermore, recently, FGFR1 kinase-driven RMSs were published.

Comparing the Efficacy of a Unique Advanced Bioengineered Type-I Collagen-Based Skin Substitute Versus an Amnion Graft With Standard of Care in the Treatment of Non-healing Diabetic Foot Ulcers: A Randomized Clinical Trial.

The increased cost and morbidity associated with diabetic foot ulcers (DFUs) place a substantial strain on the entire global healthcare system. In this trial, 24 subjects with a chronic DFU, Wagner grade 1 (University of Texas grade 1A), were treated with Standard of Care (SOC) therapy and randomized, one-half to receive advanced high-purity Type-I collagen-based skin substitute (HPTC; manufactured by Encoll Corp., Fremont, CA, USA), and the other half to receive a dehydrated human amnion/chorion membrane (dHACM) or viable cryopreserved human placental membrane (vCHPM).

Delayed diagnosis of posterior tibialis tendon interposition in the distal tibiofibular and tibiotalar joints after open fracture-dislocation of the ankle joint: A case report with a 10-year follow-up.

Irreducible ankle fracture-dislocations due to posterior tibialis tendon (PTT) interposition in the distal tibiofibular and tibiotalar joints are rarely reported, and their diagnoses are often missed and delayed. In addition, previous reports lacked a longer clinical follow-up period, and objective and subjective evaluations of such cases have not been reported. A 22-year-old man sustained an open fracture-dislocation of the ankle joint associated with a distal third of the fibular shaft fracture and diastasis of the distal tibiofibular joint.

Tibiotalocalcaneal nailing as a treatment for ankle fractures in the elderly population: A systematic review.

This study evaluated patient outcomes of tibiotalocalcaneal (TTC) nailing for ankle fractures in an elderly population. A systematic literature search of PubMed and Google Scholar identified 24 studies involving 657 patients aged over 65. Key outcome measures included union rates, healing time, functional scores, and complications.

Radiographic Soft Tissue Thickness is not a Risk Factor for Infection after Primary Total Ankle Arthroplasty.

As the incidence of total ankle arthroplasty (TAA) for the management of end-stage arthritis is on the rise, identification of risk factors for periprosthetic joint infection (PJI) is essential. There has been limited research exploring the use of radiographic soft tissue thickness in TAA despite its predictive value in other forms of arthroplasty. This study evaluated the predictive capabilities of radiographic soft-tissue thickness for PJI following TAA.

Age-related Arterial Stiffening is Associated with A Body Shape Index (ABSI) and Lean Body Mass Index -A Retrospective Cohort Study in Healthy Japanese Population.

Introduction: Several anthropometric indices reflecting cardiometabolic risks have been developed, but the relationship of body composition with arterial stiffness remains unclear. We aimed to determine the interaction between age-related anthropometric changes and progression of arterial stiffness.

Methods: This research analyzed cross-sectional data (N=13,672) and 4-year longitudinal data (N=5,118) obtained from a healthy Japanese population without metabolic disorders.

PFKFB3 decreases α-ketoglutarate production while partial PFKFB3 knockdown in macrophages ameliorates arthritis in tumor necrosis factor-transgenic mice.

Objective: Aberrant 6-phosphofructo-2kinase/fructose-2,6-bisphoshatase 3 (PFKFB3) expression is tightly correlated with multiple steps of tumorigenesis; however, the pathological significance of PFKFB3 in macrophages in patients with rheumatoid arthritis (RA) remains obscure. In this study, we examined whether PFKFB3 modulates macrophage activation and promotes RA development.

Method: Peripheral blood mononuclear cells (PBMCs) from patients with RA, THP-1 cells, and bone marrow-derived macrophages from conditional PFKFB3-knockout mice were used to investigate the mechanism underlying PFKFB3-induced macrophage regulation of RA.

A rare case of ankle peri-implant infection by multi drug resistant Chryseobacterium indologenes.

Chryseobacterium indologenes is a rare human pathogen which is nowadays considered an emerging fearsome organism because of its upcoming antibiotic resistance. We present a quite unique case of a multi drug resistant C. indologenes surgical wound infection in a patient submitted to cannulated screw fixation of a displaced medial malleolus fracture.

The real rotational capacity of the human joints - the muscular and gravitational torques and the foot as a platform.

The purpose was to answer what is the relationship between torques acting on the human body, how does the triceps calf muscle balance the weight of a tilted body and what is the foot's role in the titling body? Two research models were developed. Model 1 - the one-sided lever system consists of a flat bar with, an axis of rotation, used to determine the weight and torque at a given point on it. Model 2 - the two-sided lever system consists of a flat bar imitating a tilted body counteracted by the Achilles tendon, and a platform imitating a foot.

Comparison of Bicortical versus Unicortical Medial Malleolus Fixation.

Background: Ankle fractures continue to increase in incidence and severity in an older, more challenging geriatric population. Medial malleolus fixation with partially threaded cancellous 4.0-mm screws, a common fixation method, has been shown to fail due to pullout strength.

Prophylactic Irradiation for the Prevention of Heterotopic Ossification After Foot Amputation: A Case Series.

Background: The formation of heterotopic ossification (HO) is a common complication after transosseous partial foot amputation. Development of HO in weightbearing and/or superficial areas can lead to increased pressures, which increases the likelihood of wound formation and pain. Current treatment modalities for HO of the foot include mechanical off-loading and surgical resection; however, prophylactic measures such as nonsteroidal anti-inflammatory drugs, bisphosphonates, and other medical therapies have been attempted previously with mixed efficacy.

Tissue Selective Ultrasonic Debridement with Cryopreserved Human Skin Allograft to Heal a Chronic Wound: A Case Report.

Tissue selective ultrasonic debridement is a new method of debriding chronic wounds that prepares the wound for advanced tissue application. This article presents the case of an 89-year-old woman with a chronic nonhealing wound to her lateral distal leg. The wound had a significant amount of biofilm and fibrous slough.

Heel Offloading Posterior Splint for Treatment of Heel Ulcerations.

Total contact casting is the gold standard for plantar foot ulcers but has been questioned in heel pressure ulcers. Current offloading of heel ulcers is typically removable offloading boots. We describe using a modified posterior splint to offload heel ulcers in nonweightbearing patients.

Supernumerary Muscles in the Leg and Foot: A Review of Their Types, Frequency, and Clinical Implications.

Variations of the ankle anatomy are infrequent and exist as supernumerary muscles and tendons. Often understudied and overlooked, their presence can cause many complications of the lower extremity. These muscles, although often asymptomatic, can cause great pain and complications such as tenosynovitis, tarsal tunnel syndrome, lateral ankle instability, and ankle pain when they impinge on the normal anatomy of the patient.

Shear wave elastography reveals passive and active mechanics of triceps surae muscles in vivo: From shear modulus-ankle angle to stress-strain characteristics.

Characterizing individual muscle behavior is crucial for understanding joint function and adaptations to exercise, diseases, or aging. Shear wave elastography (SWE) is a promising tool for measuring the intrinsic material properties of muscle. This study assessed the passive and active shear modulus of the triceps surae muscle group in 14 volunteers (7 females, 25.

Patients With Chronic Lateral Ankle Instability and Small Osteochondral Lesions of the Talus Obtain Good Postoperative Results: A Minimum 10-Year Follow-up With Radiographic Evidence.

Background: Few studies reported the long-term clinical outcomes and joint degeneration of patients with chronic lateral ankle instability (CLAI) and small osteochondral lesions of the talus (OLTs) following simultaneous open modified Broström-Gould (MBG) surgery and arthroscopic bone marrow stimulation (BMS). The purpose of this study was to study the long-term results of patients after BMS and BMG surgery, and to further evaluate the potential effect of OLT size on postoperative results.

Methods: In this retrospective study, 110 CLAI patients were divided into 57 patients with OLTs (including 24 patients having combined small osteochondral lesions of the tibial plafond) receiving simultaneous BMS and MBG surgeries (BMS+MBG group), and 53 patients without OLTs receiving isolated open MBG surgery (MBG group).

Morselized Femoral Head Impaction Bone Grafting of Large Defects in Ankle and Hindfoot Fusions.

Background: Ankle and hindfoot fusion in the presence of large bony defects represents a challenging problem. The purpose of this study was to evaluate outcomes of patients who underwent ankle-hindfoot fusions with impaction bone grafting (IBG) with morselized femoral head allograft to fill large bony void defects.

Methods: This was a 3-center, retrospective review of a consecutive series of 49 patients undergoing ankle or hindfoot fusions with femoral head IBG for filling large bony defects.

Peroneus brevis split tear - A challenging diagnosis: A pictorial review of magnetic resonance and ultrasound imaging. Part 1. Anatomical basis and clinical insights.

Diagnosing peroneus brevis split tears is a significant challenge, as many cases are missed both clinically and on imaging. Anatomical variations within the superior peroneal tunnel can contribute to peroneus brevis split tears or instability of the peroneal tendons. However, determining which anatomical variations predispose patients to these injuries remains challenging due to conflicting data in the literature.

Influence of early rehabilitation nursing on postoperative rehabilitation of patients with hallux valgus based on information-motivation-behavior skills model.

Objective: To probe the influence of early rehabilitation nursing on postoperative rehabilitation of patients with hallux valgus on the basis of information-motivation-behavior skills (IMB) model.

Methods: Convenience sampling was adopted, and 80 patients with hallux valgus admitted to the Sixth People's Hospital Affiliated to Shanghai Jiaotong University from July 2020 to July 2022 were randomly separated into control group (CG) and observation group (OG) with 40 patients in each group according to the time of admission. Patients in the CG received routine nursing and rehabilitation guidance and follow-up.

Secondary Subtalar Arthrodesis: Surgical Outcome and Predictors of Functional Outcome and Quality of Life After Bone Block Distraction vs In Situ Technique.

Background: The outcome of a secondary subtalar arthrodesis after prior calcaneal fracture has been widely described. However, the surgical treatment has evolved significantly over the past decade, paralleling the shifts observed in primary repair strategies. Therefore, we describe the outcome following a secondary arthrodesis after an intra-articular calcaneal fracture, comparing the in situ (ISA) and bone block distraction arthrodesis (BBDA) techniques.

Single-Site Endoscopic Surgery for Soft Tissue Lesions: An Innovative Technique.

Purpose We aimed to report an innovative single-site endoscopic surgery for soft tissue lesions performed at our center. Methods All patients who underwent soft tissue surgery were reviewed. All consecutive patients who underwent single-site endoscopic surgery between September 2019 and March 2024 were included in the study.

Adaptive changes in balance control strategies under continuous exposure to visual-somatosensory conflicts.

Human postural control system has the capacity to adapt to balance-challenging perturbations. However, the characteristics and mechanisms of postural adaptation to continuous perturbation under the sensory conflicting environments remain unclear. We aimed to investigate the functional role of oscillatory coupling drive to lower-limb muscles with changes in balance control during postural adaptation under multisensory congruent and incongruent environments.

Differential Associations of Cigar, Pipe, and Smokeless Tobacco Use Versus Combustible Cigarette Use With Subclinical Markers of Inflammation, Thrombosis, and Atherosclerosis: The Cross-Cohort Collaboration-Tobacco Working Group.

Background: Understanding the association of tobacco product use with subclinical markers is essential in evaluating health effects to inform regulatory policy. This is particularly relevant for noncigarette products (eg, cigars, pipes, and smokeless tobacco), which have been understudied because of their low prevalence in individual cohort studies.

Methods: This cross-sectional study included 98 450 participants from the Cross-Cohort Collaboration-Tobacco data set.