Imaging Diagnosis of Foot and Ankle Injuries

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 5598

Special Issue Editors


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Guest Editor
1. Lab. Prof. Manlio Mario Marco Napoli, Departamento de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
2. Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Sao Paulo 05652-900, Brazil
Interests: foot and ankle; trauma; cartilage; sports medicine; replacement

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Guest Editor
MedStar Orthopedic Institute, MedStar Union Memorial Hospital-3333 Calvert Street, Baltimore, MD 21218, USA
Interests: foot and ankle; trauma; cartilage; sports medicine; replacement

Special Issue Information

Dear Colleagues,

The primary focus of this Diagnostics Special Issue, "Imaging Diagnosis of Foot and Ankle Injuries", is to update advances and innovations in the area of foot and ankle diagnostic imaging in through original articles and review articles, and also to show its role in therapeutic decision making for better functional outcomes for patients.

Welcome to submit your research work to this Special Issue.

Prof. Dr. Alexandre Leme Godoy dos Santos
Dr. Nacime Salomão Barbachan Mansur
Guest Editors

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Keywords

  • diagnosis
  • imaging
  • foot
  • ankle
  • injury
  • surgery
  • treatment
  • decision making
  • MRI
  • US
  • CT
  • X-ray

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Published Papers (5 papers)

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12 pages, 859 KiB  
Article
The INVISION Talar Component in Revision Total Ankle Arthroplasty: Analysis of Early Outcomes
by Bruno Valan, Albert T. Anastasio, Billy Kim, Alexandra Krez, Kevin A. Wu, Grayson M. Talaski, James Nunley, James K. DeOrio, Mark E. Easley and Samuel B. Adams
Diagnostics 2024, 14(15), 1612; https://doi.org/10.3390/diagnostics14151612 - 26 Jul 2024
Cited by 1 | Viewed by 636
Abstract
Introduction: Launched in 2018 for revision total ankle arthroplasty (rTAA), the INVISION talar component addresses subsidence when poor talar bone stock is present. Due to the recency of the market-availability of the INVISION, studies evaluating its efficacy are lacking. This study presents the [...] Read more.
Introduction: Launched in 2018 for revision total ankle arthroplasty (rTAA), the INVISION talar component addresses subsidence when poor talar bone stock is present. Due to the recency of the market-availability of the INVISION, studies evaluating its efficacy are lacking. This study presents the first analysis of early-term outcomes of patients undergoing rTAA with the INVISION talar component. Methods: This was a single-center, retrospective review of 28 patients undergoing rTAA with the INVISION talar component and INBONE II tibial component performed between 2018 and 2022. Data on preoperative characteristics, postoperative complications, secondary procedures, and survivorship were collected. The primary outcome measures were rates of major complications, re-operation, and implant failure. Secondary outcomes included post-operative changes in varus and valgus alignment of the tibia and talus. Results: The most common secondary procedures performed with rTAA were medial malleolus fixation (n = 22, 78.6%) and gastrocnemius recession (n = 14, 50%). Overall, 10.7% (n = 3) of patients underwent reoperation and 14.3% (n = 4) suffered major complications. Incidence of implant failure was 10.7% (n = 3). All reoperations were caused by infection. Mean varus alignment of the tibia and talus improved from 4.07 degrees and 4.83 degrees to 1.67 degrees and 1.23 degrees, respectively. Mean valgus alignment of the tibia and talus improved from 3.67 degrees and 4.22 degrees to 2.00 degrees and 2.32 degrees, respectively. Conclusions: In a series of 28 patients undergoing rTAA with the INVISION talar component, we discovered comparatively low rates of reoperation, major complication, and implant failure (10.7%, 14.3%, and 10.7%). The INVISION system appears to have a reasonable safety profile, but further studies evaluating long-term outcomes are required to assess the efficacy of the INVISION system. Full article
(This article belongs to the Special Issue Imaging Diagnosis of Foot and Ankle Injuries)
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12 pages, 4654 KiB  
Article
Biomechanical Efficacy of Three Methods for the Fixation of Posterior Malleolar Fractures: A Three-Dimensional Finite Element Study
by Vincenzo Giordano, Márcio Antônio Babinski, Anderson Freitas, Robinson Esteves Pires, Felipe Serrão de Souza, Luiz Paulo Giorgetta de Faria, Pedro José Labronici and Alexandre Godoy-Santos
Diagnostics 2023, 13(23), 3520; https://doi.org/10.3390/diagnostics13233520 - 24 Nov 2023
Cited by 2 | Viewed by 1230
Abstract
Introduction: We investigated the biomechanical behaviour of different fixations of the tibial posterior malleolus (TPM), simulating distinct situations of involvement of the tibiotalar articular surface (TTAS) through a finite element model (FEM). Material and methods: A 3D computer-aided design model of the left [...] Read more.
Introduction: We investigated the biomechanical behaviour of different fixations of the tibial posterior malleolus (TPM), simulating distinct situations of involvement of the tibiotalar articular surface (TTAS) through a finite element model (FEM). Material and methods: A 3D computer-aided design model of the left ankle was obtained. The materials used were divided according to their characteristics into ductile and non-ductile, and all materials were assumed to be linear elastic, isotropic, and homogenous. Three different fracture lines of the TPM were defined, with sagittal angles of 10°, 25°, and 45°. For biomechanical comparison, different constructions using a trans-syndesmotic screw (TSS) only (Group T), a one-third tubular plate only with (Group PT) and without (Group PS) a TSS, and a locked compression plate with (Group LCPT) and without (Group LCPS) a TSS were tested. FEM was used to simulate the boundary conditions of vertical loading. Load application regions were selected in the direction of the 700 N Z-axis, 90% on the tibia and 10% on the fibula. Data on the displacement and stress in the FEM were collected, including the total principal maximum (MaxT) and total principal minimum (MinT) for non-ductile materials, total displacement (desT), localized displacement at the fragment (desL), localized displacement at syndesmosis (desS), and Von Mises equivalent stress for ductile materials. The data were analysed using ANOVA and multiple comparison LSD tests were used. Results: For TPM fractures with sagittal angles 10° and 25°, desL in the PT and LCP groups was significantly lower, as well as Von Mises stress in Group LCPT in 10°, and PT and LCPT groups in 25°. For TPM fractures with a sagittal angle of 45°, desL in the LCP group and Von Mises stress in Group LCPS and LCPT were significantly lower. We found that any TPM fracture may indicate instability of the distal tibiofibular syndesmosis, even when the fragment is small. Conclusion: Our study showed that in fragments involving 10% of the TTAS, the use of a TSS is sufficient, but when the involvement is greater than 25% of the TTAS, either a non-locked or locked plate must be used to buttress the TPM. In posterior fragments affecting 45% or more of the TTAS, the use of a locking plate is recommended. Full article
(This article belongs to the Special Issue Imaging Diagnosis of Foot and Ankle Injuries)
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8 pages, 3580 KiB  
Interesting Images
Twelve-Year Progression of Osteochondral Lesions of the Talus Observed Using Magnetic Resonance Imaging
by Bradley J. Lauck, Isabel Shaffrey, Albert T. Anastasio, Conor N. O’Neill, Andrew E. Hanselman and Samuel B. Adams
Diagnostics 2024, 14(12), 1251; https://doi.org/10.3390/diagnostics14121251 - 13 Jun 2024
Viewed by 644
Abstract
Osteochondral lesions of the talus are common injuries that are most often the result of trauma. The natural progression of osteochondral lesions is not well understood. It is still unclear which lesions eventually lead to joint degeneration and osteoarthritic changes and if the [...] Read more.
Osteochondral lesions of the talus are common injuries that are most often the result of trauma. The natural progression of osteochondral lesions is not well understood. It is still unclear which lesions eventually lead to joint degeneration and osteoarthritic changes and if the treatment method affects the progression. The existing literature surrounding this topic is sparse, with inconsistent findings. The presented images are taken from a 72-year-old man with bilateral osteochondral lesions of the talus. To our knowledge, this is the first published series of images illustrating the natural progression of a patient with bilateral osteochondral lesions of the talus over a 12-year time period. Full article
(This article belongs to the Special Issue Imaging Diagnosis of Foot and Ankle Injuries)
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16 pages, 404 KiB  
Systematic Review
Weightbearing Imaging Assessment of Midfoot Instability in Patients with Confirmed Hallux Valgus Deformity: A Systematic Review of the Literature
by Grayson M. Talaski, Anthony N. Baumann, Bshara Sleem, Albert T. Anastasio, Kempland C. Walley, Conor N. O’Neill and Samuel B. Adams
Diagnostics 2024, 14(2), 193; https://doi.org/10.3390/diagnostics14020193 - 16 Jan 2024
Cited by 1 | Viewed by 1298
Abstract
Hallux valgus deformity (HVD) involves subluxation of the first metatarsophalangeal joint. While HVD is primarily considered a forefoot condition, midfoot instability may play a significant role in its development and severity. However, very few studies have placed a heavy emphasis on studying this [...] Read more.
Hallux valgus deformity (HVD) involves subluxation of the first metatarsophalangeal joint. While HVD is primarily considered a forefoot condition, midfoot instability may play a significant role in its development and severity. However, very few studies have placed a heavy emphasis on studying this phenomenon. Therefore, this review had a particular focus on understanding midfoot instability based on weightbearing imaging assessments of the TMT joint. This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched five databases for studies on midfoot instability in HVD patients. The severity of HVD was defined by hallux valgus angle (HVA) and distal metatarsal articular angle (DMAA). Data was extracted, and articles were graded using the Methodological Index for Non-Randomized Studies (MINORS). Of 547 initially retrieved articles, 23 met the inclusion criteria. Patients with HVD showed higher HVA and DMAA on weightbearing radiographs (WBRG) and weightbearing computed tomography (WBCT) compared to healthy individuals. Midfoot instability was assessed through intermetatarsal angle (IMA) and tarsometatarsal angle (TMT angle). Patients with HVD exhibited greater IMA and TMT angles on both WBRG and WBCT. This review highlights the importance of weightbearing imaging assessments for midfoot instability in HVD. IMA and TMT angles can differentiate between healthy individuals and HVD patients, emphasizing the significance of midfoot assessment in understanding HVD pathology. These findings validate the limited evidence thus far in the literature pertaining to consistent midfoot instability in HVD patients and are able to provide ample reasoning for physicians to place a larger emphasis on midfoot imaging when assessing HVD in its entirety. Full article
(This article belongs to the Special Issue Imaging Diagnosis of Foot and Ankle Injuries)
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7 pages, 2984 KiB  
Brief Report
Normal Distal Tibiofibular Syndesmosis Assessment Using Postmortem Computed Tomography (PMCT)
by Jahyung Kim, Jeong-Hyun Park, Hyung-Wook Kwon, Mijeong Lee, Digud Kim, Yu-Jin Choi, Kwang-Rak Park, Sookyoung Lee and Jaeho Cho
Diagnostics 2024, 14(1), 36; https://doi.org/10.3390/diagnostics14010036 - 24 Dec 2023
Cited by 2 | Viewed by 1186
Abstract
Background: Distal tibiofibular syndesmotic injuries, often misdiagnosed, can lead to substantial morbidity. This study utilized postmortem computed tomography (PMCT) to define normal syndesmotic relationships in 131 subjects. Methods: Three parameters were measured: fibular rotation (FR), sagittal translation (ST), and incisura depth (ID). Results: [...] Read more.
Background: Distal tibiofibular syndesmotic injuries, often misdiagnosed, can lead to substantial morbidity. This study utilized postmortem computed tomography (PMCT) to define normal syndesmotic relationships in 131 subjects. Methods: Three parameters were measured: fibular rotation (FR), sagittal translation (ST), and incisura depth (ID). Results: Interobserver reliability was excellent for FR and ID but moderate for ST. Anatomical variability was wide, with FR ranging from −0.4° to 16.6°, ST from 0.33 mm to 3.49 mm, and ID from 1.89 mm to 6.05 mm. Side-to-side variability within subjects was minimal. Gender-specific differences were observed in ST, possibly due to size variations, highlighting the need for gender-specific diagnostic criteria. Conclusions: Although establishing universal reference values is challenging, using contralateral ankles for comparison can enhance diagnostic accuracy in syndesmotic injuries. This study, the first of its kind, offers valuable insights into normal distal tibiofibular syndesmotic relationships based on PMCT data. Future validation studies in patients with syndesmotic injuries can further improve diagnostic accuracy. Full article
(This article belongs to the Special Issue Imaging Diagnosis of Foot and Ankle Injuries)
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