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Foot and Ankle Surgery: State of the Art and Future...
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Foot and Ankle Surgery: State of the Art and Future Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 25 July 2025 | Viewed by 1700

Special Issue Editors

Dr. Sung Jae Kim

E-Mail
Guest Editor
Department of Orthopedic Surgery, Dongtan Sacred Hospital, Hallym University, Hwaseong, Republic of Korea
Interests: foot and ankle; minimally invasive surgery (MIS) hallux valgus surgery; diabetic foot; calcaneal fracture; stem cell; extracellular matrix (ECM)
Dr. Jaehwang Song

E-Mail Website
Co-Guest Editor
Department of Orthopedic Surgery, Konyang University Hospital, Daejeon, Republic of Korea
Interests: charcot marie tooth foot; weightbearing CT; tendon regeneration; ultrasound

Special Issue Information

Dear Colleagues,

As the guest editor of the Special Issue “Foot and Ankle Surgery: State of the Art and Future Perspectives”, I am truly honored to introduce a collection of valuable insights and recent advancements in this exciting and constantly changing field. This edition focuses on foot and ankle surgery areas, including hallux disorders, lesser toe problems, diabetic foot salvage strategies, complex calcaneal fractures, pilon fractures, and ligament disorders. This special edition would welcome any topics that challenge our foot and ankle surgeons. These topics are essential to modern orthopedic practice and represent the many challenges and opportunities that foot and ankle surgeons face today.

The articles in this special edition showcase innovative surgical techniques, meaningful research findings, and practical, evidence-based strategies to improve patient outcomes. Leading experts have shared their knowledge and experiences, offering new perspectives on emerging methods, advanced technologies, and solutions to some of the toughest problems in orthopedic and trauma surgery.

This special edition reflects the collective efforts of our global orthopedic community, especially for passionate foot and ankle surgeons. Combining traditional practices with new ideas and technologies aims to inspire and guide surgeons at all levels. It also highlights our shared commitment to improving the field, delivering better patient care, and creating a strong foundation for the continuous learning process.

Dr. Sung Jae Kim
Dr. Jaehwang Song
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • foot and ankle surgery
  • hallux disorders
  • lesser toe problem
  • diabetic foot salvage
  • calcaneal fracture
  • pilon fracture
  • ligament disorder

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Published Papers (4 papers)

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15 pages, 5644 KiB  
Article
Talar Allografts in Tibiotalocalcaneal Arthrodesis: A Salvage Approach for Complex Hindfoot Pathologies
by Young Uk Park, Jae Ho Cho, Taehun Kim, Won-Tae Cho, Jinyoung Jun and Young Wook Seo
J. Clin. Med. 2025, 14(8), 2683; https://doi.org/10.3390/jcm14082683 - 14 Apr 2025
Viewed by 190
Abstract
Background: Tibiotalocalcaneal (TTC) arthrodesis using talar allografts has emerged as a viable surgical option for managing complex hindfoot pathologies, including post-traumatic avascular necrosis (AVN), infection-related complications, and failed total ankle replacement (TAR). These conditions present significant therapeutic challenges due to extensive bone [...] Read more.
Background: Tibiotalocalcaneal (TTC) arthrodesis using talar allografts has emerged as a viable surgical option for managing complex hindfoot pathologies, including post-traumatic avascular necrosis (AVN), infection-related complications, and failed total ankle replacement (TAR). These conditions present significant therapeutic challenges due to extensive bone loss and joint instability. Previous reports have focused on TTC arthrodesis using talar allografts, highlighting its potential to provide enhanced structural support. This study aims to further evaluate the efficacy and safety of this surgical approach by assessing union, clinical outcomes, and complications in a diverse patient population. Methods: This retrospective study reviewed 11 patients who underwent TTC arthrodesis with talar allograft between January 2020 and November 2022. The study cohort included patients with post-traumatic AVN, infection-related complications, and failed TAR. Preoperative and postoperative evaluations included X-rays, computed tomography scans, and functional outcome scores such as the Visual Analog Scale (VAS) and the Foot and Ankle Outcome Score (FAOS). Results: This study included 11 patients who underwent surgical treatment between January 2020 and November 2022, with a minimum follow-up of 24 months and a mean follow-up of 33.45 months (range, 24–50 months). Successful arthrodesis was observed in nine patients, yielding a success rate of 82%. Significant improvements in functional outcomes were noted, including marked reductions in pain and enhanced activity levels, as evaluated by VAS and FAOS scores. Two patients demonstrated radiographic nonunion (one tibiotalar, one subtalar), but both remained asymptomatic and did not require revision surgery. No other complications such as infection, wound issues, or thromboembolism were observed. Immediate postoperative radiographs confirmed appropriate allograft alignment and placement. Conclusions: TTC arthrodesis using structural talar allografts may be a viable and safe option for managing severe hindfoot pathology, potentially resulting in satisfactory fusion rates and clinical outcomes. Full article
(This article belongs to the Special Issue Foot and Ankle Surgery: State of the Art and Future Perspectives)
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10 pages, 7545 KiB  
Article
Arthroscopic Deltoid Ligament Repair as a Potential Alternative Treatment for Ankle Deltoid Ligament Injury
by Sung Hwan Kim, Sang Heon Lee, Joo Young Cha, Seung Won Choi and Young Koo Lee
J. Clin. Med. 2025, 14(5), 1662; https://doi.org/10.3390/jcm14051662 - 28 Feb 2025
Viewed by 362
Abstract
Background: Arthroscopic deltoid ligament (DL) repair is a recently introduced technique, with few studies currently comparing the outcomes of open and arthroscopic deltoid repairs. This study compares the clinical and radiologic outcomes of patients who underwent either open or arthroscopic DL repair. Methods: [...] Read more.
Background: Arthroscopic deltoid ligament (DL) repair is a recently introduced technique, with few studies currently comparing the outcomes of open and arthroscopic deltoid repairs. This study compares the clinical and radiologic outcomes of patients who underwent either open or arthroscopic DL repair. Methods: Forty-one patients underwent surgical repair for a ruptured DL by a single surgeon at the study site hospital between 2013 and 2022. Clinical outcomes were assessed using the Foot and Ankle Outcome Score (FAOS), the American Orthopedic Foot and Ankle Society (AOFAS) Ankle–Hindfoot Scale, and a visual analog scale (VAS). Radiologic outcomes were evaluated through anterior talar translation and talar tilt tests, with stress radiography conducted at 6 months and 1 year post-surgery. Results: No significant differences in sex ratio, age, or direction of injury were observed between the groups. Additionally, there were no significant differences in clinical and radiologic outcomes between the groups. However, both clinical and radiologic outcomes showed significant improvement after surgery compared to preoperative conditions in both groups. Conclusions: Considering the benefits of arthroscopic surgery, arthroscopic deltoid repair can be regarded as a suitable option for treating DL injuries. Full article
(This article belongs to the Special Issue Foot and Ankle Surgery: State of the Art and Future Perspectives)
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19 pages, 2496 KiB  
Article
Treatment Strategy for Posterior Malleolar Fractures: Different Operative Strategies Are Needed for Each Morphological Type
by Byung-Ki Cho, Sivakumar Allur Subramanian, Jihyun Hwang, Collin Lee, Young Phil Yune, Sung Jae Kim and Seung Myung Choi
J. Clin. Med. 2025, 14(4), 1216; https://doi.org/10.3390/jcm14041216 - 12 Feb 2025
Viewed by 754
Abstract
Background: The operative indication for posterior malleolar fracture (PMF) remains controversial. This study aimed to assess the midterm outcomes of PMF treatment for developing a treatment strategy for each morphological type. Methods: In this retrospective analysis, patients undergoing operative treatment for an unstable [...] Read more.
Background: The operative indication for posterior malleolar fracture (PMF) remains controversial. This study aimed to assess the midterm outcomes of PMF treatment for developing a treatment strategy for each morphological type. Methods: In this retrospective analysis, patients undergoing operative treatment for an unstable ankle fracture involving PMF were included after at least 3 years of follow-up. PMFs were classified by fracture morphology according to the Haraguchi classification. This study divided the entire cohort into three independent populations based on the types of PMF. For each population, patients were further categorized into two groups depending on whether PMF was surgically fixed or not, and comparisons were made between these two groups. Demographic data, functional and radiographical outcomes were compared between two groups in each of the three populations. Results: With a total of 472 patients, the mean patient age was 45.8 years, and the mean follow-up was 51 months. For type 1 fracture, a total of 237 cases were found. Quality of reduction by CT (QRC) was mostly good in both groups (83.6% vs. 83.3% in the non-fixation vs. fixation group, respectively, p = 0.269). Functional and radiological outcomes between both groups showed no significant difference. For type 2 PMFs, a total of 199 cases were found, and QRC was significantly different between the two groups (good grade, 5.4% vs. 60.7% in the non-fixation vs. fixation group, respectively, p < 0.001). The radiological and clinical outcomes of the PMF fixation group were statistically superior to those of the non-fixation group (both p < 0.001). For type 3 fractures, a total of 36 cases were found. In all the cases in this group, surgical fixation of PMF was not performed. Only the syndesmosis instability was analyzed as a viable factor to be considered for achieving favorable surgical outcomes. PMF fixation group showed significantly more postoperative complications (24.4% vs. 40.4%, non-fixation vs. fixation, respectively, p < 0.001). Major complications in the fixation group were deep wound infection (6.8%), superficial peroneal nerve injury (6.8%), and hallux flexion deficit (5.0%). Conclusions: Different treatment strategies seem to be required for each PMF morphological subtype. Further studies with more detailed designs for each PMFs are warranted for more clinically related results that are helpful for making practical surgical decisions. Full article
(This article belongs to the Special Issue Foot and Ankle Surgery: State of the Art and Future Perspectives)
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7 pages, 25226 KiB  
Case Report
Arthroscopic Flexor Hallux Brevis and Plantar Capsule Release (Cochrane Procedure) for Hallux Rigidus: Case Presentation with Long-Term Follow-Up
by Kenichiro Nakajima
J. Clin. Med. 2025, 14(8), 2785; https://doi.org/10.3390/jcm14082785 - 17 Apr 2025
Viewed by 119
Abstract
Background: In 1927, Cochrane observed persistent elastic resistance to hallux dorsiflexion after cheilectomy for hallux rigidus, attributing it to soft tissue tightness beneath the first metatarsophalangeal (MTP) joint. An innovative surgery was introduced using a plantar approach, dividing the plantar tissues. This [...] Read more.
Background: In 1927, Cochrane observed persistent elastic resistance to hallux dorsiflexion after cheilectomy for hallux rigidus, attributing it to soft tissue tightness beneath the first metatarsophalangeal (MTP) joint. An innovative surgery was introduced using a plantar approach, dividing the plantar tissues. This procedure achieved complete pain resolution and high satisfaction in 12 patients. Despite addressing the etiology of hallux rigidus, this approach has not been adopted in current surgeries. This report presents a case treated with the arthroscopic Cochrane procedure with a long-term follow-up. Methods: A 73-year-old male with hallux rigidus presented with limited dorsiflexion, a painful bony prominence, and pain during walking at the first MTP joint, treated with the arthroscopic Cochrane procedure. Results: During surgery, hallux dorsiflexion did not improve after resecting all spurs in the MTP joint, but the dorsiflexion angle immediately improved from 55° to 85°after releasing the flexor hallucis brevis tendon, plantar capsule, and plantar portion of the lateral ligament. Improvements in both visual analog scale scores (70–0) and Japanese Society for Surgery of the Foot scores (57–88) were noted from preoperatively to 9 years and 6 months postoperatively. No postoperative cockup deformity was observed. Conclusions: The arthroscopic Cochrane procedure can yield favorable long-term outcomes without postoperative cockup deformity. Full article
(This article belongs to the Special Issue Foot and Ankle Surgery: State of the Art and Future Perspectives)
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