Search Results (5)

Since its introduction, weight-bearing computed tomography (WBCT) has gained prominence due to its ability to produce accurate three-dimensional images under natural loading conditions, making it particularly useful for assessing complex foot deformities. This review aimed to focus on the diseases of the foot and categorized the pathological conditions into forefoot disease (hallux valgus), midfoot disease (Lisfranc injuries and midfoot osteoarthritis), and progressive collapsing foot deformity. For each category, the authors detail how WBCT enhances diagnostic accuracy and informs treatment strategies. In hallux valgus, WBCT allows for more precise measurement of established parameters and reveals crucial information about metatarsal pronation and ray instability. For midfoot pathologies, WBCT’s superiority in detecting subtle Lisfranc injuries and characterizing midfoot osteoarthritis is emphasized, highlighting the development of novel measurement techniques. The review extensively covers the application of WBCT in assessing the complex three-dimensional features of PCFD, including hindfoot valgus, midfoot/forefoot abduction, medial column instability, peritalar subluxation, and valgus tilting, presenting several WBCT-specific measurements and the use of distance mapping to quantify joint surface interaction. The authors conclude that WBCT, potentially enhanced through integration with artificial intelligence (AI), represents a significant advancement in foot and ankle care, promising improved diagnostic accuracy, streamlined treatment planning, and, ultimately, better patient outcomes. Full article

The Lisfranc joint connects the forefoot to the midfoot. Tarsometatarsal (TMT) arthrodesis is commonly employed for Lisfranc joint injuries; however, there is active discussion regarding the optimal method of fixation for TMT arthrodesis. The purpose of this systematic review is twofold: to assess the stability of various constructs used in TMT arthrodesis and to evaluate joint motion and force distribution in the foot following arthrodesis. The PubMed, CINAHL, MEDLINE, and Web of Science databases were searched for articles evaluating biomechanical and kinetic properties of TMT arthrodesis constructs in accordance with PRISMA guidelines. The preliminary search yielded 367 articles and the final review included 14 articles with 195 cadaveric and 70 synthetic bone constructs. Plantar plates and intramedullary screw fixation at the first TMT joint were consistently found to bear significantly greater loads and resist diastasis more effectively than crossed screws. Furthermore, whole foot and lateral column arthrodesis significantly elevate calcaneocuboid and lateral column pressures. This increase was not observed with isolated fourth or fifth TMT arthrodesis. TMT arthrodesis should aim to avoid the lateral column and fuse as few joints as possible. Overall, plantar plates are an effective construct for first TMT arthrodesis due to their ability to withstand both compressive and tensile forces while maintaining stable alignment of the foot via reinforcement of the transverse arch. Intramedullary fixation devices are an alternative option that provide a high degree of active compression across the joint space while avoiding irritation of surrounding soft tissue structures. Full article

Contrary to Lisfranc joint fracture-dislocation, ligamentous Lisfranc injury can lead to additional instability and arthritis and is difficult to diagnose. Appropriate procedure selection is necessary for a better prognosis. Several surgical methods have recently been introduced. Here, we present three distinct surgical techniques for treating ligamentous Lisfranc employing flexible fixation. First is the “Single Tightrope procedure”, which involves reduction and fixation between the second metatarsal base and the medial cuneiform via making a bone tunnel and inserting Tightrope. Second is the “Dual Tightrope Technique”, which is similar to the “Single Tightrope technique”, with additional fixation of an intercuneiform joint using one MiniLok Quick Anchor Plus. Last but not least, the “internal brace approach” uses the SwiveLock anchor, particularly when intercueniform instability is seen. Each approach has its own advantages and disadvantages in terms of surgical complexity and stability. These flexible fixation methods, on the other hand, are more physiologic and have the potential to lessen the difficulties that have been linked to the use of conventional screws in the past. Full article

Ankle arthrodesis is considered to be an optimal treatment strategy to relieve pain during walking in patients with isolated, end-stage tibiotalar osteoarthritis. The aim of this study was to investigate the post-operative effect of an arthrodesis on the ankle and foot joint biomechanics. We included both patients (n = 10) and healthy reference data (n = 17). A multi-segment foot model was used to measure the kinematics and kinetics of the ankle, Chopart, Lisfranc, and first metatarsophalangeal joints during a three-dimensional (3D) gait analysis. These data, together with patient reported outcome measures, were collected at baseline (pre-operative) and one year post-operatively. Patients experienced a decrease in pain and an increase in general well-being after surgery. Compared to the baseline measurements, patients only demonstrated a significant average post-operative increase of 0.22 W/kg of power absorption in the ankle joint. No other significant differences were observed between baseline and post-operative measurements. Current findings suggest that the biomechanical behavior of distal foot joints is not altered one year after fusion. The pain relief achieved by the arthrodesis improved the loading patterns during walking. Clinical significance of this study dictates that patients do not have to fear a loss in biomechanical functionality after an ankle arthrodesis. Full article

Ankle/foot pain is a common complaint encountered in clinical practice. Currently, due to the complex anatomy, the diagnosis and management of the underlying musculoskeletal disorders are extremely challenging. Nowadays, high-resolution ultrasound has emerged as the first-line tool to evaluate musculoskeletal disorders. There have been several existing protocols describing the fundamental sonoanatomy of ankle/foot joints. However, there are certain anatomic structures (e.g., Lisfranc ligament complex or Baxter nerve) which are also clinically important. As they are rarely elaborated in the available literature, a comprehensive review is necessary. In this regard, the present article aims to brief the regional anatomy, illustrate the scanning techniques, and emphasize the clinical relevance of the ankle/foot region. Full article