Search Results (192)

Diabetic wounds, especially diabetic foot ulcers, pose a major global clinical challenge due to their slow healing and high infection susceptibility. Their typical pathological features include impaired angiogenesis, chronic hypoxia, persistent inflammation, oxidative stress, bacterial colonization, and neuropathy. Traditional treatment methods have limited efficacy, creating an urgent need for innovative therapeutic strategies. In recent years, biomaterials have emerged as a research focus in diabetic wound treatment, owing to their biocompatibility, versatility, and tissue regeneration potential. This article comprehensively reviews the pathological mechanisms of diabetic wounds. It also summarizes the application progress of biomaterials in diabetic wound healing. Over the past decade, researchers have explored the properties, mechanisms of action, and roles of various natural and synthetic biomaterials. These biomaterials include DNA nanomaterials, peptide hydrogels, cells, exosomes, and cytokines. These biomaterials play significant role in promoting angiogenesis, regulating inflammation, inhibiting bacteria, and enhancing cell proliferation and migration. Full article

Background and Objectives: Plantar fasciitis is one of the most common foot pathologies, and its diagnosis and clinical follow-up increasingly rely on the use of ultrasound. The aim of this study is to compare the reliability of ultrasound measurements of plantar fascia thickness between an expert technician, with more than 5 years of ultrasound experience, and a novice technician, with no prior ultrasound experience—both of whom are podiatrists. This allows us to assess whether operator experience significantly influences the results. Methods: An observational, descriptive, and cross-sectional study was designed with a sample of 60 healthy patients aged between 20 and 32 years. The thickness of the plantar fascia in both feet was measured using ultrasound. Each patient was evaluated by two observers (one expert and one novice) using a Vinno E35 ultrasound machine. Results: The results of the analysis indicated that there were no statistically significant differences in the measurements obtained either between the two technicians or between the left and right feet of the same individual, as the calculated p-value in both cases was greater than the conventional threshold of 0.05. This suggests that the measurements were consistent regardless of the operator or the side being evaluated. Nevertheless, when examining the differences in the time required to measure the plantar fascia between the two technicians, the situation was different. In this case, the data distribution did not meet the assumption of normality, as evidenced (p-value of less than 0.001). Furthermore, it was observed that the experienced technician not only completed the measurements in a shorter amount of time but also demonstrated less variability in those times, indicating a more efficient and standardized approach to the procedure. In contrast, the novice technician initially took longer and exhibited greater inconsistency; however, as the study progressed, a noticeable and progressive learning effect became apparent. Specifically, from approximately the midpoint of the study onward, the novice technician showed a significant improvement, achieving faster and more consistent measurement times compared to the earlier stages of the research. Conclusions: The study demonstrates that ultrasound measurements of the plantar fascia are consistent between technicians. However, the expert technician performs the measurements with greater speed and precision, and a learning effect is evident in the novice technician. Full article

Background: Cerebral palsy (CP) is a static, non-progressive brain pathology that affects mobility and musculoskeletal health. Objective: This review aims to describe the pediatric orthopedic management strategy at one specialty center with focus on optimal lifelong mobility function for ambulatory CP. Methods: Beginning in the 1990s, a protocol was developed to proactively monitor children with surgical or conservative interventions. After three decades, we undertook a prospective institutional review, board-approved 25–45-year-old adults callback study. Inclusion criteria were all children treated through childhood who could be located and were willing to return for a full evaluation. Results: Pediatric orthopedic interventions focused on regular surveillance with proactive treatment of progressive deformities. When function was impacted, we utilized multi-level orthopedic surgery guided by instrumented gait analysis. Childhood outcomes of this approach were evaluated through retrospective studies. Results show high correction rates were achieved for planovalgus foot deformity, knee flexion contracture, torsional malalignments, and stiff-knee gait. Our prospective adult callback study evaluated 136 adults with CP, gross motor function classification system levels I (21%), II (51%), III (22%), and IV (7%), with average ages of 16 ± 3 years (adolescent visit) compared with 29 ± 3 years (adult visit). Adults in the study had an average of 2.5 multi-level orthopedic surgery events and 10.4 surgical procedures. Compared with adults without disability, daily walking ability was lower in adults with CP. Adults with CP had limitations in physical function but no increased depression. A higher frequency of chronic pain compared with normal adults was present, but pain interference in daily life was not different. Adults demonstrated similar levels of education but higher rates of unemployment, caregiver needs, and utilization of Social Security disability insurance. Conclusions: The experience from our center suggests that consistent, proactive musculoskeletal management at regular intervals during childhood and adolescence may help maintain in gait and mobility function from adolescence to young adulthood in individuals with CP. Full article

Background/Objectives: Diabetic foot syndrome (DFS) is a chronic complication of diabetes mellitus that negatively impacts patients’ quality of life (QoL). Patients’ perceptions of health status and healthcare can be assessed using Patient-Reported Experience Measures (PREMs) and Patient-Reported Outcome Measures (PROMs). This article aims to review the available literature on PREMs and PROMs, evaluate their characteristics, and determine whether an existing measure is applicable to or can be developed for the patient population of a third-level unit for diabetic foot. Methods: A search through Cinahl, Scopus, and Pubmed electronic databases was conducted to identify studies published between 2000 and 2024. Eligible studies included those using PREMs and PROMs in patients with DFS. Studies that used self-assessment methods or open questions and those that applied PROMs in people living with diabetes without diabetic foot were excluded. Results: After a careful selection, 53 studies met the inclusion criteria: none of these applied PREMs. Regarding PROMs, 46 studies applied a generic method alone or in combination with a specific tool to large populations comparing patient groups, while 7 studies applied a specific PROM alone to small populations evaluating specific aspects of pathology. Conclusions: In the existing literature, generic tools are mainly reported. No gold standard has yet been identified among all the tools considered for assessment of quality of life or patients’ perceptions of their health. Further studies are needed to develop a reliable and specific PREM or PROM questionnaire for complex patients affected by DFS. Full article

Objective: Symptomatic flat foot is quite a common pathology in adults. Myofascial release is one of the physiotherapeutic methods that are currently very often used in the treatment of musculoskeletal diseases. This study aimed to assess the impact of myofascial release on the range of motion and functional efficiency of the flat foot in adults. Method: The study involved 60 people with flat feet allocated to four groups and subjected to therapy lasting four weeks: group MRE (Myofascial Release and Exercises; 15 people): myofascial techniques and an exercise programme; group MR (Myofascial Release; 15 people): only myofascial techniques; group E (Exercises; 15 people): only an exercise programme; and the control group C (Control; 15 people): no intervention. Goniometric measurements of the range of motion of the ankle joint and the Foot and Ankle Outcomes Questionnaire (FAOQ) were used to evaluate the effects of the therapy. Results: The range of all tested movements significantly improved after therapy in both feet simultaneously in groups MRE (left foot: dorsiflexion p = 0.017; plantar flexion p = 0.006; inversion p = 0.003; and eversion p = 0.001; right foot: dorsiflexion p = 0.008; plantar flexion p = 0.003; inversion p = 0.008; and eversion p = 0.004) and MR (left foot: dorsiflexion p = 0.001; plantar flexion p = 0.001; inversion p = 0.001; and eversion p = 0.001; right foot: dorsiflexion p = 0.001; plantar flexion p = 0.002; inversion p = 0.001; and eversion p = 0.029). The FAOQ results were significantly better after therapy in groups MRE (p = 0.010), MR (p = 0.001) and E (p = 0.015). Conclusions: In the people studied, the combination of myofascial techniques and exercises (MRE) was the most effective for improving the tested ranges of motion of the ankle joint. Myofascial techniques had a significant impact on the performance of the feet assessed with the FAOQ. Full article

Background: Spring ligament (SL) injuries are primarily associated with progressive collapsing flatfoot deformity, but can also occur due to trauma. It remains unclear whether the morphological changes following trauma differ from those caused by chronic overload. The aim of this study was (1) to analyze whether a relationship exists between the injury pattern and foot deformity and (2) to evaluate whether there is a distinction between trauma-related and non-trauma-related injuries. Method: We prospectively enrolled 198 patients with a median age of 57 years (range, 13 to 86 years; female, 127 (64%); male, 71 (36%)) who had a clinically diagnosed, surgically confirmed, and classified SL injury. We used weight-bearing standard X-rays to assess foot deformity. The control group consisted of 30 patients (median age 51 years, range, 44–66; female, 21 (70.0%); male, 9 (30.0%)) with no foot deformities or prior foot surgeries. Results: A 41.9% incidence of trauma was identified as the cause of these injuries, accounting for 16 (20.8%) of isolated injuries to the SL, 30 (42.9%) of SL injury accompanied by a posterior tibial (PT) tendon avulsion, and 37 (72.5%) of SL injury alongside a bony avulsion at the navicular injuries. The odds of being post-traumatic decreased with each year of age by a factor of 0.97 (95% CI: 0.95–0.99). Conclusions: While all radiographic measurements for flatfoot deformity became pathological after an injury to the SL, they did not accurately predict the injury patterns of the SL and distal PT tendon. Generally, post-traumatic cases exhibited lower severity of foot deformity, suggesting that other structures beyond the SL may contribute to the development of flatfoot deformity. Full article

Hallux valgus (HV) is described as a lateral deviation of the great toe at the first metatarsophalangeal joint (MTP), which is a very common foot deformity in the clinic. This deformity extends beyond localized foot mechanics to affect the entire lower extremity kinetic chain, potentially increasing dynamic instability during locomotion. This study aimed to characterize the kinematics of ankle and knee joints during walking in HV patients compared to controls. In total, 23 patients with bilateral HV and matched healthy controls were recruited. The 6-DOF kinematics data of ankles and knees were collected using a joint motion function analysis system while level walking at adaptive speed. HV patients demonstrated significant kinematic alterations in the ankle joint at IC, including decreased varus by 2.87° (p < 0.001), decreased internal rotation by 1.77° (p = 0.035), and decreased plantarflexion by 4.39° (p < 0.001) compared with healthy subjects. Concurrent compensatory changes in the knee joint included increased varus rotation by 1.41° (p = 0.023), reduced anterior translation by 0.84 mm (p < 0.001), and increased lateral translation by 0.26 mm (p = 0.036). HV patients showed increased ankle dorsiflexion of 3.61° (p = 0.06) and decreased ankle internal rotation of 2.69° (p = 0.043), with concurrent increased knee internal rotation of 2.59° (p = 0.009) at SPF. The ripple effect during walking in the HV population may elevate the risk of knee pathologies. These findings may inform both conservative management strategies and post-surgical rehabilitation regimens. Full article

Background: Iliotibial band syndrome (ITBS) through the tensor fascia latae (TFL) is a well-known pathology among runners whose etiology is not completely clear, nor is the effectiveness of plantar insoles for different types of feet known well enough for them to be considered a possible approach for this issue. Objective: to understand how foot type and foot orthotics may influence the electromyographic (EMG) activity of the TFL. Methods: A total of 41 healthy recreational runners (mean age 32.66 ± 3.51) were recruited for the present cross-sectional study, categorizing them as neutral (NEUg = 15), supinators (SUPg = 15), and pronators (PROg = 11) according to the foot postural index, over a period of 11 months. The EMG of the TFL was measured using a surface electromyograph device while they ran on a treadmill at a constant speed of 9 km/h for 3 min, randomly using supinating (SUP), pronating (PRO), or heel lift (TAL) insoles of 5 mm each one, compared to the baseline condition (SIN). The intraclass correlation coefficient (ICC) was performed to check the reproducibility of the tests, pairwise comparisons with Bonferroni adjustment were made, and to test the differences between measurements, the Friedman test was performed. Results: The Shapiro–Wilk test indicated a normal distribution of the sample (p > 0.05). Almost all obtained results showed a “perfect reproducibility” close to one; a significant statistical increase was observed in the mean EMG values from NEUg (87.58 ± 4.81 mV) to SUPg (97.17 ± 4.3 mV) (p < 0.05) during SIN+ basal condition. Additionally, there was a statistical reduction from SIN (87.58 ± 4.81 mV) vs. PRO (74.69 ± 3.77 mV) (p < 0.001) in NEUg and from SIN (97.17 ± 4.3 mV) vs. PRO (90.96 ± 4 mV) (p < 0.001) in SUPg. Conclusions: The SUPg exhibited increased activation of TFL fibers compared to the NEUg, likely due to the biomechanical demands associated with a supinated foot type. In contrast, the use of PRO appeared to promote relaxation of the TFL fibers by inducing internal rotation of the lower limb. Based on these preliminary results from a cross-sectional study in a healthy population, it is recommended to assess foot type when addressing ITBS and to consider the use of PRO as a complementary therapeutic strategy alongside conventional treatments. Full article

The gut microbiota has emerged as a critical modulator in metabolic diseases, with substantial evidence supporting its role in attenuating diabetes-related nephropathy. Recent investigations demonstrate that strategic manipulation of intestinal microflora offers novel therapeutic avenues for safeguarding renal function against diabetic complications. This investigation sought to determine the nephroprotective potential of Lactobacillus rhamnosus GG (LGG) administration in diabetic nephropathy models. Six experimental cohorts were evaluated: control, probiotic-supplemented control, diabetic, diabetic receiving probiotic therapy, diabetic with antibiotics, and diabetic treated with both antibiotics and probiotics. Diabetic conditions were established via intraperitoneal administration of streptozotocin (50 mg/kg) following overnight fasting, according to validated protocols for experimental diabetes induction. Probiotic therapy (3 × 10⁹ CFU/kg, bi-daily) began one month before diabetes induction and continued throughout the study duration. Glycemic indices were monitored at bi-weekly intervals, inflammatory biomarkers, renal function indices, and urinary albumin excretion. The metabolic profile was evaluated through the determination of HOMA-IR and the computation of metabolic syndrome scores. Microbiome characterization employed 16S rRNA gene sequencing alongside metagenomic shotgun sequencing for comprehensive microbial community mapping. L. rhamnosus GG supplementation substantially augmented microbiome richness and evenness metrics. Principal component analysis revealed distinct clustering of microbial populations between treatment groups. The Prevotella/Bacteroides ratio, an emerging marker of metabolic dysfunction, normalized following probiotic intervention in diabetic subjects. Results: L. rhamnosus GG administration markedly attenuated diabetic progression, achieving glycated hemoglobin reduction of 32% compared to untreated controls. Pro-inflammatory cytokine levels (IL-6, TNF-α) decreased significantly, while anti-inflammatory mediators (IL-10, TGF-β) exhibited enhanced expression. The renal morphometric analysis demonstrated preservation of glomerular architecture and reduced interstitial fibrosis. Additionally, transmission electron microscopy confirmed the maintenance of podocyte foot process integrity in probiotic-treated groups. Conclusions: The administration of Lactobacillus rhamnosus GG demonstrated profound renoprotective efficacy through multifaceted mechanisms, including microbiome reconstitution, metabolic amelioration, and inflammation modulation. Therapeutic effects suggest the potential of a combined probiotic and pharmacological approach to attenuate diabetic-induced renal pathology with enhanced efficacy. Full article

Background: Type 2 diabetes (T2D) is a chronic disease that significantly impacts individuals’ quality of life, affecting their physical, psychological, social, and environmental well-being. Objectives: This study investigates how self-care habits influence quality of life and key health indicators, such as glycated hemoglobin (HbA1c), blood sugar levels, and body mass index (BMI), among newly diagnosed diabetic individuals in Vlore, Albania. Methods: In this cross-sectional study, 332 individuals recently diagnosed with diabetes were surveyed between April and July 2024. Data were collected using the World Health Organization Quality of Life Assessment (WHOQOL-BREF) and the Summary Diabetes Self-Care Activity (SDSCA) surveys. Sociodemographic and clinical information, including age, education, occupation, duration of diabetes, HbA1c, and BMI, were collected through structured interviews and medical records. Descriptive and multivariate analyses were conducted to examine the relationships between self-care behaviors, sociodemographic factors, and quality of life. Results: The findings reveal a low quality of life, with a mean quality of life (QoL) score of 35.33 ± 8.25. Environmental domains were most affected, registering a low QoL score of 30.93 ± 9.04. Significant relationships between QoL, self-care practices, and sociodemographic factors and pathologic factors were found. The analysis indicated that distinct factors influenced various domains of quality of life. Physical health was associated with residence, comorbidities, BMI, and HbA1c, follow-up visits, dietary self-care and physical activity self-care. Psychological health correlated with residence, educational level, BMI, and HbA1c, follow-up visits, dietary, physical activity and foot self-care. Age, occupation, BMI, and physical activity self-care were linked to social relationships. Finally, environmental well-being was influenced by gender, residence, BMI, HbA1c, follow-up visits, and dietary and physical activity self-care. Conclusions: This study emphasizes the impact of sociodemographic and clinical factors on the quality of life of patients with T2D. Older age, lower education levels, comorbidities, increase in BMI and HbA1c levels, and inadequate self-care were associated with reduced quality of life. These findings highlight the need for targeted interventions and policies that promote self-care and support for at-risk groups. Full article

Background: Hallux rigidus is a painful and degenerative pathology of the first metatarsophalangeal (MTP1) joint. In severe cases it is usually appropriate to consider arthrodesis or arthroplasty of the joint. Arthrodesis represents the gold standard, but arthroplasty allows patients to recover mobility. Although arthroplasty has slightly inferior functional results to arthrodesis, it has shown very good results in terms of joint mobility, patient satisfaction and pain reduction. The goal of the present study was to evaluate short-term outcomes of patients that received a third-generation double-stemmed MTP1 implant manufactured from high-performance silicon. Methods: In this retrospective study the authors analyzed data of 37 patients who underwent MPT1 joint arthroplasty with Silktoe^TM double-stemmed implant using the R 4.2.2 software (R Foundation for Statistical Computing, Vienna, Austria). The indications were hallux rigidus of grade III and grade IV (81.1%), hallux rigidus plus valgus (10.8%), painful or unstable joint following previous surgery (5.4%) and hallux rigidus due to gout (2.7%). Data were collected during routine visits at 1 and 6 months and 1 and 2 years. Results: There were no intraoperative and postoperative complications. There were no revisions or reoperations at a follow-up of two years. The American Orthopaedic Foot and Ankle Society-Hallux Metatarsophalangeal-Interphalangeal Scale (AOFAS-HMI) score was 94.6 ± 7.6 (median, 100; range, 70–100) and the Visual Analogue Scale (VAS) score was 0.4 ± 0.80 (median, 0; range, 0–3.5) at the final follow-up. Conclusions: The data from this study presented excellent short-term results for patients who received an arthroplasty of the MTP1 joint using a third-generation double-stemmed spacer made of high-performance silicone. For all patients who received the Silktoe^TM implant, AOFAS-HMI scores of 94.6 and VAS scores of 0.4 were obtained at a two-year follow-up. These values were in line with results reported in the literature for similar devices. Full article

Background and Objectives: This study aimed to evaluate the imaging characteristics of computed tomography (CT) for diagnosing and assessing cellulitis in patients with leg swelling. Materials and Methods: Overall, 1545 patients who underwent CT for leg swelling were retrospectively analyzed. Among them, 174 were diagnosed with cellulitis based on clinical findings, laboratory tests indicating inflammation, and their response to antibiotics. Patients with previous follow-up CT scans, negative CT findings, or alternative diagnoses were excluded (n = 1123). Two radiologists independently assessed the CT images while blinded to other clinical data, resolving discrepancies through consensus. Results: Among 174 patients with cellulitis, 112 were men, and 62 were women, with a mean age of 64.1 ± 15.8 years. The patients were categorized into two groups based on the affected region: Group I (thigh or lower leg, n = 130) and Group II (foot involvement only, n = 44). The qualitative CT features analyzed included skin thickening (83.9%), subcutaneous edema (94.8%), early venous return (82.8%), lymph node pathological findings (72.4%), and prominent lymph node enhancement (79.3%). Group I demonstrated significantly higher rates of skin thickening, subcutaneous edema, and early venous return than Group II. Pairwise analysis of CT findings revealed significant associations between skin thickening and subcutaneous edema, skin thickening and early venous return on MIP, and early venous return on MIP and lymph node pathology. Conclusions: CT provides valuable diagnostic features of cellulitis in patients with leg swelling. Skin thickening, subcutaneous edema, early venous return, and lymph node abnormalities are key findings in the diagnosis of cellulitis. Full article

Background: Basolateral amygdala (BLA) deep brain stimulation (DBS) has been shown to alleviate the symptoms of post-traumatic stress disorder (PTSD), but the specific mechanisms remain incompletely understood. The hippocampus, a brain region closely connected to the amygdala, plays a key role in the pathological processes of PTSD. The N6-methyladenosine (m⁶A) methylation of RNAs in the hippocampus is known to play a significant role in regulating the brain’s response to stress and emotional disorders. Methods: This study aimed to comprehensively analyze the roles of transcriptome-wide m⁶A modifications of the hippocampus in the BLA DBS treatment of a PTSD mouse model using m⁶A sequencing. Results: Significant alterations in functional connectivity between the ventral hippocampus (vHPC) and BLA were observed in foot shock (FS) mice through functional magnetic resonance imaging (fMRI) analysis. Furthermore, we observed that the expression of the key m⁶A methyltransferase enzyme, METTL3, in the FS and BLA DBS groups was higher than that in the control group. At the same time, both FS and BLA DBS induced the widespread m⁶A methylation of RNAs in the vHPC. Gene ontology (GO) enrichment analysis revealed that FS altered methylation in metabolic, developmental, and cytoskeletal pathways, while BLA DBS targeted metabolic, cell cycle, and neuroplasticity-related genes. Additionally, BLA DBS reversed the aberrant methylation of genes associated with multiple functional pathways induced by FS, including those related to cholinergic transmission, sodium and calcium ion homeostasis, and stress hormone responsiveness. We identified a set of RNAs with methylation changes that were reversed by BLA DBS in the FS vs. Ctrl (control) comparison, including those associated with cholinergic transmission, sodium and calcium ion balance, and stress hormone response. Additionally, we detected several specific BLA DBS-related genes through MeRIP-qPCR, indicating that DBS influences crucial genes linked to calcium signaling and synaptic plasticity. Conclusions: We draw two conclusions from these findings: BLA DBS may alleviate PTSD-like symptoms by reversing FS-induced methylation changes and by altering the methylation levels of crucial genes. These findings indicate that epigenetic m⁶A modifications in the vHPC may play an important role in the amelioration of PTSD using BLA DBS. Full article

Background/Objectives: Chronic plantar fasciopathy is a degenerative pathology that elicits persistent heel pain, significantly impacting quality of life. When conservative treatments fail to yield satisfactory outcomes, radiofrequency microtenotomy utilizing the Topaz technique presents a minimally invasive alternative with regenerative potential. This study aims to evaluate its efficacy in pain reduction, functional improvement, and complication rate compared to other treatments. Methods: A systematic review was conducted in accordance with the PRISMA guidelines and registered in PROSPERO (CRD4202525648314). PubMed, EBSCOhost, Web of Science, and Scopus (2014–2024) were comprehensively searched to identify studies on the Topaz technique for refractory chronic plantar fasciopathy. Clinical trials, cohort studies, and case series were included, and a meta-analysis was performed using a random-effects model to assess pain, the Visual Analog Scale (VAS), American Orthopaedic Foot & Ankle Society function(AOFAS), and complications. Results: Fifteen studies encompassing 1576 patients were analyzed. The meta-analysis demonstrated a significant reduction in pain of 5.90 points on the VAS scale (95% CI: 5.03 to 6.77, p < 0.001) and a functional improvement of 0.28 points on the AOFAS scale (95% CI: 0.27 to 0.28, p < 0.001). The complication rate was low (3.00%), with high patient satisfaction (90%) and rapid recovery. Conclusions: The findings suggest that the Topaz technique is a safe and effective option for chronic plantar fasciopathy, demonstrating significant improvements and minimal complications. Full article

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