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J Orthop Translat 2021 May 7;28:140-147. Epub 2021 Apr 7.

Rehabilitation Hospital of National Research Center for Rehabilitation Technical Aids; Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability; Key Laboratory of Human Motion Analysis and Rehabilitation Technology of the Ministry of Civil Affairs, Beijing, China.

Objective: To analyze the characteristics of foot and ankle deformity with ulceration in patients with spina bifida, to conclude experiences on management with improved Ilizarov method in one stage.

Methods: 77 cases suffering foot and ankle deformity with ulceration of spina bifida were included from January 2008 to June 2019, in which 30 male and 47 female, aged 6-46 years with an average age of 22.86 years. Read More

Int Orthop 2021 Apr 25. Epub 2021 Apr 25.

Orthopedic Department, Assiut University, Assiut, Egypt.

Purpose: The study aims to prospectively compare double and triple arthrodesis in terms of functional outcomes and deformity correction. To the best of our knowledge, this is the first prospective comparative study in the literature to date.

Methods: This is a prospective comparative cohort study carried out between May 2017 and May 2019. Read More

Foot Ankle Surg 2021 Jan 2. Epub 2021 Jan 2.

Department of Traumatology and Orthopaedics, Hospital Santa Maria, Porto, Portugal. Electronic address:

Post-traumatic dystonia is an underrecognized condition that can present with bizarre symptoms after trauma, usually out of proportion to the trigger event. We describe the case of a 31-year-old man with a severe lower extremity deformity, gradually developed after minor trauma. An interdisciplinary treatment was tried without any improvement and surgery was performed as a rescue approach. Read More

Foot Ankle Int 2020 Dec 17:1071100720971269. Epub 2020 Dec 17.

Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.

Background: Nonunion rates in hind or midfoot arthrodesis have been reported as high as 41%. The most notable and readily modifiable risk factor that has been identified is smoking. In 2018, 14. Read More

World J Orthop 2020 Nov 18;11(11):507-515. Epub 2020 Nov 18.

Orthopedic and Trauma Unit, ASST Sette Laghi, Varese 21100, Italy.

Background: Müller-Weiss disease (MWD) is an idiopathic foot condition characterized by spontaneous tarsal "scaphoiditis" in adults. Frequently bilateral and affecting females during the 4-6 decades of life, the pathogenesis of MWD remains unclear: It has been traditionally considered a spontaneous osteonecrosis of the navicular. The typical presentation of MWD is a long period of subtle discomfort followed by prolonged standing, atraumatic, disabling pain. Read More

Mod Rheumatol Case Rep 2021 01 19;5(1):29-35. Epub 2020 Nov 19.

Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

We treated a 60 - year - old man with pes planovalgus due to rheumatoid arthritis. He had been suffering from left foot pain with swelling. Despite drug therapy, his foot pain and deformity had got worsen. Read More

J Med Life 2020 Jul-Sep;13(3):356-361

Department of Pediatric Orthopedics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

Flatfoot is a common deformity in the pediatric population and has a multitude of causes. Sometimes, it can be a normal finding in children, and treatment should not be guided only based on the appearance, but rather after thoroughly assessing the patient and the impact it has on the child's daily life. In this paper, we describe the quality of life that the patients are experiencing after the surgical treatment of this pathology. Read More

JBJS Case Connect 2020 Apr-Jun;10(2):e0268

1Department of Orthopaedic Trauma Surgery, University Hospitals Cleveland Medical Center and Case Western School of Medicine, Cleveland, Ohio.

Case: Complete extrusion of the talus is rare and associated with high rates of complications including infection, osteonecrosis, persistent pain and stiffness, and post-traumatic arthritis. Less well described is associated midfoot instability. We report a case of a complete extruded missing talus that resulted in significant midfoot instability treated with a modified triple arthrodesis of the tibiocalcaneal, tibionavicular, and calcaneocuboid joints. Read More

Foot Ankle Int 2020 08 20;41(8):911-915. Epub 2020 May 20.

Massachusetts General Hospital, Boston, MA, USA.

Background: Pain following autograft harvest has been studied; however, published literature has typically focused on the iliac crest with follow-up limited to only a few years. It remains unknown if pain continues or improves over time. The purpose of this study was to evaluate long-term pain associated with autograft harvest to supplement hindfoot or ankle arthrodesis. Read More

J Foot Ankle Surg 2020 Sep - Oct;59(5):1101-1105. Epub 2020 May 10.

Orthopedic Surgeon, Orthopaedic and Traumatology Department, University Hospital of Martinica, Martinique, France.

Total or complete dislocation of the talus is a triple dislocation of the tibiotalar, talocalcaneal, and talonavicular joints. It is a rare injury and is considered to be 1 of the most disabling ankle injuries. In light of the literature, there is a lack of consensus on their surgical treatment. Read More

JBJS Essent Surg Tech 2020 Jan-Mar;10(1). Epub 2020 Feb 13.

Steps2Walk, Inc., Baltimore, Maryland.

Middle facet tarsal coalition is one of the commonly seen tarsal coalitions in clinical practice that can cause pain and associated flatfoot deformity. Excision of the coalition is one of the treatment options for symptomatic cases. Although symptoms may subside in children following a period of immobilization, resection should be considered as a treatment alternative for children and adolescents because of the potential for restoration of subtalar joint movement. Read More

Foot Ankle Spec 2020 Mar 19:1938640020912859. Epub 2020 Mar 19.

Penn State College of Medicine, Hershey, Pennsylvania (MG, JL, JK).

The purpose of this study was to report the natural history, demographics, and mechanisms of requirement for additional surgery in patients undergoing flatfoot reconstruction for adult acquired flatfoot. A total of 321 consecutive patients undergoing flatfoot reconstruction over a 14-year period were included (2002-2016). All procedures were performed by a senior orthopaedic foot and ankle surgeon at our institution. Read More

Foot Ankle Spec 2020 Mar 13:1938640020910951. Epub 2020 Mar 13.

Department of Orthopaedics, The Medical College of Wisconsin, Wisconsin (AB).

Background: Foot and ankle surgeries in the United States (US) are currently performed by orthopaedic surgeons or podiatrists with specialty surgical training. With the trend in healthcare now placing increased emphasis on quality and standardizing patient care, this study aimed to characterize the distribution, volume, and trends of certain foot and ankle surgeries performed in the US by both orthopaedic surgeons and podiatrists.

Materials And Methods: A retrospective analysis was performed using the Marketscan Claims Database (Truven Health Analytics, Ann Arbor, Michigan) which covers most privately insured patients under the age of 65 in the USA from 2005 to 2014. Read More

Medicine (Baltimore) 2020 Feb;99(7):e18826

Department of Sports Medicine - Foot and Ankle Surgery, Cangzhou Hospital of Integrated TCM-WM, Cangzhou, Hebei, PR China.

To analyze the efficacy of arthrodesis combined with osteotomy applied to subtalar, calcaneocuboid, and talonavicular joints for the treatment of adult rigid flatfoot.This retrospective study included 29 adult patients with rigid flatfoot who underwent triple arthrodesis combined with osteotomy from January 2015 to December 2017. All patients suffered from stage III of adult acquired flatfoot. Read More

Arthrosc Tech 2020 Jan 14;9(1):e103-e109. Epub 2019 Dec 14.

Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong SAR, China.

Severe flatfoot deformity with lack of coverage of the talonavicular joint is frequently treated by triple arthrodesis. Various arthroscopic triple arthroscopic techniques have been described to reduce the extent of soft-tissue dissection. The purpose of this Technical Note is to describe the details of 3-portal arthroscopic triple arthrodesis for correction of severe flatfoot deformity. Read More

Instr Course Lect 2020 ;69:371-380

Tarsal coalitions are common, but fortunately the majority of patients with coalitions are asymptomatic and do not require intervention. When symptomatic, preoperative radiographs and CT scans are useful to characterize the type and extent of coalition. If a trial of nonsurgical management fails, resection, deformity correction, and triple arthrodesis may be considered. Read More

J Orthop Surg (Hong Kong) 2020 Jan-Apr;28(1):2309499019900472

Regional Spinal Department, UOC Ortopedia A, AOUI, Verona, Italy.

Purpose: For anterior spine column reconstruction after corpectomy, expandable cages offer solid anterior support and allow correction of deformity, providing excellent primary stability. To provide a larger body of clinical observations concerning the effectiveness of the approach, this retrospective study examines patients treated by corpectomy and reconstruction with an expandable cage for different pathologies.

Methods: Across 5 years, 39 patients underwent vertebral reconstruction with expandable cages after single ( = 34), double ( = 4), or triple ( = 1) corpectomy. Read More

J Orthop Trauma 2020 Feb;34 Suppl 1:S38-S44

Department of Orthopaedic Surger, University of South Florida, Tampa, FL.

Objective: To assess injury patterns and outcomes after navicular fractures.

Design: Retrospective radiographic review using the Schmid classification.

Setting: Academic Level 1 Trauma Center; PATIENTS/PARTICIPANTS:: Thirty-nine navicular fractures associated with additional foot injuries. Read More

Clin Podiatr Med Surg 2020 Jan 21;37(1):117-123. Epub 2019 Oct 21.

Penn Presbyterian Medical Center, Philadelphia, PA, USA; Temple University School of Podiatric Medicine, Philadelphia, PA, USA. Electronic address:

This article discusses rearfoot fusions for foot and ankle surgeons. It establishes normal foot and ankle function primarily in the stance phase of gait. The foot is greatly affected by external and internal forces, which contribute to normal function or the need for compensatory mechanisms. Read More

Spine Deform 2019 11;7(6):917-922

Setting Scoliosis Straight Foundation, 2535 Camino Del Rio S. Suite 325, San Diego, CA, 92108, USA.

Study Design: Observational.

Objective: To examine changes in patient-reported two-year postoperative outcomes via the Scoliosis Research Society (SRS)-24 Outcomes Instrument from 2001 through 2015.

Summary Of Background Data: Techniques for correction of adolescent idiopathic scoliosis (AIS) have evolved over the years, but it is unclear how these changes have impacted patient-reported outcomes. Read More

J Foot Ankle Surg 2019 Sep;58(5):904-915

Community Doctor, Department of Medicine, National and Kapodistrial University of Athens, Athens, Greece.

The purpose of this study is to recognize those young patients with symptomatic flexible flatfoot deformity who need treatment and to provide radiological evidence that arthroereisis is capable of relocating the talus properly over the calcaneus. We included 28 feet in 14 children who underwent subtalar arthroereisis in association with percutaneous triple-hemisection Achilles tendon lengthening. Selected for arthroereisis were children with symptomatic flexible flatfoot deformity who complained of foot and leg pain, had decreased endurance in sports activities and long walks, who did not respond to conservative treatment modalities for at least 6 months, and in whom at radiological assessment on stance position with the medial arch support orthosis the talonavicular joint lateral subluxation still remained, with Meary's angle in anteroposterior (A/P) and lateral view remaining increased. Read More

Clin Orthop Relat Res 2020 01;478(1):8-15

E. L. McDonald, D. I. Pedowitz, R. J. Shakked, D. J. Fuchs. B. S. Winters, J. N. Daniel, S. M. Raikin, Rothman Institute of Orthopaedics, Philadelphia, PA, USA.

Background: With the increase in the number of total ankle arthroplasties (TAA), guidelines on when physicians should begin to consider patients' return to driving are valuable. Further, due to sagittal motion strength, the ankle is the most important mover in braking motions over the knee and hip.

Questions/purposes: (1) Does brake-reaction time return to a safe value within 6 weeks of TAA? (2) Are there factors associated with a delay of return of brake-reaction time to safe values after TAA?

Methods: After obtaining institutional review board approval for the study, we prospectively recruited 60 patients undergoing right TAA. Read More

Rev Bras Ortop (Sao Paulo) 2019 May 27;54(3):275-281. Epub 2019 Jun 27.

Departamento de Ortopedia e Traumatologia, Santa Casa de São Paulo, São Paulo, SP, Brasil.

 The present study aims to evaluate the ability of triple arthrodesis in eliminating the main complaints presented by patients with adult acquired flatfoot deformity (AAFD): 1) disabling hindfoot pain; 2) major deformities, such as medial arch collapse, valgus, abduction, and supination.  A total of 17 patients (20 feet) with advanced AAFD who underwent surgical correction by triple arthrodesis were evaluated after a mean follow-up period of 43 months (range: 18-84 months). The average age of the patients at surgery was 62 years old (range: 38-79 years old). Read More

Med Sci Monit 2019 Jul 1;25:4885-4891. Epub 2019 Jul 1.

Department of Orthopedics, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).

BACKGROUND The aim of this study was to investigate the biomechanical fixation effects of different segments of the goat spine on adjacent segmental motion and intradiscal pressure (IDP) change. MATERIAL AND METHODS Eighteen goat spine specimens were randomly divided into 3 groups: group A (single-segment fixation), group B (double-segment fixation), and group C (triple-segment fixation). The motion was tested on each specimen using a spinal motion simulation test system with rational pressure loading. Read More

J Orthop Case Rep 2019 Jan-Feb;9(1):85-89

Department of Orthopaedics, Walk-A-Mile Centre for Advanced Orthopaedics, Centurion 0046, Pretoria, South Africa.

Introduction: Management of neglected clubfoot presents a challenging problem. Treatments traditionally involve extensive posteromedial soft tissue releases, bony procedures, and the Ilizarov technique of differential distraction.

Case Report: We present a case of bilateral neglected clubfoot in a 34-year-old female. Read More

Foot Ankle Surg 2020 Jun 19;26(4):412-420. Epub 2019 May 19.

Applied Mechanics and Bioengineering Group (AMB), Aragón Institute of Engineering Research (I3A), Universidad de Zaragoza, Spain.

Background: Treatments of adult acquired flatfoot deformity in early stages (I-IIa-IIb) are focused on strengthening tendons, in isolation or combined with osteotomies, but in stage III, rigidity of foot deformity requires more restrictive procedures such as hindfoot joint arthrodesis. Few experimental studies have assessed the biomechanical effects of these treatments, because of the difficulty of measuring these parameters in cadavers. Our objective was to quantify the biomechanical stress caused by both isolated hindfoot arthrodesis and triple arthrodesis on the main tissues that support the plantar arch. Read More

J Foot Ankle Surg 2019 Mar;58(2):374-376

Orthopedic Surgeon, Department of Orthopaedic Surgery, Bergman Clinics, Rijswijk, The Netherlands.

We report a rare case of a female, aged 42 years, with symptomatic bilateral triple tarsal coalition, that is, talocalcaneal, calcaneonavicular, and talonavicular tarsal coalition. The patient was treated conservatively by adjusting her activities. At the 12-month follow-up, the patient was asymptomatic. Read More

J Orthop Surg (Hong Kong) 2019 Jan-Apr;27(1):2309499019826492

Department of Orthopaedics and Traumatology, Duchess of Kent Children's Hospital, Hong Kong.

Objective: The aim of the study is to investigate the long-term outcome of patients who received Lambrinudi arthrodesis for severe equinovarus deformities.

Methods: This is a single-center, retrospective study of patients who received Lambrinudi triple arthrodesis of the foot. Both clinical and radiological information were analyzed. Read More

J Orthop Surg Res 2019 Feb 21;14(1):62. Epub 2019 Feb 21.

Department of Orthopedic Surgery, Southwest Hospital, Army Medical University, Chongqing, 400038, China.

Background: Adult acquired flatfoot deformity (AAFD) represents a spectrum of deformities affecting the foot and the ankle. The optimal management of AAFD remains controversial. We evaluated the efficacy of surgical treatments of AAFD using both direct and indirect evidences. Read More