Effectiveness of an mHealth-based impact exercise program for bone health in postmenopausal women: a randomised controlled trial protocol.

Background: Osteoporosis, a major global health concern, increases fracture risk due to reduced bone mineral density (BMD), particularly in postmenopausal women. Weight-bearing and high-impact exercises are recommended for bone health, yet accurately quantifying mechanical loading outside the laboratory remains a challenge. Without precise tools, it is difficult to assess whether individuals engage in sufficient osteogenic activity.

Mid-to-Long-term Clinical Outcomes of Ankle Arthroscopy on the Treatment of Chronic Ankle Conditions: Systematic Review and Meta-analysis.

BackgroundThe effectiveness of arthroscopic ankle surgery for chronic ankle conditions, including pain intensity, functionality, and success rates, remains uncertain.MethodsPubMed, Scopus, and Web of Science databases were searched until October 2023. Mean differences (MDs) were calculated for pain reduction and functional improvements, and arthroscopy success rates were determined using a random-effects model.

A clinical practice guideline for the management of the foot and ankle in rheumatoid arthritis.

Rheumatoid arthritis causes progressive joint destruction in the long term, causing a deterioration of the foot and ankle. A clinical practice guideline has been created with the main objective of providing recommendations in the field of podiatry for the conservative management of rheumatoid arthritis. Thus, healthcare professionals involved in foot care of adults with rheumatoid arthritis will be able to follow practical recommendations.

Ultrasound assessment of the spring ligament and posterior tibial tendon in healthy subjects: A descriptive study.

Background: The main aim of this study was to ultrasonographically analyse the thickness and the relationship between the Superomedial Bundle of the Spring Ligament and the Posterior Tibial Tendon in healthy subjects and its relationship with different epidemiological variables.

Methods: Fifty-five healthy feet with a mean of 47 years old measuring the same ultrasound model and researcher. Demographic variables (age, sex, laterality, BMI, type of sports activity performed, and type of work activity) were collected from all participants.

The Classic Three-Month Post-Operative Adaptation Phase in Foot and Ankle Surgery-An Expert Perspective.

Foot and ankle disorders are a common reason for orthopedic surgical intervention. After surgery, specific precautions such as partial weight bearing or complete unloading, and the use of walking aids, coupled with a period of rest, are usually implemented to ensure the surgical outcome. However, when these aids are discontinued and the patients resume load increase and normal daily activities, they may enter a transitional phase characterized by inflammation, swelling, and pain.

Increased subtalar rotational motion in patients with symptomatic ankle instability under load and stress conditions.

Purpose: Differentiating subtalar and ankle instability in the clinical setting is challenging. This study aims to analyze the rotational laxity of the subtalar joint bilaterally in patients with asymptomatic and symptomatic ankle instability under simulated load and stress-induced position of the subtalar joint.

Methods: A case-control study was conducted using an adjustable load device (ALD).

Complex Left Atrial Appendage Occlusion Using the Novel Amplatzer Steerable Delivery Sheath.

Left atrial appendage (LAA) occlusion has emerged as an al- ternative to oral anticoagulation in non-valvular atrial fibril- lation. The success rate is high, but we are still facing some challenging LAA anatomies that may increase the risk of sub- optimal results. These images show that the Amplatzer steer- able sheath is useful for LAA occlusion, especially in cases with challenging anatomies.

Severe equinus cavo-varus correction through triplanar tarsectomy and posterior tibial tendon transfer based on 3D-printed biomodel.

Surgery for severe equine cavo-varus is complex and must be individualized. The interindividual phenotypic variability demands a personalized planning of each foot to be operated. The study's primary goal was to evaluate the function and satisfaction of a series of patients with severe equinus cavo-varus deformity who underwent a triplanar tarsectomy and transposition of the posterior tibial tendon in a single stage surgery after a patient specific 3D biomodel planning.

Hindfoot motion through helical axis image-based on dynamic CT scan using an original simulated weightbearing device.

Background: Determining the treatment of subtalar joint (STJ) instability requires a better understanding of the biomechanical principles underlying the condition and, a proper diagnosis. This study aimed to analyze "in vivo" the range of motion of the subtalar joint (STJ) measured on two (2D) and three dimensions (3D) image-based on CT Scan using an original device that maintains a simulated weightbearing. The secondary goal was to correlate the 2D and 3D measurement.

Allograft and Autologous Reconstruction Techniques for Neglected Achilles Tendon Rupture: A Mid-Long-Term Follow-Up Analysis.

Achilles tendon ruptures that are not immediately recognized and treated are sometimes diagnosed as delayed injuries and may require different surgical repair options based on gap size. The potential complications associated with using an allograft for reconstruction may lead some surgeons to prefer the use of autologous techniques. However, allografts are often considered a salvagement option when large defects are present.

Diagnosis of subtle syndesmotic instability using conventional CT-imaging and axial force in different foot positions.

Background: Currently, there is no available method that can objectively and reliably detect subtle instability of the distal tibiofibular joint. The purpose of this study is to diagnose, using computerized axial tomography and an adjustable simulated loading device, subtle instability of the tibiofibular syndesmosis.

Methods: Fifteen healthy individuals and 15 patients with clinical suspicion of subtle instability of the tibiofibular syndesmosis (total 60 ankles) were studied using an adjustable simulated loading device (ASLD).

Ankle osteoarthritis: comprehensive review and treatment algorithm proposal.

Ankle osteoarthritis (OA) is much less frequent than knee or hip OA, but it can be equally disabling, greatly affecting the quality of life of the patients. Approximately 80% of ankle OA is post-traumatic, mainly secondary to malleolar fractures, being another of the main causes untreated in chronic instability. The average age of the patient affected by ankle OA is around 50 years, being therefore active patients and in working age who seek to maintain mobility and remain active.

Tibiotalocalcaneal nailing for osteoporotic ankle fractures in the frail patient: a narrative review with a clinical score proposal for the decision-making process.

Osteoporotic ankle fractures result from mechanical forces that would not ordinarily result in fracture, known as 'low-energy' trauma, such as those equivalent to a fall from a standing height or less. Osteoporotic ankle fractures in frail patients are becoming more and more frequent in daily practice and represent a therapeutic challenge for orthopaedic surgeons. The main problems with frail patients are the poor condition of the soft tissues around the ankle, dependence for activities of daily living and high comorbidity.

Joint-Preserving Surgery in Varus Ankle Osteoarthritis.

Ankle deformity is a disabling condition especially if concomitant with osteoarthritis (OA). Varus ankle OA is one of the most common ankle OA deformities. This deformity usually leads to unequal load distribution in the ankle joint and decreases joint contact surface area, leading to a progressive degenerative arthritic situation.

Infected unstable Charcot ankle neuroarthropathy, any hope before amputation? A prospective study.

Background: Charcot neuroarthropathy is a destructive disease characterized by progressive bony fragmentation as a result of the isolated or accumulative trauma in patients with decreased sensation that manifests as dislocation, periarticular fractures, and instability. In this study, we present the results of salvage procedure of the ankle Charcot neuroarthropathy using aggressive debridement and Ilizarov frame fusion with early weight bearing.

Methods: Twenty-three patients with severely infected ulcerated and unstable Charcot neuroarthropathy of the ankle were treated between 2013 and 2018.

Neglected Stress Fracture of the Second Proximal Phalanx in a Teenage Triathlete.

We present a case of nondiagnosed comminuted stress fracture of the base of the proximal phalanx associated with flexor digitalis longus rupture in a teenage athlete. To our knowledge, there is no description in the literature of such a combination of injuries due to delayed diagnosis and incorrect treatment, including injections in the metatarsophalangeal joint of the second toe. The present article focuses on the importance of clinical suspicion of this rare lesion to achieve early diagnosis and avoid surgical treatment.

Intraoperative checking of the first ray rotation and sesamoid position through sonographic assistance.

Introduction: Hallux valgus (HV) deformity affects the orientation of the metatarsophalangeal (MTP) joint in three planes. Displacement in the coronal plane results in axial rotation of the first metatarsal, with progressive subluxation of the first MTP joint. Multiple techniques have been described to correct the malrotation itself.

Ultrasound Examination of the Ligament Complex Within the Medial Aspect of the Ankle and Foot.

To properly diagnose and treat injuries to the ankle or foot, the physician must have good anatomical knowledge of the ligaments involved. The bundles can be distinguished and identified by ultrasound examination of the medial aspect, but this may be a challenging task. In the present illustrated study, we discuss how a detailed ultrasound examination can be made of the different ligaments within the medial aspect of the ankle and foot.

Management of Ankle Charcot Neuroarthropathy: A Systematic Review.

Background: Charcot neuroarthropathy is a non-infective, destructive process occurring in patients rendered insensate by peripheral neuropathy, which is caused mainly by diabetes. Repetitive trauma from standing and walking provides a neuro-traumatic stimulus that leads to dislocation, or peri-articular fracture, or both, within the ankle. This review concentrates on the management protocols regarding the ankle only.

Conservative Treatment of Ankle Osteoarthritis.

Despite the disabling nature of ankle osteoarthritis (OA), there is poor scientific evidence for a conservative treatment compared to the hip and knee OA. In this regard, most of the treatment options in use are not based on clinical studies of the ankle, and they are extracted from evidence obtained from clinical studies of other lower limb joints. However, this does not seem to be a good idea, since the aetiology of ankle OA is quite different from that of the hip or knee.

Ankle Osteoarthritis Aetiology.

Ankle osteoarthritis affects 1% of the population and, unlike gonarthrosis or coxarthrosis, is secondary to previous trauma in more than 75% of cases. Another peculiarity of this disease is that it affects a younger and active population, with socio-occupational implications. Mechanical factors, such as incongruity, instability, malalignment, and impacts, which increase stress on isolated areas of the ankle cartilage, have been clearly associated with the development of osteoarthritis.

Analysis of the uninjured tibiofibular syndesmosis using conventional CT-imaging and axial force in different foot positions.

Background: Syndesmosis measurments and indices have been controversial and showed interindividual variability. The purpose of this study was to analyze, by conventional axial computed tomography images and a simulated load device, the uninjured tibiofibular syndesmosis under axial force and forced foot positions.

Methods: A total of 15 healthy patients (30 ankles) were studied using adjustable simulated load device (ASLD).

Functional results and quality of life after joint preserving or sacrificing surgery in Charcot-Marie-Tooth foot deformities.

Introduction: The purpose of this study was to assess the functional results, quality of life, and complications in two groups of Charcot-Marie-Tooth (CMT) patients according to the type of surgical operations, joint preserving, or joint sacrificing surgery.

Methods: Fifty-two feet in forty-six patients with CMT who had undergone surgical deformity correction were divided into two groups based on the main surgical procedure for the correction: Class I (joint preserving surgery) and class II (joint sacrificing surgery). Foot ankle disability index (FADI) and short form 12 version 2 (SFV were documented pre-operative and 12 months post-operative.

Protective Approach for Anatomical Structures at Risk in Total Ankle Replacement.

Currently, total ankle replacement (TAR) is an alternative to arthrodesis in selected patients, with the anterior approach being the most widely used to carry it out. Regardless of the type of implant used, the pins for bone resection guides, chisels, and the saw for distal tibial resection can endanger the neurovascular and tendon structures that lie in intimate proximity to the posterior aspect of the ankle. Additionally, there is a documented complication rate of up to 15.