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Clinical Advancements in Foot and Ankle Surgery

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

Deadline for manuscript submissions: 28 August 2025 | Viewed by 3796

Special Issue Editor


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Guest Editor
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
Interests: foot and ankle disease; deformity; fracture; diabetic foot

Special Issue Information

Dear Colleagues,

Foot and ankle related problems are increasing as socioeconomic status develops. The complex structure of the foot and ankle consists of 28 bones, 33 joints and 112 ligaments, controlled by 13 extrinsic and 21 intrinsic muscles. In addition to just the anatomical features of the musculoskeletal system, dynamic biomechanics related to gait must be considered. It is the part that is most easily injured while walking or exercising, and its relationship with shoes must also be considered. In addition, as it is the most distant part of our body, it is prone to ischemic conditions, which can easily become a problem in the diabetic foot. It is the most distal part of the nerve distribution and is prone to neuropathic pain and problems.

In this Special Issue, we welcome authors to submit articles about the debatable topic of forefoot deformity, hindfoot biomechanics, ankle fracture, ligament injury, diabetic foot, flat foot and arthritis.

In this Special Issue, we hope to add to the research and treatment of foot and ankle problems by updating the knowledge and ideas which are still debated.

Prof. Dr. Ho-seong Lee
Guest Editor

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Keywords

  • flat foot
  • hindfoot motion
  • diabetic foot
  • hallux valgus
  • foot infection

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Published Papers (4 papers)

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Research

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11 pages, 1969 KiB  
Article
Which Measuring Method Is Better for Reflecting Subtalar Joint Stiffness?
by You-Keun Kim, Myoungyeol Shin, Jaehyeon Seo, Sun-Kyoung Lee and Ho-Seong Lee
J. Clin. Med. 2025, 14(6), 1887; https://doi.org/10.3390/jcm14061887 - 11 Mar 2025
Viewed by 486
Abstract
Background/Objectives: A standard method for the measurement of subtalar joint motion has yet to be developed. This study aimed to determine which of the two methods (AMA and modified McBride) for the measurement of subtalar joint motion better reflects subtalar joint stiffness. [...] Read more.
Background/Objectives: A standard method for the measurement of subtalar joint motion has yet to be developed. This study aimed to determine which of the two methods (AMA and modified McBride) for the measurement of subtalar joint motion better reflects subtalar joint stiffness. Methods: We evaluated the intraobserver and interobserver reliability and validity of the two methods in the normal group (n = 50) and the patient group (n = 90; 30 with normal hindfoot, 30 with ankle joint pathology, and 30 with subtalar joint pathology). We assessed the intraclass correlation coefficient (ICC) and receiver operating characteristic (ROC) curve for statistical analysis. Results: In the normal group, the intraobserver reproducibility and interobserver reliability of the AMA method were better than those of the modified McBride method. In the hindfoot patient group, both methods showed excellent interobserver reliability (ICC > 0.75). The results of the ROC curve also indicated that the modified McBride method (AUC: 0.919, 0.813) was better than the AMA method (AUC: 0.715, 0.749) in reflecting subtalar joint stiffness. Conclusions: In patients with subtalar joint lesions, the modified McBride method had a relatively better validity and was more appropriate than the AMA method for measuring the stiffness of the subtalar joint. Full article
(This article belongs to the Special Issue Clinical Advancements in Foot and Ankle Surgery)
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12 pages, 1893 KiB  
Article
The Modified Broström Procedure with Suture-Tape Augmentation for Chronic Lateral Ankle Instability
by Byung-Ki Cho and Sung-Hoo Kim
J. Clin. Med. 2025, 14(5), 1683; https://doi.org/10.3390/jcm14051683 - 2 Mar 2025
Viewed by 929
Abstract
Background/Objectives: As a representative anatomic ankle ligament repair technique, the Broström procedure continues to be modified to reach better clinical outcomes, superior mechanical stability, early rehabilitation, and minimal risk of recurrent instability. This study aimed to evaluate the intermediate-term clinical outcomes after [...] Read more.
Background/Objectives: As a representative anatomic ankle ligament repair technique, the Broström procedure continues to be modified to reach better clinical outcomes, superior mechanical stability, early rehabilitation, and minimal risk of recurrent instability. This study aimed to evaluate the intermediate-term clinical outcomes after the modified Broström procedure (MBP) with suture-tape augmentation for chronic lateral ankle instability. Methods: Ninety-four patients with chronic lateral ankle instability were followed for ≥3 years after MBP augmented with suture tape. The patient-reported clinical outcomes were evaluated with the Foot and Ankle Outcome Score (FAOS) and the Foot and Ankle Ability Measure (FAAM). The changes in mechanical ankle stability were evaluated with physical examination and periodic stress radiography. The changes in static and dynamic postural control ability were assessed with the single-leg stance test and Biodex posturography. Results: FAOS and FAAM scores significantly improved from preoperative means of 52.6 and 54.2 points to 91.8 and 90.5 points at final follow-up, respectively (p < 0.001). Talar tilt angle and anterior talar translation significantly improved from preoperative means of 15.4° and 14.3 mm to 2.7° and 4.5 mm at final follow-up, respectively (p < 0.001). Two patients (2.1%) complained of a recurrence of mechanical and functional instability. One patient (1.1%) showed non-specific inflammation related to a suture tape. Balance retention time significantly improved from a preoperative mean of 3.7 to 6.4 s at final follow-up (p < 0.001), with a non-significant side-to-side difference. The overall stability index significantly improved from a preoperative mean of 3.7 to 1.9 at final follow-up (p < 0.001), with a significant side-to-side difference. Conclusions: The MBP augmented with suture tape appears to be an effective surgical technique for chronic lateral ankle instability. Through anatomic repair of attenuated ankle ligaments and suture-tape augmentation, this modified procedure can provide reliable stability and minimal risk of recurrent instability. In addition, static and dynamic postural control ability may be improved through continuous proprioceptive-oriented rehabilitation following surgery. Full article
(This article belongs to the Special Issue Clinical Advancements in Foot and Ankle Surgery)
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9 pages, 2780 KiB  
Article
Morphology of the Calcaneofibular Ligament Reflects Degeneration of the Talonavicular Articular Surface: A Cadaver Study
by Ryuta Tanaka, Daisuke Kiyoshima, Kaori Suyama, Ning Qu, Miyu Inagawa and Shogo Hayashi
J. Clin. Med. 2024, 13(24), 7565; https://doi.org/10.3390/jcm13247565 - 12 Dec 2024
Viewed by 1030
Abstract
Background: Osteoarthritis is caused by damage to the articular cartilage due to bone-on-bone collisions and friction. The length, width, and thickness of the ligaments are expected to change in order to regulate excessive bone-to-bone movement. We aimed to clarify the relationship between ligament [...] Read more.
Background: Osteoarthritis is caused by damage to the articular cartilage due to bone-on-bone collisions and friction. The length, width, and thickness of the ligaments are expected to change in order to regulate excessive bone-to-bone movement. We aimed to clarify the relationship between ligament morphology and joint surface degeneration in the ankle joints using macroscopic observations and measurements. Methods: The participants were 50 feet of 45 Japanese cadavers. The lengths, widths, and thicknesses of the tibionavicular, tibiospring, tibiocalcaneal, posterior tibiotalar, anterior tibiotalar, and calcaneofibular ligaments (CFLs) were measured. The degeneration of the talonavicular joint surface was investigated macroscopically and classified into two groups: the Degeneration (+) group and Degeneration (−) group. Unpaired t-tests were performed for each measurement. Logistic regression analysis was performed on the significantly different items to obtain cutoff values, sensitivity, and specificity. Results: Only the width of the CFL differed significantly between the Degeneration (+) (20 feet) and Degeneration (−) groups (p < 0.001). In the logistic regression analysis, the width of the CFL had an R2 of 0.262, sensitivity of 75.0%, and specificity of 83.3%, with a cutoff value of 8.7 mm. Conclusions: A wide CFL indicates a high likelihood of talonavicular articular surface degeneration. Full article
(This article belongs to the Special Issue Clinical Advancements in Foot and Ankle Surgery)
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17 pages, 1601 KiB  
Systematic Review
A Multi-Dimensional Systematic Review of Minimally Invasive Bunion Surgery (MIBS)
by Danielle Lonati, Ewan Kannegieter and Douglas McHugh
J. Clin. Med. 2025, 14(8), 2757; https://doi.org/10.3390/jcm14082757 - 17 Apr 2025
Viewed by 785
Abstract
Background/Objectives: Hallux valgus, or a bunion, is a prevalent foot deformity associated with pain, limited mobility, and reduced quality of life. Surgical treatments include minimally invasive and traditional open techniques, but the optimal approach remains debated. This systematic review evaluates long-term outcomes, [...] Read more.
Background/Objectives: Hallux valgus, or a bunion, is a prevalent foot deformity associated with pain, limited mobility, and reduced quality of life. Surgical treatments include minimally invasive and traditional open techniques, but the optimal approach remains debated. This systematic review evaluates long-term outcomes, patient satisfaction, cost-effectiveness, the influence of patient-specific factors, rehabilitation protocols, and complication rates for these methods. Methods: A comprehensive search of PubMed, Medline, EMBASE, and Cochrane databases identified 22 studies published within the last 15 years, each with a minimum follow-up of 2 years. The systematic review adhered to PRISMA-ScR guidelines. Eligible studies reported on at least one of six key outcomes, and data were extracted on radiographic and clinical results, patient satisfaction, costs, rehabilitation timelines, and adverse events. Results: Minimally invasive bunion surgery (MIBS) showed faster recovery, higher patient satisfaction, and improved quality of life compared to open surgery. Radiographic outcomes, including hallux valgus and intermetatarsal angle correction, were durable, though outcomes were less consistent for severe deformities. MIBS was more cost-effective over time, owing to shorter operating times and faster recovery. Rehabilitation was accelerated, and wound complications were fewer with MIBS. However, open techniques remained preferable for severe deformities due to their reliability in complex corrections. Conclusions: MIBS offers substantial advantages for most patients undergoing bunion surgery, including faster recovery and fewer complications. However, open techniques may be better suited for severe deformities. Further research is needed to refine patient selection criteria and evaluate long-term outcomes in diverse populations. Full article
(This article belongs to the Special Issue Clinical Advancements in Foot and Ankle Surgery)
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