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Medicina
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Advances in Foot and Ankle Surgery
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Advances in Foot and Ankle Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 1 August 2025 | Viewed by 8824

Special Issue Editors

Prof. Dr. Alfonso Martínez-Nova

E-Mail Website
Guest Editor
Nursing Department, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain
Interests: foot and ankle pathology; sports injuries; rheumatic diseases; rheumatic diseases; foot surgery; thermography
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Gabriel Gijón-Noguerón

E-Mail Website
Guest Editor
Department Nursing and Podiatry, Universidad de Malaga, Malaga, 29100 Spain
Interests: foot and ankle pathology; sports injuries; rheumatic diseases; badminton; pediatric podiatry; application of VR in teaching and clinical practice
Special Issues, Collections and Topics in MDPI journals
Dr. Eva Lopezosa-Reca

E-Mail Website
Guest Editor Assistant
Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga. Arquitecto Francisco Peñalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain
Interests: foot and ankle pathology; sports injuries; rheumatic diseases; application of VR in teaching and clinical practice
Dr. Javier Ferrer-Torregrosa

E-Mail Website
Guest Editor Assistant
Universidad Católica de Valencia San Vicente Mártir., Valencia, Spain
Interests: podiatric surgery; new surgical techniques; 3D printing using fused deposition of orthopodiatric and/or surgical products and their effects on the patient; health promotion and prevention; augmented reality; application of AR in teaching and clinical practice

Special Issue Information

Dear Colleagues,

This Special Issue, entitled "Advances in Foot and Ankle Surgery", aims to present a comprehensive overview of the latest developments and innovative techniques in this field. This collection of articles aims to highlight significant progress being made in both surgical procedures and postoperative care, aimed at enhancing patient outcomes and recovery times. Key topics include minimally invasive surgery, advanced imaging techniques, and the use of biologics in healing. This Special Issue also aims to explore novel approaches to complex conditions such as diabetic foot complications, ankle arthritis, and sports-related injuries. Emphasis is placed on interdisciplinary collaboration, combining expertise from orthopedic surgeons, podiatrists, and rehabilitation specialists to deliver holistic care. Additionally, case studies that provide practical insights into the application of new technologies and methods in real-world settings are welcome to be submitted to this Special Issue. Through rigorous research and clinical trials, these contributions underscore the importance of continuous innovation and evidence-based practices in advancing foot and ankle surgery. This Special Issue aims to serve as a valuable resource for clinicians, researchers, and medical professionals dedicated to improving standards of care in this specialized area of orthopedics.

We invite you to contribute to this Special Issue, entitled "Advances in Foot and Ankle Surgery", which will present the latest developments and innovative techniques in this field. Your participation is essential to this Special Issue’s success to highlight advances in surgical procedures and postoperative care, improving patient outcomes and recovery times. Join us in sharing your expertise and contributing to an interdisciplinary collaboration that elevates the standards of care in this specialized area of orthopedics. We look forward to receiving your valuable contributions.

Prof. Dr. Alfonso Martínez-Nova
Prof. Dr. Gabriel Gijón-Noguerón
Guest Editors

Dr. Eva Lopezosa-Reca
Dr. Javier Ferrer-Torregrosa
Guest Editor Assistants

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • foot and ankle
  • surgery
  • advances
  • foot surgery
  • pre–post-surgical rehabilitation
  • minimally invasive techniques
  • comparison of surgical techniques
  • innovative surgical procedures
  • rehabilitation methods
  • functional results

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Published Papers (5 papers)

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Research

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10 pages, 1490 KiB  
Article
Surgical Precision of MICA and Reverdin-Isham Using 3D-Printed Guides: A Cadaveric Study
by Nadia Fernández-Ehrling, Eduardo Nieto-García, Leonor Ramirez-Andrés, Elena Nieto-González, Carlos Barrios, Sergio García-Vicente and Javier Ferrer-Torregrosa
Medicina 2024, 60(10), 1613; https://doi.org/10.3390/medicina60101613 - 2 Oct 2024
Cited by 1 | Viewed by 1343
Abstract
Background/Objectives: Hallux valgus is a common foot deformity that requires surgical correction to restore proper alignment. Precision in the osteotomies performed during these surgeries is critical to avoid complications and improve outcomes. However, variability in surgeon experience can negatively affect precision. In [...] Read more.
Background/Objectives: Hallux valgus is a common foot deformity that requires surgical correction to restore proper alignment. Precision in the osteotomies performed during these surgeries is critical to avoid complications and improve outcomes. However, variability in surgeon experience can negatively affect precision. In this context, advances in 3D printing have enabled the development of customized surgical guides, which may enhance precision and reduce variability among surgeons with different levels of expertise. This study aims to evaluate the effectiveness of a 3D-printed surgical guide in minimally invasive hallux valgus correction, focusing on the accuracy of osteotomies performed by novice surgeons, experienced surgeons, and theoretically trained consultants. Methods: An ex vivo study was performed with 30 cadaveric feet, divided into three groups according to the level of experience of the surgeons: 3D guide group, Master’s students, professionals. All surgeons performed Akin and Reverdin-Isham osteotomies, but the experimental group (the 3D guide group) utilized a customized 3D-printed surgical guide for enhanced precision during these procedures. Radiographic measurements of osteotomy angles and alignment were taken after the interventions, and compared with the planned values. Statistical analyses were conducted to evaluate the variability in the precision of the cuts. Results: The use of the 3D-printed surgical guide significantly reduced angular variability in the experienced group, achieving higher levels of accuracy than experienced surgeons. Effect sizes, which ranged from small to large, indicated a greater impact on angle measurements (η2 = 0.46, p < 0.001); no significant differences were found between the groups in other evaluated parameters. Conclusions: The incorporation of 3D-printed surgical guides in hallux valgus surgery significantly improves osteotomy accuracy, particularly in less experienced surgeons. This suggests that these guides can help standardize procedures, reduce the learning curve, and lower intraoperative complications. Full article
(This article belongs to the Special Issue Advances in Foot and Ankle Surgery)
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Review

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17 pages, 1036 KiB  
Review
Avascular Necrosis of the Talus: Diagnosis, Treatment, and Modern Reconstructive Options
by Michał Jan Kubisa, Marta Gabriela Kubisa, Karol Pałka, Jakub Sobczyk, Filip Bubieńczyk and Paweł Łęgosz
Medicina 2024, 60(10), 1692; https://doi.org/10.3390/medicina60101692 - 15 Oct 2024
Cited by 3 | Viewed by 4503
Abstract
Talar avascular necrosis (AVN) is a devastating condition that frequently follows type III and IV talar neck fractures. As 60% of the talus is covered by hyaline cartilage, its vascular supply is limited and prone to trauma, which may eventually lead to AVN [...] Read more.
Talar avascular necrosis (AVN) is a devastating condition that frequently follows type III and IV talar neck fractures. As 60% of the talus is covered by hyaline cartilage, its vascular supply is limited and prone to trauma, which may eventually lead to AVN development. Early detection of AVN (Hawkins sign, MRI) is crucial, as it may prevent the development of the irreversible stages III and IV of AVN. Alertness is advised regarding non-obvious conditions that may cause this complication (sub chondroplasty, systemic lupus erythematosus, diabetes mellitus). Although, in stages I–II, AVN may be treated with non-surgical procedures (ESWT therapy, non-weight bearing) or joint-sparing techniques (core drilling, bone marrow aspirate injections), stages III–IV require more advanced procedures, such as joint-sacrificing procedures (hindfoot arthrodesis/ankle arthrodesis), or replacement surgery, including total talar replacement (TTR) or combined total ankle replacement (TAR). The advancement of 3D-printing technology and increased access to implant manufacturing are contributing to a rise in the production rates of third-generation total talar prostheses. As a result, there is a growing frequency of alloplasty procedures and combined total ankle replacement (TAR) surgeries. By performing TTR as opposed to deses, the operator avoids (i) delayed union, (ii) a shortening of the limb, (iii) a lack of mobility, and (iv) the stiffening of adjacent joints, which are the main disadvantages of joint-sacrificing procedures. Simultaneously, TTR and combined TAR offer (i) a brief period of weight-bearing restriction, (ii) quick pain relief, and (iii) preservation of the length of the limb. Here, we summarize the most up-to-date knowledge regarding AVN diagnosis and treatment, with a special focus on the role of TTR. Full article
(This article belongs to the Special Issue Advances in Foot and Ankle Surgery)
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Other

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12 pages, 578 KiB  
Systematic Review
Efficacy and Safety of Different Local Anesthesia Techniques in Podiatric Procedures
by Bibiana Trevissón Redondo, Nathael Lago García, Rubén García Fernández, Hector Pereiro Buceta, Roi Painceira Villar, Alberto Gonzalez Garcia, David Bermejo Martínez, Natalia Calvo Ayudo and Enedina Quiroga-Sánchez
Medicina 2025, 61(4), 588; https://doi.org/10.3390/medicina61040588 - 25 Mar 2025
Viewed by 675
Abstract
Background and Objectives: Local anesthesia is essential in podiatry, ensuring painless procedures. Technological and pharmacological advances require us to stay updated on the safest and most effective techniques. Lidocaine and bupivacaine are common anesthetics in this field, with the choice of technique tailored [...] Read more.
Background and Objectives: Local anesthesia is essential in podiatry, ensuring painless procedures. Technological and pharmacological advances require us to stay updated on the safest and most effective techniques. Lidocaine and bupivacaine are common anesthetics in this field, with the choice of technique tailored to each procedure. To evaluate the effectiveness and safety of local anesthesia techniques in reducing pain in podiatric procedures. Materials and Methods: A systematic review followed PRISMA guidelines, searching for studies in PubMed, Scopus, and Web of Science published in the last 10 years in English and Spanish. Studies focused on local anesthesia in podiatry were included, excluding those unrelated or without validated results. Results: Of 485 initial studies, nine were selected that met all criteria. These studies demonstrated the efficacy and safety of various local anesthesia techniques, such as WALANT and ultrasound-guided peripheral nerve blocks, highlighting their effectiveness in pain control and patient satisfaction. Conclusions: Local anesthesia techniques are effective in reducing pain in podiatric procedures. The safety of these techniques is high, with few serious complications. Local anesthesia without a tourniquet and specific techniques, such as subparaneural injection, are effective for pain control. Individual patient factors and surgeon experience influence results. Full article
(This article belongs to the Special Issue Advances in Foot and Ankle Surgery)
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8 pages, 1541 KiB  
Case Report
One-Stage Technique with Calcaneal Graft for the Treatment of Brachymetatarsia: A Case Report
by Mercedes Ortiz-Romero, Álvaro Fernández-Garzón, Rocío Caceres-Matos, Raquel García de la Peña, Ana M. Rayo-Perez and Luis M. Gordillo-Fernández
Medicina 2025, 61(3), 497; https://doi.org/10.3390/medicina61030497 - 13 Mar 2025
Viewed by 784
Abstract
Brachymetatarsia is a rare congenital anomaly characterized by the shortening of one or more metatarsals, which can lead to functional impairment, pain, and aesthetic concerns. This case report describes a 17-year-old female patient with brachymetatarsia affecting the third and fourth metatarsals of the [...] Read more.
Brachymetatarsia is a rare congenital anomaly characterized by the shortening of one or more metatarsals, which can lead to functional impairment, pain, and aesthetic concerns. This case report describes a 17-year-old female patient with brachymetatarsia affecting the third and fourth metatarsals of the right foot, which was unresponsive to conservative treatment and caused persistent pain while standing. To address this condition, a single-stage surgical approach was performed using an autologous calcaneal bone graft to lengthen the affected metatarsals. Additionally, the second and fifth metatarsals were shortened to restore a physiological metatarsal parabola and resolve chronic metatarsalgia. The procedure resulted in complete correction of the metatarsal parabola, full resolution of metatarsal pain, and satisfactory functional recovery. The use of an autologous calcaneal graft proved to be an effective and reliable surgical option due to its cortico-cancellous composition, high osteogenic potential, and low antigenicity. This case highlights the advantages of autologous bone grafting as a valuable technique in the surgical management of brachymetatarsia. Full article
(This article belongs to the Special Issue Advances in Foot and Ankle Surgery)
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21 pages, 7603 KiB  
Systematic Review
Proximal Articular Set Angle Correction with the Reverdin–Isham Osteotomy in Mild and Moderate Hallux Valgus: A Systematic Review and Meta-Analysis
by Diego Mosquera-Canosa, Eduardo Nieto-García, Óscar Álvarez-Calderón-Iglesias, Rubén García-Fernández, Miguel López-Vigil, Hector Pereiro-Buceta, Roi Painceira-Villar, Natalia Calvo-Ayuso and Bibiana Trevissón-Redondo
Medicina 2025, 61(3), 406; https://doi.org/10.3390/medicina61030406 - 26 Feb 2025
Viewed by 994
Abstract
Background and Objectives: The Reverdin–Isham osteotomy via minimal incision is a prominent option for the surgical treatment of hallux valgus, a foot deformity characterized by medial deviation of the first metatarsal and lateral deviation of the first toe. This technique is particularly indicated [...] Read more.
Background and Objectives: The Reverdin–Isham osteotomy via minimal incision is a prominent option for the surgical treatment of hallux valgus, a foot deformity characterized by medial deviation of the first metatarsal and lateral deviation of the first toe. This technique is particularly indicated for cases with an elevated proximal articular angle, enabling effective correction and improved foot functionality. However, its efficacy has not been fully established in the scientific literature. Objective: The main objective of this analysis was to evaluate the correction of radiological angles (PASA, IMA, and HVA), the improvement in functionality according to the AOFAS scale, pain reduction, and patient satisfaction. Materials and Methods: A systematic review was conducted following the PRISMA guidelines in scientific databases such as PubMed, Scopus, and Web of Science, assessing publication biases and heterogeneity. Ten studies were included, covering 579 procedures in 500 patients, with an average follow-up of 33.8 months. Results: The results did not show significant improvements in the PASA (p = 0.14; CI [−1.52, 0.32]), not in the AIM (p = 0.05; CI [−2.63, 0.02]), although the meta-regression was statistically significant (p = 0.0022) with a ratio of 61.2%. It did show significant improvements in the AHV (p = 0.0009; CI [−3.14, −1.33]). An increase of 37.4 points in the AOFAS scale was revealed, and a 5.4-point reduction in pain. Patient satisfaction was high, with 89.3% of patients satisfied and 94.7% willing to undergo the procedure again. However, 20 major complications were reported, primarily recurrences. Conclusions: The Reverdin–Isham osteotomy is a safe and effective technique for treating mild-to-moderate hallux valgus. It offers significant improvements in foot functionality and pain reduction, with high patient satisfaction rates. Although recurrences remain the main complication, their low frequency reinforces the validity of the technique as a surgical option for specific deformities. Full article
(This article belongs to the Special Issue Advances in Foot and Ankle Surgery)
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