Medial ankle sprains have a very low incidence (5% of ankle ligament injuries), and most of the time, the first structure involved is the deltoid ligament complex. However, other structures, such as the spring ligament, posterior tibial tendon, and flexor retinaculum, can also get damaged. A 32-year-old man who had an ankle sprain while performing sports activities showed magnetic resonance imaging findings compatible with a detachment of the flexor retinaculum and medial dislocation of the posterior tibial tendon. Surgical intervention was suggested to this patient; deepening of the medial retromalleolar groove and reattaching of the retinaculum were performed. It is very important to consider this rare injury after a medial ankle sprain and to think out of the box, not always assuming a deltoid ligament lesion. Level of Evidence V; Therapeutic Studies; Expert Opinion.

Background: Ankle hemiarthroplasty is a 1-piece implant system replacing the talar side of the tibiotalar joint. Hemiarthroplasty offers limited bone resection and may provide easier revision options than joint-ablating procedures. Methods: Prospective, multicenter, noncomparative, nonrandomized clinical study with short term follow-up on patients undergoing hemiarthroplasty of the ankle. Radiologic and functional outcomes (Foot and Ankle Outcome Score FAOS, Foot and Ankle Ability Measure [FAAM], Short Form–36 Health Survey [SF-36], Short Musculoskeletal Functional Assessment [SMFA], and visual analog scale [VAS] pain scores) were obtained at 3 and 12 months and the last follow-up (mean 31.9 months). Results: Ten patients met the inclusion criteria. Three were converted to total ankle replacement at 14, 16, and 18 months. Pain VAS scores improved on average from 6.8 to 4.8 ( P = .044) of the remaining 7 at a mean of 31.9 months’ follow-up. For these 7 in the Survival Group, we found that SF-36 physical health component improved from 25.03 to 42.25 ( P = .030), SMFA dysfunction and bother indexes improved from 46.36 to 32.28 ( P = .001), and from 55.21 to 30.14 ( P = .002) in the Survival Group, and FAAM sports improved from 12.5 to 34.5 ( P = .023). Conclusion: Patients undergoing hemiarthroplasty of the ankle joint for talar-sided lesions had a 30% failure rate by 18 months. Those who did not have an early failure exhibited modest pain reduction, functional improvements, and better quality of life in short-term follow-up. This procedure offers a possible alternative for isolated talar ankle cartilage cases. Level of Evidence: Level IV, prospective case series.

Objective: Our objective was to compare foot width (bony and soft tissues) in radiological images pre- vs. post-corrective scarf osteotomy in patients with hallux valgus. Methods: We retrospectively performed measurements of forefoot width (both bony diameter and total diameter including soft tissues) on anterior posterior standard radiographs of 30 patients, totaling 42 feet, pre- and postoperatively, at three months. These measurements were performed by two evaluators and their reliability was calculated. Results: Radiologically, preoperative mean of the 1-5 metatarsal bony width was 89.30mm (SD ± 5.8), reduced to 80.42mm postoperatively (SD ± 3.5; p<0.001). Regarding the soft tissue width, preoperative mean was 102.45mm (SD ± 6.4) and postoperative, 98.3mm (SD ± 5.1; p<0.001). The interclass correlation coefficient between both observers was excellent in most measurements (range, 0.884-0.973). Conclusion: We report an objective reduction in forefoot width, in both bony and soft tissue diameter, finding means of 8.88 mm (10%) and 4.12mm (4.1%), respectively, after scarf-Akin osteotomy. Level of Evidence IV; Case Series.

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Hallux saltans is a rare condition characterized by an entrapment of the flexor hallucis longus. Its tendon passes through the retromalleolar groove below the flexor retinaculum, directing the plantar aspect of the foot through a fibro-osseous tunnel below the sustentaculum tali. This study presents a young active patient without any of the conditions or etiological agents previously described in the literature that could explain the cause of this rare condition. After failing conservative treatments, an arthroscopic release of the tendon and the fibrous tunnel was performed, achieving direct visualization and minimal soft tissue injury. At six month follow-up, the patient resumed sports and daily living activities without symptoms. Level of Evidence V; Therapeutic Studies; Expert Opinion.