The objective of this study was to find the effect of hallux valgus (HV) deformity on the inter-segmental motion of the foot using an MFM with a 15-marker set (DuPont Foot Model, DuFM) in comparison with age and sex controlled healthy adults. Fifty-eight female symptomatic HV patients and 50 female asymptomatic older female volunteers were included in this study. According to the radiographic hallux valgus angle (HVA), the study population was divided into severe HV (SHV, HVA ≥ 40°, n = 25), moderate HV (MHV, 20°≤ HVA < 40°, n = 47), and control (CON, n = 36). MHV group was divided into symptomatic MHV group (S-MHV, n = 33) and asymptomatic MHV group (A-MHV, n = 14) according to the symptoms associated with HV. For temporal parameters, gait speed and stride length were diminished according to the severity of HV deformity. Sagittal range of motion of hallux and hindfoot decreased significantly in SHV group. Loss of push-off during the preswing phase was observed and forefoot adduction motion during terminal stance was decreased in SHV group. In a subgroup analysis of MHV, asymptomatic HV minimally affects gait and inter-segmental motion during gait. HV deformity affects gait parameters and inter-segmental motion of the foot during gait in proportion to the severity of the deformity. However, the effect of MHV itself on foot kinematics might be limited while pain or arthritic change of the joint might cause changes in gait in patients with symptomatic HV.

The nature of implant-related infections is complex. Currently, there is no definitive test for periprosthetic joint infection (PJI) and diagnosis remains challenging despite recent developments. Failure to diagnose and investigate pathologies of the hip appropriately results in delayed management and prolonged patient morbidity. A systematic approach to establishing clear diagnostic criteria for PJI is needed to improve our ability to avoid devastating outcomes associated with these infections. In the current review, we describe an algorithmic approach to the diagnosis of PJI and current controversies surrounding novel diagnostic methods.

Accessory bones and tarsal coalitions are the most common developmental variations in the foot and ankle. Accessory bones are usually derived from unfused primary or secondary ossification centers and may exist adjacent to the main bone where they are separated. 1) Tarsal coalitions are abnormal connections of two or more tarsal bones and are regarded as the results of impaired mesenchymal separation of the tarsal bones. 2,3) They can be divided into os-seous (synostosis), fibrous (syndesmosis), or cartilaginous (synchondrosis) connections. 4) Although accessory bones and tarsal coalitions may be present at birth, individuals with accessory bones or tarsal coalitions can be asymptomatic; therefore, these might not be noticed until an incidental radiographic examination reveals their presence. However, some conditions, such as talocalcaneal coalition, calcaneonavicular coalition, os subfibulare, os trigonum, and os naviculare, can cause pain around the foot and ankle and require clinical interventions. Symphalangism of the toe, also known as the biphalangeal toe, is an uncommon condition characterized by fusion of interphalangeal joints. Toe symphalangism has been evaluated in several studies and has been shown as the most common variant resulting from incomplete segmentation rather than pha

High tibial osteotomy (HTO) is a well-established treatment for medial compartment knee osteoarthritis (OA), which shifts the weight-bearing axis from the medial to the lateral side of the knee. As the adjacent ankle joint may be directly affected by the change in biomechanics, this study aimed to evaluate the change in the intersegmental foot and ankle motion after HTO in patients with genu varum. The study SUPPORTING INFORMATION

The transfibular approach is a common procedure for tibiotalar fusion. However, this technique has several concerns: inadequate stability to resist rotational and shearing forces, a fibula is suboptimal for bone grafting, and an onlay fibular graft that might prevent impacting and cause distraction. We present a modified transfibular technique using partial fibular resection and onlay bone graft, which may address these potential problems. This study aimed to evaluate whether the ankle joint is well fused with neutral alignment and functionally improved at the final follow-up. For this study, 27 consecutive patients (mean age, 68.5 years; range, 58–83) who underwent tibiotalar fusion with a follow-up period of >1 year were retrospectively included. A modified transfibular lateral approach was performed, in which the distal anterior half fibula was resected and fixed as an onlay graft to achieve fusion between the tibia, fibula, talus, and fibular onlay graft simultaneously. Radiographic outcomes were assessed using computed tomography at 4 months after operation and serial follow-up radiographs. Functional outcomes were assessed using the American Orthopedic Foot and Ankle Society hindfoot scale and Foot and Ankle Outcome Score. The mean follow-up period was 17.3 (range, 12–32) months. Four months after operation, complete union was achieved in 13 patients, near-complete union in 8 patients, and partial union in the remaining 6 patients. At the final follow-up, all the patients achieved complete union and maintained neutral ankle alignment. The functional outcome showed a significant increase between the preoperative and postoperative periods. One minor complication occurred, in which medial side ankle pain was relieved after screw removal. This modified technique is safe and effective, and has several merits, including saving the soft tissue of the anterior ankle, saving the course of the peroneal tendons by leaving the posterior half of the fibula, resected fibula serving as a good bone stock, and reducing the likelihood of valgus deformity after fibulectomy.