UNASSIGNED: Ankylosing spondylitis (AS) is a chronic, inflammatory, and autoimmune disease. This condition primarily affects the axial skeleton and presents direct foot involvement, such as Achilles enthesitis or plantar fascia involvement.
UNASSIGNED: This study aimed to investigate the impact of foot health on the quality of life of individuals with AS compared to a control group without AS.
UNASSIGNED: A sample of 112 subjects was recruited, with a mean age of 46.80 ± 10.49 years, divided into two groups: 56 individuals with AS (cases) and 56 individuals without AS (controls). Demographic data were collected, and the scores obtained in the Foot Health Status Questionnaire domains were recorded.
UNASSIGNED: Of the participants, 27.79% (N = 30) were men and 73.21% (N = 82) were women. The mean age in the group was 46.80 ± 10.49. Significant differences (p < 0.05) were found in the domains of foot function, foot pain, footwear, overall foot health, general health-related physical activity, and social capacity between the AS group and the control group.
UNASSIGNED: Individuals with AS exhibited a decreased quality of life, as indicated by their Foot Health Status Questionnaire scores.

UNASSIGNED: Neuropathic osteoarthropathy of the foot and ankle (Charcot foot) is a disease that can lead to progressive malpositioning and deformation up to complete collapse of the foot. In most cases, diabetic polyneuropathy is the underlying disease, but polyneuropathy of any cause can lead to neuropathic osteoarthropathy. Pathogenesis is still not completely understood. Due to the non-specific clinical presentation, the symptoms of Charcot arthropathy are generally easily misdiagnosed and proper therapy is delayed, especially in patients with an underlying disease other than diabetes mellitus. To date, published literature on patients with rheumatoid arthritis who develop neuropathic osteoarthropathy of the foot is scarce.
UNASSIGNED: We present a rare case of a 61-year-old patient with Charcot foot and rheumatoid arthritis. The patient presented with an extreme foot deformity after a failed conservative treatment. The surgical procedures, complications, and outcome are described. The pitfalls in this special patient group are highlighted.
UNASSIGNED: If necessary, a variety of surgical options are available to maintain ambulation and prevent infection from open ulcers and amputation. For surgical management of patients with rheumatoid arthritis, the overall statics of the lower extremity and the influence of antirheumatic drugs must be considered.

We present a 21-year-old female with a previously known myelomeningocele who underwent myelomeningocele repair 10 years ago. She presented to the orthopedic outpatient clinic with bilateral calcaneovalgus deformity, causing non-healing ulcers and multiple hospitalizations for pressure ulcers, cellulitis, and osteomyelitis. She had successful tibialis anterior transfer surgery on her right foot six years ago. The patient arrived for treatment of her left foot deformity to underwent three hours of surgery that was uneventful without any complications and recovered well postoperatively and was discharged on day 2. On week 1, the patient came to the clinic for follow-up; the wound was healthy, placed in the full cast in the equinus position, and referred to physiotherapy. In the third month postoperatively, she was able to tolerate her weight with her foot back to a neutral position with full dorsiflexion.

Checkrein deformity (CD) is a dynamic deformity of the hallux characterized by flexion contracture of the interphalangeal (IF) joint and extension contracture of the metatarsophalangeal (MTP) joint, worsened by ankle dorsiflexion. It is due to post-traumatic or ischemic retraction of the long hallux flexor tendon (FHL) following soft tissue trauma, leg fractures, ankle fractures and, more rarely, calcaneal or talar fractures. Diagnosis is essentially clinical, associated with imaging, to rule out unrecognized causes and evaluate fracture healing process. Few cases are reported in literature without univocal treatment. Background and Objectives: To analyze clinical and functional outcomes in patients with CD treated with release and retro-malleolar Z-plasty lengthening of FHL tendon. Materials and Methods: Patients diagnosed with CD treated with retro-malleolar (at tarsal tunnel) Z-plasty lengthening of the FHL tendon between January 2016 and August 2020 were included. Clinical and functional outcomes were collected on admission and post-surgery and analysed retrospectively. Patients with a minimum follow-up of 18 months were included. Results: A total of 14 patients, with mean age of 37.4 years old, with CD diagnosis were included in the study. All patients were suffering from post-traumatic CD and the mean time from trauma to onset of deformity was of 7 months (range 1−12). At a mean follow-up of 31.8 months (range 18−48) we found a significant improvement (p < 0.05) in terms of pain relief (VAS), function (AOFAS score) and ROM of the IP and MTP hallux joints. No recurrence, loss of strength, nerve injury or tarsal tunnel syndrome were observed. No patient required revision surgery. Conclusions: In this case series the retro-malleolar FHL tendon Z-plasty proved to be a suitable option for CD correction, allowing a good clinical and functional recovery.

Cleft foot is a congenital anomaly characterised by absence of the metatarsal bones and phalanges. It is commonly seen in children with ectrodactyly-ectodermal dysplasia-clefting syndrome ranging from a median cleft up to the mid metatarsals to a deep cleft up to the tarsal bones. Surgical treatment in the form of cleft closure, excision of the rudimentary metatarsal bone and cross K-wire fixation of metatarsal bones have been tried for the management of such cases. We report a one-year-old child who presented to the paediatric orthopaedic clinic at a medical college in New Delhi, India, in 2018 with type III cleft foot with four metatarsals. The patient was treated with a suture-button system using three transverse tunnels in the second and third metatarsal bones in order to bring them closer together. A satisfactory outcome was achieved with normal fitting footwear.

BACKGROUND: We aimed to investigate the diagnostic accuracy of known two-dimensional (2D) and three-dimensional (3D) measurements for Progressive Collapsing Foot Deformity (PCFD) in weight-bearing computed tomography (WBCT). We hypothesized that 3D biometrics would have better specificity and sensitivity for PCFD diagnosis than 2D measurements.
METHODS: This was a retrospective case-control study, including 28 PCFD feet and 28 controls matched for age, sex and Body Mass Index. Two-dimensional measurements included: axial and sagittal talus-first metatarsal angles (TM1A and TM1S), talonavicular coverage angle (TNCA), forefoot arch angle (FFAA), middle facet incongruence angle (MF°) and uncoverage percentage (MF%). The 3D Foot Ankle Offset (FAO) was obtained using dedicated semi-automatic software. Intra and interobserver reliabilities were assessed. Receiver Operating Characteristic (ROC) curves were calculated to determine diagnostic accuracy (Area Under the Curve (AUC)), sensitivity and specificity.
RESULTS: In PCFD, mean MF% and MF° were respectively 47.2% ± 15.4 and 13.3° ± 5.3 compared with 13.5% ± 8.7 and 5.6° ± 2.9 in controls (p < 0.001). The FAO was 8.1% ± 3.8 in PCFD and 1.4% ± 1.7 in controls (p < 0.001). AUCs were 0.99 (95%CI, 0.98-1) for MF%, 0.96 (95%CI, 0.9-1) for FAO, 0.90 (95%CI, 0.81-0.98) for MF°. For MF%, a threshold value equal or greater than 28.7% had a sensitivity of 100% and specificity of 92.8%. Conversely, a FAO value equal or greater than 4.6% had a specificity of 100% and a sensitivity of 89.2%. All other 2D measurements were significantly different in PCFD and controls (p < 0.001).
CONCLUSIONS: MF% and FAO were both accurate measurements for PCFD. MF% demonstrated slightly better specificity. FAO better sensitivity. A combination of threshold values of 28.7% for MF% and 4.6% for FAO yielded 100% sensitivity and specificity.

BACKGROUND: Parkinson\'s disease (PD) is a common neurodegenerative disorder, characterised by the presence of motor disturbances. Therefore, it can be related to musculoskeletal and orthopaedic problems, particularly in the foot status, that are linked to a negative effect on overall health, mobility and social function.
OBJECTIVE: The aim was to analyse the impact of foot health and quality of life in patients with Parkinson\'s disease and people without Parkinson\'s disease, with normalised reference scores, in the light of the values recorded with regard to foot health status and overall health.
METHODS: This is a prospective case-control investigation. A sample of Parkinson\'s patients (n = 62) including 24 men and 38 women was recruited, and foot HQoL was measured using the Foot Health Status Questionnaire Spanish (Sp_FHSQ).
RESULTS: The PD group recorded lower levels of foot health quality of life (HQoL) with lower scores on the Sp_FHSQ in general foot health, general health, physical activity, social capacity and vigour sub-scales. Regarding the rest of the sub-scales of the Sp_FHSQ, foot pain showed higher values in the PD group. Differences between the cases and control groups were analysed by means of a Mann-Whitney U test, showing statistical significance (P < 0.05).
CONCLUSIONS: PD presents an increased negative impact on foot health and quality of life which appears to be related to the chronic neurodegenerative disease.

Stiff equinocavus foot deformities are challenging clinical entities that may be treated with osteotomies and extensive soft-tissue release. The most common causes of such lesions are neglected trauma and Charcot-Marie-Tooth disease; other causes include burns, neurologic diseases, and compartment leg syndrome. Conventional treatments, including extensive soft-tissue release, osteotomies, and arthrodesis combined with or without internal splinting, may result in severe complications such as neurovascular or soft-tissue damage and shortening of the foot. The Ilizarov technique may be superior to the traditional approach, because it allows surgeons to apply gradual and titrated correction of individual components of complex deformities and results in minimal surgical morbidity without shortening of the foot. This is the first case report in the literature describing the simultaneous use of Cole osteotomy, combined with external Ilizarov hinged frame fixation, soft-tissue release, and Achilles tendon lengthening for the treatment of an extreme neglected stiff equinocavus foot deformity.

The study purpose was to determine the safety/efficacy of a split anterior tibialis tendon transfer (SPLATT) to the peroneus tertius or brevis in children with static encephalopathy and varus feet.
A retrospective review of short- and long-term complications, change in ankle range of motion, strength, and gait kinematics. Predictors of postoperative varus or valgus were examined.
One hundred thirty-three patients were included (average age [SD] 10.3 [3.7]), with an average follow-up of 3.9 (3.4) years. Forefoot/hindfoot eversion range of motion improved (P ≤ 0.05), dorsiflexor strength was maintained or improved in 76.9% of patients, and dorsiflexion in swing phase was maintained. Complications occurred in 6 of 133 patients (4.5%) and included 1 transfer failure, 1 wound dehiscence, and four pressure areas from casts. Successful correction was achieved in 77% of patients. Later onset of recurrent varus (14.4%, 10.6% requiring revision surgery) and pes valgus (8.7%, 4.8% requiring revision surgery) occurred. The length of the follow-up predicted the development of the pes valgus (odds ratio 1.28, 95% CI 1.0 to 1.6).
SPLATT to the peroneus tertius or brevis is effective, and complications are rare. Subsequent valgus or recurrent varus deformities may occur, possibly requiring repeat surgery.

Tailor\'s bunion (TB) disease should be considered one of the foot injuries that causes disability in feet as well as general health. This case-control descriptive study investigated and contrasted the effects of different TB types in a sociodemographic population using the Foot Health Status Questionnaire (FHSQ). A sample of 100 subjects with a mean age of 51.70 ± 17.78 years was recruited and requested to reply to a foot health survey. Results were self-reported. Subjects were scored. Participants with TB type III (TB3) registered lower scores for foot pain, foot function, footwear, and foot health. Physical activity and social capacity had higher scores, and vigor and general health were lower. A Kruskal-Wallis test was used for systematic differences between the FHSQ and different TB types. In all analyses, statistical significance was considered a p-value <0.05 with a 95% confidence interval. Statistically significant differences were found between all domains of the FHSQ and TB, except for the social capacity domain and vigor. The FHSQ is an important measurement tool in TB subjects, showing that factors such as sex, age, and footwear used throughout an individual\'s life are significantly associated with the development of TB3 and its influence on foot pain and foot health.