Isolated cuboid dislocation without fracture is a rare injury, and there is a lack of literature describing its treatment. Studies report the use of closed or open reduction, with Kirschner wire fixation in the treatment of these injuries. This case report presents the clinical condition of a 24-year-old male patient who arrived at the emergency department with an isolated dislocation of the right foot cuboid bone without the presence of a fracture, after suffering trauma during a football game. Open reduction was performed in the surgical center with stabilization and fixation using a Kirschner wires. The patient showed an excellent response to the treatment, with no loss of the foot\'s range of motion.

BACKGROUND: To evaluate the relationship between the pattern and severity of metatarsophalangeal (MTP) joint dislocation in the lesser toes and severity of joint destruction in rheumatoid forefoot deformities.
METHODS: Participants comprised of 13 patients (16 feet) who underwent resection arthroplasty of the metatarsal head of the lesser toes for rheumatoid arthritis of the MTP joints. Correlations between preoperative radiographic findings and histological grades second to fifth metatarsal heads taken intraoperatively were analyzed.
RESULTS: In 62 metatarsal heads, complete dislocation of the MTP joint in the lesser toes significantly resulted in severe joint destruction compared to mild or moderate dislocation (P < 0.05). The proportion of severe cartilage damage in MTP joints with complete dislocation was 100 % in the 5th MTP joint, 83.3 % in the 4th MTP joint, and 58.3 % in the 2nd and 3rd MTP joints. Moreover, complete dislocation of the MTP joints in the lateral column showed the most severe joint destruction compared to that in the medial column (P = 0.03).
CONCLUSIONS: Complete dislocation of the MTP joint in the lateral column is related to joint destruction in rheumatoid forefoot deformities.

AAFD comprises ligamentous failure and tendon overload, mainly focused on the symptomatic posterior tibial tendon and the spring ligament. Increased lateral column (LC) instability arising in AAFD is not defined or quantified. This study aims to quantify the increased LC motion in unilateral symptomatic planus feet, using the contralateral unaffected asymptomatic foot as an internal control. In this case matched analysis, 15 patients with unilateral stage 2 AAFD foot and an unaffected contralateral foot were included. Lateral foot translation was measured as a guide to spring ligament competency. Medial and LC dorsal sagittal instability were assessed by direct measurement of dorsal 1st and 4th/5th metatarsal head motion and further video analysis. The mean increase in dorsal LC sagittal motion (between affected vs unaffected foot) was 5.6 mm (95% CI [4.63-6.55], p < 0.001). The mean increase in the lateral translation score was 42.8 mm (95% CI [37.48-48.03], p < 0.001). The mean increase in medial column dorsal sagittal motion was 6.8 mm (95% CI [5.7-7.8], p < 0.001). Video analysis also showed a statistically significant increase in LC dorsal sagittal motion between affected and unaffected sides (p < 0.001). This is the first study that quantifies a statistically significant increased LC dorsal motion in feet with AAFD. Understanding its pathogenesis and its link to talonavicular/spring ligament laxity improves foot assessment and may allow the development of future preventative treatment strategies.

Lateral column (LC) instability occurs in adult acquired flatfoot deformity (AAFD). Differential ligament contribution to LC stability is unknown. The primary aim was to quantify this by using cadaver sectioning of lateral plantar ligaments. We also determined the relative contribution of each ligament to dorsal translation of the metatarsal head in the sagittal plane. 17 below-knee cadaveric specimens, preserved by vascular embalming method, were dissected to expose plantar fascia, long/short plantar ligaments (L/SPL), calcaneocuboid (CC) capsule and inferior 4th/5th tarsometatarsal (TMT) capsule. Dorsal forces of 0 N, 20 N and 40 N were applied to the plantar 5th metatarsal head after sequential ligament sectioning in different orders. Pins provided linear axes on each bone, allowing relative angular bone displacements to be calculated. Photography and ImageJ processing software were then used for analysis. The LPL (and CC capsule) had the greatest contribution to metatarsal head motion (107 mm) after isolated sectioning. In the absence of other ligaments, sectioning these resulted in significantly increased hindfoot-forefoot angulation (p ≤ 0.0003). Isolated TMT capsule sectioning demonstrated significant angular displacement even when other ligaments remained intact (with intact L/SPL, p = 0.0005). CC joint instability required both LPL and capsular sectioning for significant angulation to occur, whilst TMT joint stability was largely dependent on its capsule. The relative contribution of static restraints to the lateral arch has not yet been quantified. This study provides useful information on relative ligament contribution to both CC and TMT joint stability, which may in turn improve understanding of surgical interventions used to restore arch stability.

Understanding the anatomy of the calcaneocuboid (CCJ) remains essential when selecting staple fixation to optimize osseous purchase during rearfoot procedures. This anatomic study quantitatively describes the CCJ in relation to staple fixation sites. The calcaneus and cuboid from 10 cadavers were dissected. Widths at 5 mm and 10 mm increments away from the joint were measured in dorsal, midline, and plantar thirds of each bone. The widths between each position\'s 5 mm and 10 mm increments were compared using the Student\'s t test. The widths among the positions at both distances were compared using an ANOVA then post hoc testing. Statistical significance was set at p ≤ 0.05. The middle (23 ± 3 mm) and plantar third (18 ± 3 mm) of the calcaneus at the 10 mm interval was greater than the 5 mm interval (p = .04). At 5 mm distal to the CCJ, the dorsal third of the cuboid maintained a statistically significant greater width than the plantar third (p = .02). The 5 mm (p = .001) and 10 mm (p = .005) dorsal calcaneus widths as well as the 5 mm (p = .003) and 10 mm (p = .007) middle calcaneus widths were significantly greater than the plantar widths. This investigation supports the use of 20 mm staple 10 mm away from the CCJ in dorsal and midline orientations. Care should be taken when placing a plantar staple within 10 mm proximal to the CCJ as the legs may extend beyond the medial cortex compared to dorsal and midline placements.

BACKGROUND: Injuries of the tarsometatarsal joint complex ranging from purely ligamentous to multidirectionally unstable midfoot fracture-dislocations are anatomically fixed to minimize long-term sequelae including post-traumatic arthritis, pes planus deformity, and chronic pain. Lateral column disruption is commonly treated with temporary Kirschner wire (K-wire) fixation, maintaining alignment during healing and allowing resumption of physiologic motion after hardware removal. More unstable fracture patterns may require temporary cortical screw fixation to maintain adequate reduction. We evaluated the efficacy of temporary lateral column screw fixation compared to K-wire fixation for Lisfranc fracture-dislocation treatment.
METHODS: This retrospective cohort study reviewed 45 patients over fourteen years who underwent Lisfranc fracture-dislocation fixation at a level-one trauma center. All patients underwent medial and middle column fixation; 31 underwent lateral column fixation. Twenty six patients remained after excluding those without electronic records or follow-up. The primary outcome was radiographic lateral column healing before and after hardware removal; secondary outcomes included pain, ambulation, and return to normal shoe wear.
RESULTS: Twenty patients were male, with mean age 41 years. Thirteen patients underwent cortical screw fixation and twelve K-wire fixation. One had both implants. Twenty four patients underwent lateral column hardware removal; all had radiographic evidence of bony healing before hardware removal. Mean follow-up was 88.2 ± 114 weeks for all patients. The cortical screw cohort had significantly longer mean time to hardware removal (p = 0.002). The K-wire cohort had significantly more disuse osteopenia (p = 0.045) and postoperative pain (p = 0.019).
CONCLUSIONS: Radiographic and clinical outcomes of unstable Lisfranc fracture-dislocation treatment support temporary lateral column screw fixation as an alternate technique.
METHODS: 3 (retrospective cohort study).

Ulceration or reulceration is a common complication following partial or total fifth ray amputations. The primary aim of this study was to evaluate the incidence of reulceration following partial fifth ray amputations. This was a multicenter review of 117 consecutive limbs that underwent partial fifth ray amputations at the University of Pittsburgh Medical Center and Wake Forest Baptist Medical Centers. Procedures were performed at various levels along the fifth metatarsal. Incidence of postoperative ulceration was evaluated on the ipsilateral foot. We hypothesized there would be an association between location of resection and development of reulceration. Seventy-one of 117 patients (60.7%) experienced repeat ulceration following a partial fifth ray amputation. Median follow-up time was 19 months. There was no statistical difference based on location of amputation (proximal, middle, distal, isolated base) with regards to reulceration (p = .166), further amputation (p = .271), transmetatarsal amputation (p = .160), or below knee amputation (p = .769). There was statistical significance in the follow up time between study sites (p = .013), fifth ray amputation reoperation rate between study sites (p = .001), and reulceration rates between study sites (p = .017). Partial fifth ray amputations can be a good initial salvage procedure to clear infection and prolong bipedal ambulatory status. The results of the present study put forward that there is not an association between location of amputations of the fifth ray and development of reulceration, transfer lesions or more proximal amputations.

The fourth and fifth tarsometatarsal joint, consisting of the fourth and fifth metatarsal and the cuboid, imparts a significant amount of motion to the foot during ambulation. Injury to this joint complex, through chronic deformation or acute trauma, often necessitates arthroplasty, arthrodesis, or fusion. Currently, there exists no studies that investigate the anatomy of this articulation. The purpose of this study is to describe the medial and lateral anterior cuboid articulations which allows for surgical planning and the advancement of hardware design. Twenty fresh-frozen below-the-knee cadaver legs were thawed and the cuboids were excised. The width and height of the entire joint complex were measured as the longest span across the total articular surface of the anterior cuboid. The width and height of each articular facet were recorded as the span across the geometric bisection of each individual surface. The mean anterior cuboid articulation width and height was 25.62 mm and 16.74 mm, respectively. The mean medial cuboid articulation width and height was 11.7mm and 13.65 mm, respectively. The mean lateral cuboid width and height was 16.74 mm and 12.78 mm, respectively. The medial articulation maintained a larger mean height and narrower mean width than the lateral facet (p < .05). The unique anatomy of the lateral tarsometatarsal joint complex plays an important functional role and requires attention when deciding between arthrodesis or arthroplasty. Increasing the understanding of the clinical anatomy of this joint will better prepare surgeons and product designers to anticipate hardware needs.

Open dislocations of the midfoot and subtalar joints are extremely rare injuries. Understanding the anatomy of these joints and the various injury patterns is imperative to obtain stable concentric reduction and provide good functional outcome. We present a report of a 26- year old male who was involved in a road traffic accident and sustained open dislocations of the calcaneocuboid, naviculocuneiform and subtalar joints. He initially underwent external fixation in view of the severe soft tissue injury. After improvement of the soft tissue condition, he underwent K-wiring of the calcaneocuboid joint, buttress plating of the talonaviculocuneiform joint, peroneal tendon reconstruction using hamstring allograft and defect coverage with a free anterolateral thigh flap. With appropriate rehabilitation protocols, patient recovered well and was allowed to weight bear as tolerated by 10 weeks. His wounds healed completely by 4 months. We report this case considering the rarity of the combined calcaneocuboid, naviculocuneiform and subtalar dislocations which were successfully managed.

OBJECTIVE: The main objective of this research is to record both sensory and motor information from the ascending and descending tracts within the spinal cord for decoding the hindlimb kinematics during walking on the treadmill.
METHODS: Two different experimental paradigms (i.e., active and passive) were used in the current study. During active experiments, five cats were trained to walk bipedally while their hands kept on the front frame of the treadmill for balance or to walk quadrupedally. During passive experiments, the limb was passively moved by the experimenter. Local field potential (LFP) activity was recorded using a microwire array implanted in the dorsal column (DC) and lateral column (LC) of the L3-L4 spinal segments. The amplitude and frequency components of the LFP formed the feature set and the elastic net regularization was used to decode the hindlimb joint angles.
RESULTS: The results show that there is no significant difference between the information content of the signals recorded from the DC and LC regions during walking on the treadmill, but the information content of the DC is significantly higher than that of the LC during passively applied movement of the hindlimb in the anesthetized cats. Moreover, the decoding performance obtained using the recorded signals from the DC is comparable with that from the LC during locomotion. But, the decoding performance obtained using the recording channels in the DC is significantly better than that obtained using the signals recorded from the LC. The long-term analysis shows that robust decoding performance can be achieved over 2-3 months without a significant decrease in performance.
CONCLUSIONS: This work presents a promising approach to developing a natural and robust motor neuroprosthesis device using descending neural signals to execute the movement and ascending neural signals as the feedback information for control of the movement.