Introduction: reduced mobility of the tarsal joints leads to osteoarthritis of the ankle joint. In the literature, changes at the level of the Chopard joint and the level of the subtalar joint can lead to osteoarthritis of the ankle joint. But there is no conclusive evidence of which joint arthrodesis has a worse effect on the ankle joint.
Methods: The study included 15 patients (18 feet) who underwent Chopard arthrodesis (Charcot-Marie-Tooth disease, consequences of injuries and others). We assessed the mobility of the tarsal joints in patients after Chopard joint arthrodesis by functional radiographs.
Results: in all patients, the mobility of the subtalar joint was determined by functional radiographs (p<0.05, Brunner-Munzel test).
Conclusion: the degree of the foot dorsiflexion during normal gate increases due to the mechanism of peritalar movement. Peritalar movement occurs primarily in the subtalar joint. Arthrodesis of the subtalar joint completely excludes perital movement and causes overload of the anterior part of the ankle joint. Arthrodesis of the Chopard joint preserves peritalar movement because functionally the Chopard joint becomes at the level of naviculo-cuneiform and cubo-metatarsal joints.

Background: Logsplitter Injury is a high-energy ankle fracture dislocation, a detailed understanding of the radiological features and pathological changes can further guide the treatment. Methods: 62 patients with Logsplitter injury were retrospectively analyzed. The characteristics of preoperative X-ray and CT scans were analyzed. The incidence of the different injury types was summarized. According to the Lauge-Hansen classification of ankle fractures, the correlation between Logsplitter injuries and the different mechanisms causing the injuries were analyzed. Results: Data are available in this study, 98.4% had open fractures. The fibula injuries included no fracture (1.6%), transverse or short oblique fractures (61.3%), butterfly fragments (25.8%) and comminuted fractures (11.3%). The tibial injuries included compression of lateral articular surfaces (38.7%) and posterior compressions (6.5%). Medial injuries, including medial malleolar fractures, accounted for 87.1%, and deltoid ligament rupture accounted for 12.9%. The injuries to the syndesmosis included simple ligament ruptures (11.3%), Tillaux fractures (8.1%), Volkmann fractures (43.5%), and Tillaux and Volkmann fractures (37.1%). Complete rupture of the lateral collateral ligament was found in 12.9% of cases. According to the Lauge-Hansen classification, 87.1% were pronation-abduction injuries, while 8.1% were pronation and external rotation injuries and 1.6% were supination external rotation injuries. In addition, 3.2% could not be classified. Conclusion: According to the current results, some cases may be accompanied by collateral ligament injury. Vertical violence combined with abduction may be the most common injury mechanism; however, in some cases, the mechanism may be a vertical combined external-rotation injury.

Purpose
Ligamentous Lisfranc injuries often feature avulsion fractures of the tarso-metatarsal joint (TMTJ). A proportion of these will have a congruent TMTJ joint on initial imaging, and many of these patients will have an unstable TMTJ which requires stabilisation.
The study aimed to determine the relationship between the presence of an avulsion fracture on initial imaging and instability of the first TMTJ.
Methods
A prospective database of Lisfranc fracture-dislocations was analysed for the presence of TMTJ1 avulsion fractures. All cases were managed with examination under anaesthesia (EUA) and stress testing under image intensification prior to fixation or arthrodesis surgery. The rate of TMTJ1 instability and the sensitivity and specificity of the presence of an avulsion in detecting instability was determined.
Results
153 patients with a mean age of 35.2 years were included. 99 injuries (64.7%) had an avulsion fracture of TMTJ1 on imaging. Of these, 76.7% had a congruent joint on XR or CT scan. 91.9% of patients with an avulsion fracture demonstrated instability on EUA stress testing. Amongst the 54 cases showing no avulsion, 23 (42.6%) were unstable on EUA. The presence of an avulsion had a sensitivity of 79.8% and a specificity of 79.5% in the detection of instability.
Conclusion
The presence of an avulsion fracture of TMTJ1 is highly suggestive of instability. This finding should lower the threshold to perform EUA stress testing. A high proportion of Lisfranc injuries without avulsion fractures have TMTJ1 instability, and therefore the absence of this finding does not reliably exclude instability.

Calcaneal fractures pose complex surgical challenges due to their intricate anatomy and proximity to vital tissues. This cadaveric study aimed to determine optimal screw lengths, identify high-risk zones, and prescribe a intraoperative fluoroscopic angle for visualizing screws in these areas. Using 20 fresh-frozen cadavers, calcaneus was divided into 7 zones. Initially, partitioned into three regions (Z1,2,3) by two vertical lines —one from the Gissane angle and the other from the posterior facet's terminus— each zone was further divided into upper and lower sections (Z1a,1b, 2a, 2b, 3a, 3b). The topmost region of Zone 2, designated as the subchondral area, is recognised as Zone 4. Subsequent meticulous drilling and screw placement via lateral extensile approach was followed by dissection from the medial aspect to measure distances to vasculature, nerves, and tendons, both from the point of exit and the projection of the screw. The optimal angle for C-arm fluoroscopy visualization post-Harris view was determined as the angle between two K-wires, one inserted into the joint and the other aligned with the risky proximity area axis. Our findings showed that the upper portions of Zones 1 and 2 (Z1a, Z2a) posed the most significant risk (p=0.0043). Additionally, hazardous proximities were observed along the sulcus, requiring an additional 32.312 ± 4.002-degree angulation of the C-arm fluoroscopy following Harris views for adequate intraoperative visualization.

Introduction: The aim was to demonstrate that supramalleolar osteotomy (SMO) is a valuable treatment method in eccentric ankle arthritis since it is one of the most under-utilised procedures. We retrospectively analysed the outcome of it performed over last 10-year period. We also compared the results of newly introduced computer-assisted custom-made implants with standard implant. Material and Methods: Data was analysed from 46 patients over a period of 10 years of which 40 were by standard implant and 6 by computer assisted custom implant. 29 varus, 17 valgus deformity. The mean age was 57 (26-79 y/o), male: female ratio was 27:19. Mean follow-up was 15.25 months; the computer-assisted 24 months. TAS, TTS and TT angels were measured pre and post-operatively. Fixation done using a standard plate or custom made implant with or without bone graft. All surgeries were performed by a single surgeon. MOXFQ and AOFAS questionnaires were completed pre and post-operatively. All followed similar rehabilitation programme.Results: Average radiological healing time was 24.3 weeks. MOXFQ score improved from 55.17 to 25.11 and AOFAS from 20.16 to 56.21. Complications were 2 non-unions, 1 stress fracture. 8 patients required fusion/replacement after 3 years. The computer-assisted cases gave improved correction accuracy than standard method.Conclusion: Our results are comparable to similar studies. Being a joint preserving technique, Supra Malleolar Osteotomy should be considered in addition to fusion and replacement, either as an interim or definitive procedure especially with the development of computer assisted technologies. Patient selection criteria is essential for a good outcome.

Background: Plantar fibromatosis is a hyperproliferative disease of the superficial plantar aponeurosis resulting in painful nodules and cords. Operative management, indicated in severe disease has high rates of recurrence and wound complications. Research investigating the effectiveness of radiotherapy for plantar fibromatosis is limited however demonstrates positive outcomes with minimal side effects. Aims: To determine the efficacy of radiotherapy in providing symptom relief from plantar fibromatosis. Methods: A retrospective review of patients with plantar fibromatosis treated with radiotherapy was conducted at the Cairns Base Hospital in Queensland, Australia. Patient demographics, treatment details and post operative satisfaction results were analysed. Results: The study included 53 patients. The mean age was 56.8 years and 60% of patients were female. Patients received 30Gr radiation over two treatment cycles 8-12 apart. Complete resolution occurred in 10 cases (18.9%), improvement in 25 cases (47.2%), initial improvement followed by recurrence in 10 cases (18.9%) and no improvement in seven cases (13.2%). Radiotherapy-related complications only occurred in eight cases (15.1%) the most common being fatigue experienced by three patients. Conclusion: This study demonstrated promising outcomes for patients with plantar fibromatosis treated with radiotherapy with rates of symptom improvement or complete resolution over 60% and low rates of complications.

Objectives: To present benefits of retention in MIS bunionette surgery potentially without temporary wire fixation. Material and method: In the past 12 months 8 MIS bunionette cases have been successfully performed using intensifying imaging guidance via a 5 mm incision, burrs were used and a Kirchnerwire was typically used for temporary fixation. The time for this surgery was in average 15-20 minutes. Taping and dressing was carefully planned for all 6 weeks. Result: Follow up was obtained at 6 and 12 weeks with good healing results already at 6 weeks. No infection cases, no neurovascular injury, wounds healed per primam, three cases resulted in earlier wire pull out, however, healed with no consequences. Conclusion: The implementation of MIS bunionette with K-wire could be avoided with good planning of dressing and patient compliance,  surgical time would reduce as well as image intensifier exposure.

Traumatic dislocation of interphalangeal toe joint are uncommon, usully managed in an acute phase with closed reduction. Irreducible dislocations occur when plantar plate of the capsular/collateral ligment of the flexor tendon becomes interposed between the joint. The management principles for this injueres has not been well defined with scarce surgical options described in the litterature. Open reduction is usually required, since closed reduction is rarely successful, in part due to soft tissue interposition and rigidity.
The authors describe the surgical technique and the 6-month post surgery clinical and radiographic results of a fifty year old patient, presenting with traumatic chronic irreducible dislocation of the proximal interphalangeal joint of the fifth toe submited to open reduction through a dorsal approach with temporary k-wire fixation and capsular and medial collateral ligment repair, to achieve a neutral stable position of the joint.