Background: This study evaluated postoperative outcomes following Lapidus arthrodesis (fusion of the first tarsometatarsal joint [TMT1]) using two nitinol staples for hallux valgus correction, focusing on fusion rate, reoperation rate, and patient satisfaction. Methods: A total of 60 cases undergoing Lapidus arthrodesis between June 2018 and June 2022 were analyzed with a median follow-up of 37 months (range: 15-64 months). All cases were treated using two nitinol staples (BME Elite ^TM ; DePuy Synthes) for TMT1 fusion. Among these, 38 cases involved additional foot procedures, while 22 cases had isolated TMT1 fusion. Data were collected from medical records, radiographs, and a telephone survey. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured preoperatively and postoperatively on weightbearing dorsoplantar radiographs. Functional outcomes were assessed using the Foot and Ankle Ability Measure–Activities of Daily Living (FAAM-ADL) subscale, and patient satisfaction was evaluated using a 4-point Likert scale. Results: The TMT1 fusion rate was 96.7% (58/60). The reoperation rate—including hardware removal, revision surgery for recurrence, and nonunion—was 16.7%. The staple breakage rate was 3.3%. The IMA improved from 15.8 to 8.9 degrees ( P < .001), and the HVA improved from 37.5 to 17.3 degrees ( P < .001). The average FAAM-ADL score was 81.7 out of 84, with 90% of patients reporting being very satisfied or satisfied. Conclusion: The Lapidus arthrodesis, fixed with nitinol staples, resulted in high rates of fusion and patient satisfaction. Level of Evidence: IV, retrospective cohort study.

(1) Background: The aim of this prospective study was to evaluate measurement software in comparison with manual measurements using inter-observer and intra-observer variability on radiographs in the preoperative planning of total knee arthroplasty. (2) Methods: Two independent observers retrospectively measured the mechanical lateral proximal femoral angle (mLPFA), the mechanical lateral distal femoral angle (mLDFA), the joint line convergence angle (JLCA), the mechanical medial proximal tibial angle (mMPTA), the mechanical lateral distal tibial angle (mLDTA), the hip–knee angle or mechanical tibial–femoral axis angle (HKA), and the anatomical–mechanical angle (AMA) on 55 long-leg anteroposterior radiographs manually twice, followed by measurements using dedicated software. Variability between manual and computer-aided planning was assessed, and all measurements were performed a second time after 14 days in order to assess intra-observer variability. (3) Results: Concerning intra-observer variability, no statistically significant difference was observed regarding the software-based measurements. However, significant differences were noted concerning intra-observer variability when measuring the mLDFA and AMA manually. Testing for statistical significance regarding variability between manual and software-based measurements showed that the values varied strongly between manual and computer-aided measurements. Statistically significant differences were detected for mLPFA, mLDFA, mMPTA, and mLPTA on day 1, and mLPFA, mMPTA, and mLPTA on day 15, respectively. (4) Conclusions: Preoperative planning of leg axis angles and alignment using planning software showed less inter- and intra-observer variability in contrast to manual measurements, and results differed with respect to manual planning. We believe that the planning software is more reliable and faster, and we would recommend its use in clinical settings.

Background: Talar neck fractures are complex injuries that become particularly challenging when accompanied by bone loss or comminution. This case report introduces the use of an allograft bone screw as a novel method for bridging lateral comminution at the talar neck, providing structural support and promoting bone regeneration. Methods: A 20-year-old male sustained a comminuted talar neck fracture with subtalar and tibiotalar dislocation after a bouldering fall. Urgent surgical intervention involved open reduction and internal fixation using a two-incision technique. The medial key fragment was stabilized with two conventional compression screws, revealing a significant lateral bony defect. This was bridged and stabilized with an allogeneic cortical bone screw (Shark Screw^®, Surgebright GmbH, Lichtenberg, Austria), supplemented by bone replacement material. Results: At three months, CT confirmed fracture healing, and weight-bearing was initiated. At six months, the AOFAS score was 85/100 and FAAM 69/84, with no significant pain or swelling. By one year, the patient demonstrated full weight-bearing with occasional pain (AOFAS 88/100, FAAM 79/84). At two years, the patient achieved a pain-free range of motion and full activity participation (AOFAS 100/100, FAAM 83/84). Conclusions: The successful application of this technique illustrates the potential of allograft bone screws for stabilizing and bridging defects in talar neck fractures.