Background/Objectives: Orthoses are commonly used in the treatment of various foot and ankle injuries and deformities. An effective technology in foot orthoses is a vacuum system to improve the fit and function of the orthosis. Recently, a new technology was designed to facilitate the wearing of the foot orthoses while maintaining function without the need for vacuum suction. Methods: A plantar dynamic pressure distribution measurement was carried out in 25 healthy subjects (13 w/12 m, age 23–58 y) using capacitive measuring insoles in two differently designed inlays within the VACOpedes^® orthosis (Group A: vacuum inlay vs. Group B: XELGO^® inlay) and a regular off-the-shelf shoe (Group C, OTS). The peak plantar pressure, mean plantar pressure and maximum force were analyzed in the entire foot and in individual regions of the medial and lateral forefoot, the midfoot and the hindfoot. Finally, the wearing comfort was compared using a visual analog scale from 1 to 10 (highest comfort). Results: The peak pressure of both inlays was significantly lower than in the OTS shoe (A: 230.6 ± 44.6 kPa, B: 218.0 ± 49.7 kPa, C: 278.6 ± 50.5 kPa; p < 0.001). In a sub-analysis of the different regions, the XELGO^® inlay significantly reduced plantar pressure in the medial forefoot compared to the vacuum orthosis (A: 181.7 ± 45.7 kPa, B: 158.6 ± 51.7 kPa, p < 0.002). The wearing comfort was significantly higher with the XELGO^® inlay compared to the vacuum inlay (A: 5.68/10, B: 7.24/10; p < 0.001). Conclusions: The VACOpedes^® orthosis with a new XELGO^® inlay showed at least equivalent relief in all pressure distribution measurements analyzed and greater relief in the forefoot area than the VACOpedes^® orthosis with a vacuum inlay, as well as increased wearing comfort.

Background: This study investigated syndesmotic stability after transection and the effects of stabilization using rigid and dynamic reconstruction techniques. Methods: Syndesmotic stability was analyzed using a six-degree-of-freedom robotic arm on 14 human specimens. Stability was analyzed in the neutral position and during dorsiflexion and plantar flexion using an external rotation stress test under an axial load of 200 Newtons. The examination was performed on intact and sequentially transected syndesmosis in the following order: (1) anterior inferior tibiofibular ligament (AITFL); (2) interosseous ligament (IOL); and (3) posterior inferior tibiofibular ligament (PITFL). Then, reconstruction was performed using different syndesmotic screw techniques or a dynamic Suture Button system (Arthrex TightRope; n = 7). Results: A syndesmotic transection mainly caused sagittal instability of the fibula. While both static and dynamic reconstruction provided stabilization, screw fixation, particularly with two screws and a plate, demonstrated superior control of the fibular movement, especially in the sagittal and transverse planes, compared to one Suture Button. Conclusions: The results suggest that syndesmotic stabilization with one Suture Button may be insufficient for cases involving three-ligamentous injuries, whereas two Suture Buttons may offer comparable biomechanical stability to syndesmotic screws. Additionally, the study suggests that lateral radiographs may provide additional clinical value in assessing syndesmotic stability.

Background: Pilon fractures are severe distal tibia injuries from high-energy trauma, often involving joint and soft tissue damage. Despite surgical advances, long-term outcomes remain poor. This study compared quality of life and functional limitations after surgical treatment of pilon versus tibial shaft fractures using validated PROMs. Methods: This case–control study was conducted at a Level I Trauma Center. Between 2016 and 2019, 84 patients with lower leg fractures were included: 38 pilon and 46 tibial shaft fractures. Inclusion criteria were AO type 42 or 43 fractures and follow-up of ≥24 months; exclusion criteria were polytrauma (ISS > 15), ASA ≥ 3, and incomplete consent. Outcomes were assessed with SF-12, EQ-5D-5L, and VAS-FA. Data were collected 36–48 months postoperatively. Analyses included t-tests, chi-square tests, linear regression. Results: Patients with pilon fractures had significantly poorer physical quality of life than tibial shaft fractures (SF-12 physical: 39 vs. 42, p < 0.05). Mental quality of life showed no significant difference. EQ-5D-5L scores were lower in the pilon group (70% vs. 79%). VAS-FA indicated higher pain and reduced function (total: 64 vs. 76, p = 0.009). Rehabilitation duration correlated with improved VAS outcomes in pilon fractures (p = 0.008), while physiotherapy reduced pain in tibial shaft fractures (p = 0.030). Conclusions: Pilon fractures substantially impair physical quality of life and long-term function, while mental well-being remains unaffected. PROMs provide insights beyond radiological findings and should be integrated into follow-up. Further multicenter studies are required to validate these results and optimize rehabilitation strategies.

Osteoid osteoma is a benign but painful bone tumour that typically occurs in the long bones of young adults. Intra-articular localisation in the trochlea tali is rare and may significantly delay diagnosis. We report the case of a 41-year-old patient presenting with persistent, predominantly nocturnal pain of the right ankle joint, despite previous arthroscopic treatment of an osteochondral lesion. Initial conventional imaging was unremarkable. The diagnosis of an osteoid osteoma of the trochlea tali was established only after targeted re-evaluation using contrast-enhanced magnetic resonance imaging (MRI) and high-resolution computed tomography (CT). A diagnostic trial with acetylsalicylic acid resulted in marked symptom relief and further supported the suspected diagnosis, consistent with the known NSAID sensitivity of osteoid osteoma. Definitive treatment was performed using CT-guided radiofrequency ablation (RFA). The patient was completely symptom-free four weeks after the intervention. This case highlights the diagnostic challenges of intra-articular osteoid osteomas in atypical locations. Careful clinical assessment, appropriate imaging, and interdisciplinary collaboration are essential for timely diagnosis and successful treatment.