Analyzing the correlation between patients’ basic information, three-dimensional parameters after calcaneal fractures, and the prognosis of calcaneal fractures. A retrospective analysis was conducted on 43 patients with calcaneal fractures who underwent surgical treatment in the Foot and Ankle Surgery, Xi’an Honghui Hospital, from September 2019 to August 2022. Patient demographics including gender and age were collected, as well as the preoperative posterior articular surface collapse area, number of fracture fragments, length, width, height, and volume of the calcaneus obtained from preoperative three-dimensional imaging. Patients were followed up for VAS, AOFAS, and SF-36 scores. Correlation analysis was performed on the obtained data. All 43 included patients received complete follow-up, including 40 males and 3 females, with an average follow-up time of 35.37 ± 10.73 months, and an average age of 43.98 ± 12.08 years. All patients’ VAS, AOFAS, and SF-36 scores at the last follow-up showed no correlation with patient age, gender, or the area of posterior articular collapse, number of fracture fragments, length, width, height, or volume of the calcaneus. The prognosis of calcaneal fractures is unrelated to three-dimensional factors such as patient age, gender, length, width, height, volume of the calcaneus, area of the posterior joint, and number of fracture fragments.

Purpose: This study aims to investigate the psychological status of patients with Hepple V osteochondral lesions of the talus (OLT) and evaluate the effect of autologous osteoperiosteal transplantation (AOPT) on their psychological well-being.Methods: Fifty patients with Hepple V OLT who underwent AOPT at the Comprehensive Foot and Ankle Surgery Ward of Xi’an Honghui Hospital from November 2021 to May 2023 were included in this study. The patients were divided into two groups based on the presence or absence of preoperative symptoms of anxiety/depression. Group A comprised patients with preoperative symptoms, while Group B included patients without such symptoms. Preoperative and final follow-up assessments included the Hospital Anxiety and Depression Scale for evaluating anxiety and depression, the visual analogue scale for pain assessment, and the American Orthopaedic Foot and Ankle Society scores for assessing ankle and hindfoot function.Results: Among the 50 Hepple V OLT patients who obtained complete follow-up, twenty-four had preoperative symptoms of anxiety/depression, with an incidence rate of up to 48%. Patients in Groups A and B showed significant improvement in all evaluation indexes after AOPT compared to the preoperative period, but the overall prognosis of Group A was poorer than that of Group B.Conclusion: AOPT can effectively improve patients’ pain, functional activities, and psychological status, and there is a significant correlation between patients’ preoperative psychological status and prognosis.

This study evaluated the clinical efficacy of modified Kidner procedures for painful accessory navicular(AN) syndrome. Furthermore, it investigated the differences between patients’ pre- and post-operatively, analyzing the impact on post-operative pain and functional recovery. This study included 50 patients diagnosed with painful AN and treated with the modified Kidner procedure at the Department of Foot and Ankle Surgery, Honghui Hospital, Xi’an, between May 2014 and May 2023. All patients were assessed using the Hospital Anxiety and Depression Scale (HADS), Visual Analogue Scale(VAS), and American Orthopaedic Foot & Ankle Society Midfoot Scale (AOFAS) before and after surgery. Patients were divided into two groups based on the presence of preoperative anxiety/depression symptoms. Patients without preoperative anxiety/depression were assigned to Group A, while those with preoperative anxiety/depression were assigned to Group B. The baseline data, pain, functional activity, and psychological status scores of both groups were compared, and a correlation analysis was conducted to identify factors associated with anxiety/depression. Out of 50 patients with painful AN syndrome who completed follow-up, 28 exhibited symptoms of anxiety/depression preoperatively, resulting in an incidence rate of 56%.Both Group A and Group B patients showed significant improvements in all postoperative evaluation metrics compared to preoperative levels (p < 0.05), yet the overall prognosis for Group B was poorer than that for Group A.There were significant differences in the degree of improvement in pain, functional activity, and anxiety/depression between the two groups(p < 0.05).female patients had a significantly higher prevalence of anxiety than male patients (p < 0.05). Modified Kidner surgery can significantly improve the function, pain, and psychological status of patients with painful AN.However, patients with less favorable preoperative psychological status tend to have less satisfactory outcomes.Patients with preoperative anxiety or depression symptoms experience more significant pain relief after surgery, while those without such symptoms show better functional recovery.Moreover, female patients with painful AN have a higher incidence of preoperative anxiety.Future research should further explore the impact of preoperative psychological interventions on outcomes.

This retrospective study aimed to introduce a novel method for simultaneous Y-shape osteotomy combined with subtalar arthrodesis for calcaneus malunion and to evaluate the feasibility of this method. We retrospectively analysed the clinical and imaging data of 11 patients with calcaneus malunion treated using Y-shape osteotomy and subtalar arthrodesis who were admitted to our hospital from June 2018 to October 2020. The patients included 9 males and 2 females aged from 24 to 69 years old, with an average age of 42.18 years. The clinical and radiological results were assessed with the Visual Analogue Scale (VAS) pain score and American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score. In addition, functional recovery and general quality of life were evaluated using the 12-Item Short-Form Survey (SF-12). All radiological parameters were significantly improved at the last follow-up, with increases of 14.37°, 9.18°, and 4.51 mm in the Böhler’s angle, calcaneal pitch angle, and talocalcaneal height, respectively, and decreases of 6.39 mm and 6.18° in the calcaneal width and Hindfoot alignment angle (p < 0.05). The mean AOFAS and VAS scores at the last follow-up improved compared with those preoperatively, from 34.18 ± 9.53 to 84.18 ± 11.59 and from 6.90 ± 1.22 to 1.90 ± 1.13, respectively (p < 0.05). The SF-12 physical and mental health scores were 49.65 ± 6.84 and 52.68 ± 7.88, respectively. Furthermore, the early postoperative complications included skin necrosis in one and sural neuralgia in one patient, and the late postoperative complication included ankle pain in one patient. No other complications, such as implant discomforts, malunion, nonunion and re-fracture, were presented. These results indicate that Y-shape osteotomy combined with subtalar arthrodesis is an effective new method for the treatment of calcaneal malunion. Advantages include improvement of the anatomic shape of the calcaneus and union rates for subtalar arthrodesis.

To investigate the impact of preoperative psychological factors on outcomes following metatarsophalangeal joint replacement surgery in patients with Freiberg’s infraction. This retrospective study included 127 patients diagnosed with Freiberg’s infraction who underwent metatarsophalangeal joint replacement surgery at Xi’an Honghui Hospital’s Department of Foot and Ankle Surgery between August 2013 and September 2023. Patients were stratified into two groups based on preoperative psychological status: Group A comprised patients with preoperative anxiety and/or depression symptoms, while Group B included patients without such symptoms. The Hospital Anxiety and Depression Scale (HADS) and visual analogue scale (VAS) were administered preoperatively and at final follow-up to assess psychological status and pain levels. Primary outcome measures included the 0–100 mm VAS for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) functional score. Of 127 patients, 91 (71.7%) completed follow-up. Among these 91 patients, 53 (58.2%) had preoperative anxiety and/or depression symptoms. Both groups demonstrated significant improvements in all measured parameters compared to preoperative values. However, Group A showed significantly worse clinical outcomes than Group B across all assessment measures. Metatarsophalangeal joint replacement surgery significantly improves pain and functional outcomes in patients with Freiberg’s infraction. However, preoperative anxiety and depression are associated with inferior postoperative outcomes.

Purpose: Although surgical techniques have improved, chronic pain, functional impairment and psychological effects still occur after pilon fracture surgery. The aim of this study is to evaluate the clinical efficacy after pilon fracture surgery and to explore the impact of preoperative patients with central sensitization (Central Sensitization, CS) on the improvement of postoperative pain, function, anxiety/depression. Patients and Methods: In this single-center retrospective study, we collected adult (≥ 18 years old) patients with pilon fractures who underwent open reduction and internal fixation at Xi’an Honghui Hospital from January 2020 to July 2024 and had the cognitive ability to complete the questionnaire. Exclusion criteria included incomplete medical records, concurrent other foot fractures, or severe mental disorders. The preoperative central sensitization (CS) determination criteria were a score of ≥ 18 on the Chinese version of the 9-item Central Sensitization Inventory (CSI-9). The assessment indicators at baseline and the last follow-up included the Visual Analogue Scale (VAS) for pain, the American Orthopaedic Foot & Ankle Society Hindfoot Score (AOFAS), and the Hospital Anxiety and Depression Scale (HADS). Patients were divided into the CS group and the non-CS group based on whether they had a preoperative central sensitization state, and the differences in baseline characteristics, pain severity, functional performance, and psychological state between the two groups were compared. Results: At the final follow-up, the performance of the CS group was worse than that of the non-CS group, VAS was 20.04± 6.87 compared to 14.15± 6.34 (P < 0.001); AOFAS was 77.71± 9.55 compared to 86.21± 6.57 (P < 0.001); HADS-A was 6.39± 2.87 compared to 3.00 (2.00, 4.00); HADS-D was 6.39± 3.06 compared to 3.00 (2.00, 3.00). In terms of improvement degree, there were significant differences between the two groups in the improvement of pain and anxiety/depression (p < 0.05). Conclusion: Both groups of patients showed significant improvement in pain relief, functional activity, and psychological state postoperatively compared to preoperatively. However, patients with preoperative CS showed less improvement in pain relief, functional recovery, and psychological state compared to those without CS. Therefore, foot and ankle surgeons should further investigate the impact of preoperative interventions for CS on postoperative outcomes in future studies.