Objective To evaluate the short-term effectiveness of Ilizarov technique combined with steel needle internal fixation in treating Charcot neuroarthropathy (CN) of the foot and ankle. Methods Between June 2020 and December 2023, 12 patients with Eichenholtz stage Ⅲ CN of the foot and ankle were treated with Ilizarov technique and steel needle internal fixation. There were 9 males and 3 females with an average age of 48.6 years (range, 19-66 years). The disease duration ranged from 1 to 16 months (mean, 6.8 months). Ankle joint involvement predominated in 7 cases, while midfoot involvement occurred in 5 cases; 3 cases presented with skin ulceration and soft tissue infection. Preoperative American Orthopedic Foot and Ankle Society (AOFAS) score was 31.2±9.0, 36-Item Short-Form Health Survey (SF-36)-Physical Component Summary (PCS) score was 32.6±6.8, and Mental Component Summary (MCS) score was 47.8±8.4. Postoperative assessments included wound healing, regular X-ray film/CT evaluations of fusion status, and effectiveness via AOFAS and SF-36-PCS, MCS scores. ResultsAll operations were successfully completed without neurovascular complication. Two patients experienced delayed wound healing requiring intervention, and the others achieved primary healing. All patients were followed up 15-43 months (mean, 23.3 months). Imaging confirmed successful joint fusion within 13-21 weeks (mean, 16.8 weeks). At last follow-up, the AOFAS score was 72.5±6.4, and the SF-36-PCS and MCS scores were 63.2±8.4 and 76.7±5.3, respectively, all of which improved compared to preoperative levels, with significant differences (P<0.05). Conclusion Ilizarov technique combined with steel needle internal fixation effectively restores walking function and achieves satisfactory short-term effectiveness in CN of the foot and ankle.
ObjectiveTo investigate the correlation between fourth brachymetatarsia and hallux valgus, and to provide evidence-based support for clinical decision-making. Methods A retrospective analysis was conducted on 68 patients (89 feet) with congenital fourth brachymetatarsia treated between August 2021 and November 2025. All patients were female, aged 18-44 years (mean, 28.1 years). The hallux valgus angle (HVA), intermetatarsal angle (IMA), and shortening length of the fourth metatarsal were measured on standardized weight-bearing anteroposterior foot X-ray films. Hallux valgus-related complications were recorded. The prevalence of hallux valgus was compared with the reference value reported for the general adult female population in China (14.74%). Spearman rank correlation analysis was used to evaluate the correlations of HVA and IMA with age and metatarsal shortening length. Results In the entire cohort, HVA ranged from 5.65° to 44.95° (mean, 20.56°), IMA ranged from 6.46° to 20.45° (mean, 11.61°), and the shortening length of the fourth metatarsal ranged from 5.62 to 18.01 mm (mean, 12.05 mm). Hallux valgus was present in 55 feet, giving a prevalence of 61.80%, which was significantly higher than the reference value for the general adult female population in China (Z=12.523, P<0.001). Associated symptoms in feet with hallux valgus included bunion (31 feet, 56.36%), transfer metatarsalgia of the second metatarsal head (16 feet, 29.10%), transfer metatarsalgia of the third metatarsal head (10 feet, 18.18%), plantar callosity (8 feet, 14.55%), and dorsal callosity (4 feet, 7.27%). In patients with hallux valgus, HVA ranged from 15.83° to 44.95° (mean, 26.16°) and IMA ranged from 9.01° to 20.45° (mean, 13.35°). Correlation analysis showed that both HVA and IMA were positively correlated with the shortening length of the fourth metatarsal (r=0.290, P=0.016; r=0.420, P<0.001), whereas no correlation was found between HVA or IMA and age (r=–0.061, P=0.751; r=0.132, P=0.525). Conclusion Patients with fourth brachymetatarsia have a significantly higher prevalence of hallux valgus, which is positively correlated with the degree of metatarsal shortening but not with age, suggesting an anatomical rather than age-related etiology. The study redefines the clinical nature of fourth brachymetatarsia, promoting a paradigm shift from “cosmetic correction” to “functional reconstruction”. It is recommended that this deformity be included as a screening indicator for populations at high risk of hallux valgus.