Subtalar joint instability (STI) is one of the causes of persistent hindfoot pain even after treatment for ankle instability. Diagnosis of STI is often neglected because it is a poorly understood concept. However, understanding of the anatomy and injury mechanism of the subtalar joint is a prerequisite of appropriate treatment. Patients with STI usually complain of several symptoms, such as recurrent sprains or a giving way sensation and rolling over. Recently, various diagnostic tools and treatment methods have been investigated. This study was undertaken with the aim of helping clinicians by providing a comprehensive understanding of STI.

Vaccines can cause adverse reactions, such as soreness, swelling, or redness at the injection site. Some reactions are associated with fever and rash, which are usually mild and transient, and serious side effects are rare. In particular, there are no reports of systemic infection following a COVID-19 vaccination. The authors present a case report of a patient who developed multiple abscesses caused by Staphylococcus aureus after a COVID-19 vaccination. The patient had no previous symptoms or signs of infection. The patient was controlled successfully after surgical and antibiotics treatment.

The incidence of osteoporotic ankle fractures is increasing as the population ages. These fractures are becoming more common in clinical practice and require careful management because of the higher likelihood of developing complications than typical ankle fractures.The introduction of a method for measuring the ankle joint bone mineral density is a valuable tool for assessing the bone quality of the ankle joint. By evaluating the bone mineral density, healthcare professionals can better understand the extent of osteoporosis and the overall strength of the ankle joint. This information is crucial for determining the appropriate treatment for individual fractures. Several factors must be considered when deciding on the treatment for osteoporotic ankle fractures. These include the ankle joint bone mineral density, skin condition, any comorbidities the patient may have, and the patient's functional demands. Taking these factors into consideration allows healthcare providers to tailor the treatment plan to the specific needs and the circumstances of each patient. By applying the appropriate treatment, it is expected that the complications associated with osteoporotic ankle fractures can be minimized, and the prognosis for patients can be improved.

Malignant peripheral nerve sheath tumors (MPNSTs) usually arise in soft tissues; they are rarely found in the bone. This paper reports a case of MPNST in the foot and ankle joint involving the distal tibia, talus, calcaneus, navicular, medial intermediate, and lateral cuneiform, cuboid, and 2nd to 4th metatarsal bone. Palliative treatment was performed. The authors encountered a patient with intraosseous MPNST of the midfoot who presented with nonspecific clinical and radiologic findings. This case shows that a high index of suspicion and a histopathology examination, including immunohistochemistry, will be necessary for an accurate diagnosis.

An aneurysmal bone cyst (ABC) can occur in many parts of the human body, but a primary ABC of the talus is extremely rare. ABCs are benign, but aggressively growing tumors that usually occur in the first two decades of life. Patients mainly complain of pain, limited movement of the involved joint or a palpable mass. Pain may worsen suddenly because of pathological fractures. If not treated properly, ABC has a risk of local recurrence, followed by the destruction of the joint and a significant functional deficit. While the complete removal of the bone tumor is essential, it is also important to treat the resultant bone defect after removal. The talus has an important part to play in weight-bearing. Therefore, an appropriate bone graft is required for large bone defects that occur after an ABC removal from the talus. We report a primary ABC of the talus in a 28-year-old male that was treated by curettage and a bone pillar pattern graft of autologous tricortical iliac crest bone. The patient had an excellent functional outcome with early weight-bearing, and there was no recurrence at 16 months of follow-up.

Purpose: The proximal fifth metatarsal fracture is one of the most common foot fractures. However, few studies have evaluated the associated injuries in patients with a proximal fifth metatarsal fracture. The purpose of this study was to investigate the incidence of foot and ankle joint injuries associated with proximal fifth metatarsal fractures and compare the incidence of these injuries based on the injury mechanisms and location of the fracture. Materials and Methods: This retrospective study included 157 patients with a proximal fifth metatarsal fracture who underwent surgery from January 2014 to August 2021. Their medical records and radiology images were reviewed to classify and analyze the associated injuries. The proximal fifth metatarsal fractures were classified using Lawrence and Botte's classification. Injury mechanisms were divided into direct and indirect injuries. The incidence of injuries was statistically analyzed according to the injury mechanism and classification. Results: Of the 157 patients with proximal fifth metatarsal fractures, 81 (51.6%) were diagnosed with foot and ankle joint injuries. The incidence of foot injuries was 65.4%, that of ankle joint injuries was 19.8%, and of both foot and ankle joint injuries was 14.8%. In patients with direct injuries, the incidence of foot and ankle joint injuries was 82.5% and that of indirect injuries was 41.0%. Statistical differences were observed between the incidence of direct and indirect injuries (p<0.001). The incidence of injuries, according to Lawrence and Botte’s classification, was 54.9% (Zone I), 41.2% (Zone II), and 50.0% (Zone III) respectively. However, there were no statistically significant variations in the locations of the proximal fifth metatarsal fractures (p=0.051). Conclusion In this study, the incidence of foot and ankle joint injuries associated with proximal fifth metatarsal fractures was found to be high. Therefore, a careful physical examination and appropriate radiological evaluation are recommended for patients with such fractures.

Purpose: Concomitant ankle injuries associated with tibial shaft fractures can affect postoperative ankle joint pain and various postoperative ankle complications. This study compared the clinical outcomes between surgical treatment and conservative treatment of concomitant ankle injuries associated with tibial shaft fractures. Materials and Methods: From January 2015 to June 2020, a retrospective study was conducted on 118 tibia shaft fractures at the orthopedics department of the hospital. Associated ankle injuries were analyzed using plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and intraoperative stress exams. The clinical outcomes were compared using the pain visual analog scale (pain VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score (AOFAS score), and Karlsson–Peterson ankle score (KP score). Results: Seventy-two (61.02%) of the 118 cases were diagnosed with associated ankle injuries. Fifty-six cases underwent surgery for the ankle injury, and 16 cases underwent conservative treatment. The clinical results (according to the pain VAS score, AOFAS score, the KP score) were 1.79±1.26, 94.48±4.03, and 94.57±3.60, respectively, in the surgical treatment group, and 3.00±1.03, 91.06±3.02, and 91.25±3.31, respectively, in the conservative treatment group. Conclusion Surgical treatment showed better clinical outcomes than conservative treatment in concomitant ankle injury in tibia fractures. Therefore, surgical treatment produces better clinical outcomes than conservative treatment in concomitant ankle injuries in tibia fractures. Hence to improve the clinical outcomes, more attention is needed on ankle joint injury in tibial shaft fractures for selecting suitable surgical treatments for those patients.