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Prof Mason

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🔹 Plantar Fascia Rupture — what do we know about this rare injury?

🔹 Plantar Fascia Rupture — what do we know about this rare injury?

Rupture of the plantar fascia is often overlooked in patients with persistent heel pain.
A systematic review by Mosca et al. (@sagejournalpublication Foot & Ankle Specialist, 2022) from Italy, analysed 155 patients (157 feet) across 18 studies and highlighted several key findings:

👣 Key takeaways
• The vast majority (≈ 90%) of ruptures occurred in patients already treated for plantar fasciitis.
• Corticosteroid injection was the most significant risk factor — present in 130 of 155 patients, conferring a 33-fold increased risk of rupture (Lee et al.).
• Spontaneous ruptures are rare, typically seen in athletes with high acceleration or change-of-direction movements.
• Conservative management (immobilisation, rest, and gradual physiotherapy) yielded good outcomes in nearly all cases.
• Surgery was rarely required — reserved for chronic or persistent cases with residual pain.

🏃‍♂️ Clinical relevance
The plantar fascia tolerates over 1000 N of force, yet repetitive microtrauma or steroid-related degeneration can precipitate failure. Recognising rupture is difficult — patients may describe a “pop” and sudden medial heel pain with swelling and ecchymosis.

https://lnkd.in/eCTsVxyW

#FootAndAnkle #PlantarFascia #HeelPain #SportsInjury #Orthopaedics #EvidenceBasedPractice #FootAndAnkleResearch #BOFAS #LiverpoolFootAndAnkleClinic @drlyndonmason

Open Excision vs. Percutaneous Intermetatarsal Ligament Release for Morton’s Neuroma – Is Width Important?” (Foot & Ankle Surgery, 2025)

📄 New Research Spotlight: “Open Excision vs. Percutaneous Intermetatarsal Ligament Release for Morton’s Neuroma – Is Width Important?” (Foot & Ankle Surgery, 2025) AOFAS Journals

Morton’s neuroma remains one of the most common causes of forefoot pain — yet surgical treatment can vary.

This new multicentre study by Emanuel Cortesão de Seiça João Seixas Alexei Buruian Daniel Peixoto João Vide (Foot & Ankle Surgery, 2025) provides valuable insight into how neuroma width can possibly guide treatment choice.

🔍 Key findings:
• 46 patients (58 feet) were reviewed, comparing open excision and percutaneous intermetatarsal ligament release (PILR).
• Both techniques improved pain and function, but open excision achieved significantly better outcomes for neuromas >7.4 mm in width.
• For smaller neuromas (<7.4 mm), PILR offered quicker return to daily activity with comparable satisfaction.
• Neuroma width, rather than length, emerged as the strongest predictor of outcome in the minimally invasive group.

📊 Clinical relevance:
This study highlights how preoperative MRI measurements, particularly neuroma width, can refine patient selection — offering an evidence-based rationale for choosing between open and percutaneous techniques.

Open excision remains the gold standard for larger neuromas, while PILR may provide a viable, faster-recovery alternative for smaller lesions.

🔗 Read the full paper: https://lnkd.in/e6RdZr5A

#FootAndAnkle #ForefootPain #MortonsNeuroma #MinimallyInvasiveSurgery #EvidenceBasedPractice #Orthopaedics #BOFAS #SurgicalDecisionMaking @drlyndonmason Mason2d

🇸🇪 International Invitation for Professor @drlyndonmason Lyndon Mason

🇸🇪 International Invitation for Professor @drlyndonmason Lyndon Mason

We’re proud to share that our very own Professor @drlyndonmason Lyndon Mason, has been invited to deliver the Academic Friday Session at @uppsalauniversity Uppsala University Hospital, Sweden, on October 17th.

This invitation follows Professor Mason’s recent PhD from the @livuni University of Liverpool, focused on posterior malleolar fractures — a body of work that has transformed understanding and management of these complex injuries worldwide.

At Uppsala, Professor Mason will present on the Posterior Malleolus, discussing the evolution of treatment from biomechanics and fracture morphology to surgical approaches and outcome optimisation.

It’s a privilege to see his research being recognised by the prestigious Department of Orthopaedics at Uppsala University, a leading centre of orthopaedic excellence.

We wish Professor Mason every success in his upcoming lecture and thank Professor Olof Wolf and his team for the kind invitation.

🕗 Friday 17th October 2025 | 08:00–08:30 (Sweden) / 07:00–07:30 (UK)

#LiverpoolFootAndAnkle #PosteriorMalleolus #PhD #BOFAS #FootAndAnkleSurgery #AnkleFracture #GlobalOrthopaedics #OrthopaedicResearch #UppsalaUniversity #SwedishFractureRegister #SurgicalEducation #InnovationInOrthopaedics

⚽️ Grassroots football matters! ⚽️

⚽️ Grassroots football matters! ⚽️

Liverpool Foot & Ankle Clinic is proud to sponsor West Kirby United U12s — Nebula & Celeste 🌟

Supporting local grassroots teams is about more than football — it’s about teamwork, resilience, and community. We’re thrilled to help these young players grow, stay active, and chase their goals (on and off the pitch!) 💪⚽️

Here’s to a fantastic season ahead for Nebula and Celeste — play hard, have fun, and keep shining bright ⭐️⭐️

#LiverpoolFootAndAnkleClinic #WestKirbyUnited #GrassrootsFootball #CommunitySupport #Teamwork #Nebula #Celeste #YouthFootball #FootAndAnkle #ProudSponsors #WestKirby #LFC #sportinspires @englandfootball

⚽️ Grassroots football matters! ⚽️

👏 Well done to our @drlyndonmason who has been invited as the guest speaker at the West of Scotland Foot & Ankle Society (WOSFAS) meeting in Glasgow on Monday 6th October.

👏 Well done to our @drlyndonmason who has been invited as the guest speaker at the West of Scotland Foot & Ankle Society (WOSFAS) meeting in Glasgow on Monday 6th October.

Hosted at @hotelduvin and supported by @orthosolutionsgroupltd, the meeting will also welcome the @efas_society European Foot & Ankle Society Fellows for a joint evening of education and collaboration.

Professor Mason will present his pioneering research on posterior malleolar fractures, which has helped reshape treatment and surgical approaches both nationally and internationally 🌍

#LiverpoolFootAndAnkle #BoneAndJointCentre #LiverpoolOrthopaedics #WOSFAS #BOFAS #PosteriorMalleolus #AnkleFracture #FootAndAnkle #OrthoSolutions #Research #Innovation #Education #SurgicalLeadership #ProudMoment

🎉👏 A massive congratulations to @ruthcooilphysiotherapy on being named a FINALIST at the @mediaisleofman for Excellence 2025 in the category Teams Working Together! 🌟

🎉👏 A massive congratulations to @ruthcooilphysiotherapy on being named a FINALIST at the @mediaisleofman for Excellence 2025 in the category Teams Working Together! 🌟

This achievement celebrates the amazing collaboration between Ruth Cooil Physiotherapy, @spire.healthcare Liverpool, the @liverpoolfootandankle, @hassanridha and the @bone_and_joint_centre 🏥 — bringing world-class medical expertise, innovation, and care right here to the Isle of Man 🏝️.

An incredible recognition of teamwork, passion, and dedication to making a difference for patients 💙. So well deserved — and we’re all rooting for you on the big night! 🥂✨

#AwardsForExcellence #IsleOfMan #Teamwork #HealthcareHeroes #Physiotherapy #FootAndAnkle #SpireLiverpool #LiverpoolFootAndAnkle #celebratingsuccess

🔹 Historical Benchmarks in Foot & Ankle Surgery – and What They Teach Us Today 🔹

🔹 Historical Benchmarks in Foot & Ankle Surgery – and What They Teach Us Today 🔹

I was pleased to contribute to the recently published article:

📖 Clinical Outcomes of First Metatarsophalangeal Joint Arthrodesis Using the BOFAS Registry: A Prospective Cohort Study

https://lnkd.in/e7JYm_FN

⸻

🦶 What the Study Found

This was the first ever analysis of patient-reported outcomes for first MTPJ fusion using the BOFAS Registry.
• 459 patients (mean age 64, 99% female)
• PROMs captured pre-surgery, 6 months, and 12 months post-op
• Significant improvements were seen across pain, walking/standing, social interaction and quality of life (p < 0.001).
• By 12 months, median MOXFQ pain scores dropped from 65 pre-op → 15 post-op, and NRS pain from 59 → 8.
• EQ-5D-5L scores improved from 0.65 → 0.74, reflecting better overall health-related quality of life.

The study also highlighted challenges — notably low follow-up rates (27% at 6 months, 16% at 12 months) — underscoring the importance of improving registry completeness if we are to use these data to guide national practice.

⸻

📊 Why It’s Historical

This article represents a historic snapshot of the BOFAS Registry’s early years (2014–2019). At that time:
• The registry held just over 5,000 records.
• Data completeness was patchy, but the potential was clear: to benchmark care nationally and internationally.

⸻

📈 Where We Are Now (2025 BOFAS Report)

Fast-forward to today, and the registry has grown dramatically:
• >29,000 pathways, >24,000 patients logged nationwide
• 224 pathway owners contributing across the UK
• Compliance ~60% across all pathways
• Around 200 new cases added per month

This evolution shows just how far we’ve come in a decade. @bofas_uk

🔎 Article of Interest: Fixation Merhods and Post-Operative Protocols in First MTP Joint Fusion

🔎 Article of Interest: Fixation Merhods and Post-Operative Protocols in First MTP Joint Fusion

Hallux rigidus remains the most common form of foot arthritis, and first MTP joint arthrodesis is widely accepted as the gold standard treatment for advanced cases. Despite this, questions persist regarding:

1️⃣ Which fixation method gives the most reliable outcomes?
2️⃣ What weight-bearing regime is safest and most effective post-operatively?

A new systematic review published in Foot & Ankle Surgery explores these very questions:

“An evidenced based review of the efficacy of fixation type and post-operative weight-bearing status on metatarsophalangeal joint fusion for treatment of hallux rigidus”
👉 https://lnkd.in/ejcstRks

📊 Key findings:
• Fixation: Fair evidence supports the use of screws, plates, or plate + compression screw. Insufficient evidence exists for staples and newer devices.
• Weight-bearing: Both immediate weight-bearing and non-weight-bearing show comparable clinical outcomes.
• Evidence gap: Further high-quality Level I and II studies are needed to refine recommendations.

💡 This review reinforces that there is flexibility in both fixation choice and rehabilitation, but also highlights the lack of consensus in our field.

❓ Discussion point:
In your practice:
• What fixation method do you prefer for first MTPJ arthrodesis?
• Do you allow immediate weight-bearing post-operatively, or do you still recommend a period of protection?

I’d be very interested to hear how colleagues are approaching this in their own units.

#FootAndAnkleSurgery #HalluxRigidus #MTPFusion #EvidenceBasedMedicine #Arthrodesis #WeightBearing @drlyndonmason

🔎 Article of Interest: Fixation Merhods and Post-Operative Protocols in First MTP Joint Fusion

📍 @britorthopaedic 2025 – @bofas_uk and @orthopaedictraumasociety

📍 @britorthopaedic 2025 – @bofas_uk and @orthopaedictraumasociety

Privileged to present yesterday in the British Orthopaedic Foot & Ankle Society session at British Orthopaedic Association conference on talar fractures and dislocations —always a humbling topic where nuance matters.

I also had the honour of chairing the joint Orthopaedic Trauma Society/BOFAS revalidation session, covering:
🔹 Hindfoot nailing
🔹 Pilon fractures
🔹 Subtle Lisfranc injuries
🔹 Posterior malleolar fractures

Equally valuable was reconnecting with colleagues from Liverpool, the Isle of Man, and across the UK—sharing ideas, comparing approaches, and pushing standards forward. Well done to the BOFAS education committee Yaser Ghani for organising the event.

Also great to see our systematic review paper on TTT, making it into the best paper review session by the BOFAS scientific committee Madhu Tiruveedhula https://lnkd.in/e8dfqCtB

👏 Special mention to @codingmedic Abdul-Rahman Gomaa for an outstanding set of research presentations:
• Fifth Metatarsal Fractures: Time to Discharge – Oral presentation
• Introducing DARFI: A National Collaborative Database for Researching Rare and Atypical Fractures and Injuries – ePoster
• Accessing the Posterior Malleolus: The Posterolateral or Medial Posteromedial Approach? – ePoster
• Anterior Malleolar Fractures: A Retrospective Review of Fixation Methods and Outcomes – ePoster

The breadth of pathology, the depth of research, and the quality of debate yesterday truly showcased the strength of collaboration in the society.

#BOA2025 #BOFAS #OTS #TalarFracture #PilonFracture #Lisfranc #PosteriorMalleolus #FifthMetatarsal #FootAndAnkle #TraumaSurgery #SurgicalEducation #Research #Collaboration #Liverpool #isleofman @liverpoolfootandankle @bone_and_joint_centre

🔎 New RCT on Minimally Invasive vs Open Surgery for Hallux Valgus

🔎 New RCT on Minimally Invasive vs Open Surgery for Hallux Valgus

Escudero et al. have just published a randomized controlled trial comparing MITO (minimally invasive transverse distal metatarsal osteotomy with percutaneous Akin) vs open chevron Akin (OC) surgery for mild–moderate hallux valgus in the American Orthopaedic Foot & Ankle Society journal FAI.

📊 Key findings:
• 40 patients, 40 feet randomized
• No difference in surgical time, PROMs, AOFAS, or radiographic results at 1 year
• Early wound healing favored MITO at 6 weeks (PWAT score)
• Complication rate: 15% in both groups
• At 1 year, outcomes were equivalent across both techniques

💡 Takeaway:
This small RCT suggests that minimally invasive techniques may offer short-term soft tissue benefits in wound healing, but at 1 year, both MIS and open osteotomies achieve comparable functional and radiographic outcomes. Larger, multicentre trials will be important to confirm these findings and guide practice.

📖 paper https://lnkd.in/e-2SsDiX

#HalluxValgus #MinimallyInvasiveSurgery #FootAndAnkle #RCT #EvidenceBasedSurgery #Orthopaedics @drlyndonmason @bone_and_joint_centre

Huge thank you to the fantastic team at @orthosolutionsgroupltd for consistently delivering such a high-quality, research-driven cadaveric course on novel ankle fracture techniques.

Huge thank you to the fantastic team at @orthosolutionsgroupltd for consistently delivering such a high-quality, research-driven cadaveric course on novel ankle fracture techniques.

It’s been a real privilege to serve on the faculty again, alongside Roland Walker, helping shape a course that continues to evolve in line with the latest evidence and surgical innovation. Over the past 3 years, we’ve had over 200 consultant delegates, from Foot & Ankle specialists to general trauma surgeons — with some attending more than once, which is a real testament to the value and relevance of the teaching.

A particular highlight for me has been welcoming some of my own former trainers as course delegates — a full circle moment that reinforces the collaborative and lifelong learning culture we strive for in orthopaedics.

This final course of 2025 was made even more special by the international delegates from Brazil 🇧🇷 and our continued focus on emerging topics like:

🔥 The Modified Posteromedial Approach
⚠️ Tibialis Posterior “danger zones”
🦴 Lateral plafond impaction
🧠 Management of anterior distal tibial fractures

Already looking forward to what 2026 has in store — thank you again to everyone who’s made this course what it is.

@curymedical @liverpoolfootandankle @fortiusclinic
#advancingfootandankle #OrthopaedicEducation #FootAndAnkle #VolitionSystem #2BPlate #MPMapproach #CadaverLab #BOFAS #OrthoSolutions #TraumaSurgery #LifelongLearning #FACT #EvidenceBasedSurgery #globalcollaboration

🎉 Very pleased to share that I have successfully passed my PhD by published work from the @livuni 🎓✨

🎉 Very pleased to share that I have successfully passed my PhD by published work from the @livuni 🎓✨

My thesis, “Posterior Malleolar Fractures - A greater understanding to improve outcomes”, bringing together over a decade of research exploring the anatomy, injury patterns, surgical approaches, and long-term outcomes of these type of ankle fractures. This work has aimed to improve understanding, reduce surgical risk, and ultimately enhance patient care for these patients worldwide.

I am incredibly grateful to my supervisor, @kristiaandaout, for his guidance and encouragement throughout this journey, and to my proposer Simon Tew for his support.

A sincere thank you to my examiners, Alex Trompeter and Claire Brockett, for their rigorous and constructive examination, and to Alex German for kindly chairing.

Most importantly, I want to thank everyone who has contributed to this body of work over the years—collaborators, colleagues, trainees, and patients. A special thanks to @andymolloy3, whose vision, friendship, and collaboration has been pivotal in shaping much of this research and the surgical thinking behind it.

While many research journeys aim for a randomised controlled trial (RCT) as the ultimate destination, in the case of posterior malleolar fracture treatment, each study revealed new layers of complexity — from anatomical variability and tendon entrapment to vascular risk and fixation strategy. Rather than narrowing toward a single intervention for trial, the accumulating findings reshaped the treatment landscape itself. The work became less about comparing treatments and more about defining what we were treating — refining classification, improving imaging interpretation, developing safer surgical approaches, and designing implants tailored to the fracture morphology. This evolving body of evidence has, in many ways, redefined the foundations upon which future trials may one day be built.

I’m happy to share the thesis. DM me for a copy if interested. #phd #anklefracture #posteriormalleolus #bofas #aofas

📸 Just found out I was in a BBC News article last year about setting up foot & ankle clinics on the Isle of Man… and I didn’t even realise at the time!

📸 Just found out I was in a BBC News article last year about setting up foot & ankle clinics on the Isle of Man… and I didn’t even realise at the time!

Funny thing looking back at that photo — since then I’ve lost 3 stone. A reminder of how much you can change in only a short period of time. That photo was probably the catalyst to me knowing I had to change.

Really proud of the work we’re doing with Manx Care to bring care closer to patients and reduce unnecessary travel off-island. It’s been a privilege treating patients on the Isle of Man for over 10 years, and I’m looking forward to continuing these clinics every two months.

Sometimes you don’t see the progress until you look back. Both in patients — and in yourself.

#BBC #LiverpoolFootAndAnkle #ManxCare #FootAndAnkle #Orthopaedics #IsleOfMan #WeightLossJourney #SpecialistCare #OnIslandCare #liverpoolfootandankle #iomfootandankle @hassanridha @ruthcooilphysiotherapy @liverpoolfootandankle https://www.bbc.com/news/articles/cy874l5dd13o.amp

🦶 New Publication: Fifth Metatarsal Fracture Mapping and Outcomes

🦶 New Publication: Fifth Metatarsal Fracture Mapping and Outcomes
📍 European Journal of Trauma and Emergency Surgery (2025)

@j_omi @codingmedic @lukemarsh96 @nickward1991 S Aslam, A Paramasivan, Ahmed Galhoum, @drlyndonmason

https://lnkd.in/eVusBsxF

Fifth metatarsal fractures are among the most common foot injuries, yet the classification systems we use to guide management may not be fit for purpose.

In this study, we analysed 2,165 patients treated at a Level 1 Major Trauma Centre, digitally mapping fracture configurations across the fifth metatarsal and linking these to clinical outcomes.

✅ Key findings:
• Over 60% were safely discharged directly from Virtual Fracture Clinic
• Only 1.3% required surgery
• Zone 3 fractures had the highest rate of delayed union (2.74%)
• A third of fractures spanned multiple zones—something current classification systems fail to capture
• Fracture mapping revealed significant morphological diversity and challenges the utility of the traditional 3-zone model

📊 Despite complex morphology, most fractures—including long-spanning and multifragmented patterns—healed uneventfully with functional treatment (boot or hard sole shoe, weight bearing as tolerated).
This further supports a conservative-first approach in the general population.

🚫 The term “Jones fracture” and current classification systems may be misleading. Fracture mapping revealed substantial overlap, poor reproducibility, and a need to abandon ambiguous eponyms in favour of anatomy-based, image-driven decision-making.

💡 Do you still rely on “Jones fracture” terminology?
Our findings suggest it’s time we rethink outdated eponyms and classification models in favour of reproducible, anatomy-based tools.

👣 #Orthopaedics #FootAndAnkle #FractureMapping #EvidenceBasedPractice #FifthMetatarsal #JonesFracture #VirtualFractureClinic #LiverpoolFootAndAnkle #BOFAS @liverpoolfootandankle @livuni @nhsuhlg

🔍 Do you screen the subtalar joint and medial column when fixing ankle fractures with deltoid ligament instability? 🦶

🔍 Do you screen the subtalar joint and medial column when fixing ankle fractures with deltoid ligament instability? 🦶

In our study we examined whether deltoid ligament reconstruction (DLR) during ankle fracture fixation influences pes planus (flatfoot) development.

👣 Among 132 patients with surgically managed ankle fractures and confirmed deltoid ligament injury:

✅ Those who underwent DLR, most maintained a neutral Meary’s angle, preserving the medial longitudinal arch.

❌ In contrast, patients without DLR frequently developed pes planus, despite similar medial clear space.

🩼 In those who were non-weight bearing in a cast also developed pes planus — with only DLR remaining significant on multivariate analysis for maintenance of arch.

This suggests the superficial deltoid and spring ligament complex play a structural role in subtalar and medial column stability, not just ankle mortise alignment. This has pretty much been ignored in the literature so far. See video of the subtalar screening using hindfoot stability test. https://lnkd.in/eQUb6PuB

💬 So, during ankle fracture fixation…
👉 Do you screen the subtalar joint and medial column?
👉 Is deltoid ligament reconstruction part of your algorithm for preserving the arch?
👉 Or do we underestimate the consequences of leaving the medial side unsupported?

#AnkleFractures #DeltoidLigament #PesPlanus #Flatfoot #FootAndAnkle #Orthopaedics #BOFAS #SubtalarStability #MedialColumn #ArchCollapse #BJJ #traumasurgery @liverpoolfootandankle @codingmedic @junaidaamir28

🔍 MIS vs Open in Calcaneal Fractures – What does the latest Level 1 evidence tell us? 👣

🔍 MIS vs Open in Calcaneal Fractures – What does the latest Level 1 evidence tell us? 👣

A new systematic review and meta-analysis of RCTs in Foot and Ankle Surgery ( Purdie et al., santosh baliga 2025) compares the extensile lateral approach (ELA) with minimally invasive surgical techniques (MIS)—namely the sinus tarsi and percutaneous approaches—for displaced intra-articular calcaneal fractures (DIACFs).

💡 Key findings across 14 RCTs (n = 1367):

✅ Wound Complications
MIS significantly reduces wound complications vs ELA (RR 6.48, GRADE: High)

✅ Functional Outcomes
Higher AOFAS and Maryland Foot Scores at both 6 and 12 months for MIS (especially early recovery)

✅ Radiographic Outcomes
No significant difference in Bohler’s or Gissane’s angles—MIS achieves comparable anatomical reduction

📊 Both sinus tarsi and percutaneous approaches showed consistent benefits over ELA in subgroup analyses.

🧠 For clinicians, this study reinforces the shift towards MIS for DIACFs, especially where wound risks and return to function are paramount.

🎓 For educators and trainees, it’s a great article to spark critical appraisal discussions on surgical technique selection, bias in meta-analysis, and how functional outcomes evolve over time.

🔁 Are you still using ELA routinely for Sanders II/III? Has MIS changed your algorithm?

📚 https://lnkd.in/e5kcbprx

#FootAndAnkle #CalcanealFracture #MISsurgery #Orthopaedics #BOFAS #RCT #TraumaSurgery #FunctionalOutcomes #SurgicalEducation @drlyndonmason @uniofaberdeen

👣 Anterior Pilon Fractures — Are We Missing Something?

👣 Anterior Pilon Fractures — Are We Missing Something?

Thanks to everyone who weighed in on the case yesterday about anterior pilon fracture management.

https://lnkd.in/e9j8V2ZG

Here’s a quick summary of our recent study and some reflections:

🔎 In a series of 57 anterior pilon fractures, 68% showed persistent anterior talar translation on p ost-op weightbearing radiographs—despite anatomical fracture reduction.

⚠️ No cases had ATFL repair or assessment.
This raises a key point: are we underestimating the ligamentous injury component—particularly the anterior talofibular ligament (ATFL)—in these high-energy injuries?

The case yesterday illustrated persistent anterior talar translation despite tibia anatomical reduction, on anterior drawer test. Following ATFL repair, this was corrected.

💡 Key takeaways:
• Persistent anterior talar translation is common.
• It appears unrelated to fracture pattern or reduction quality.
• The likely culprit? Undiagnosed and untreated ATFL rupture.
• We don’t routinely assess talar stability post fixation—but maybe we should.

❓So to answer the questions:
👉 Do I now consider ATFL repair in anterior pilons? I’m certainly thinking about it.
👉 Do I screen for anterior talar instability post-op? I do now..

Let’s keep the conversation going.

🦶💡 Is 3D printing changing the game in ankle surgery?

🦶💡 Is 3D printing changing the game in ankle surgery?

This new review highlights the growing role of 3D printing in complex ankle reconstruction — not just in theatre, but also in how we prepare and teach.

🔹 Total talus replacement (TTR) is emerging as a viable alternative to fusion or conventional arthroplasty — especially in cases of AVN, trauma, or tumour.
🔹 Custom implants and patient-specific instrumentation in TAA and arthrodesis are improving fit, alignment, and union.
🔹 Supramalleolar osteotomy with PSI leads to shorter op times, less blood loss, and reduced radiation.
🔹 Beyond surgery — 3D models are proving invaluable for education and simulation, giving trainees and surgeons the opportunity to visualise, rehearse, and refine complex procedures preoperatively.

🧠 As both a clinical tool and an educational platform, 3D printing is bridging the gap between planning and performance.

🔗 Full article: https://lnkd.in/eZEQfwaJ

📣 Are you using 3D models in your practice or training? Do you see them becoming routine in ankle surgery?

@malhotrafootandankle @drlyndonmason @manchesterfootankle @orthosolutionsgroupltd

#FootAndAnkle #3DPrinting #Orthopaedics #AnkleSurgery #SurgicalEducation #PatientSpecific #TTR #TAA #iom #innovationinsurgery #iomfootandankle #liverpoolfootandankle

What are the safe zones for minimally invasive midfoot surgery? ❓

What are the safe zones for minimally invasive midfoot surgery? ❓

MIS midfoot fusion and osteotomy may have the possible benefits of faster recovery, smaller scars, and less soft-tissue disruption — but without direct visualisation, critical neurovascular structures and tendons are at risk.

A new cadaveric study has created fluoroscopic heatmaps mapping the dorsal neurovascular bundle, superficial peroneal nerve, and key tendons on standard AP and oblique views.

The findings:
🔹 Red zones = highest injury risk
🔹 Blue zones = less common but possible trajectories
🔹 No-colour areas = completely safe for burr or screw placement
🔹 AP vs oblique views reveal different optimal access points for the medial and lateral columns

This “radiological safety atlas” bridges the gap between open anatomy and MIS fluoroscopic navigation — aiming to reduce iatrogenic injury and improve surgical confidence. Well done to the authors. 👏

📄 Karaismailoglu B, Peiffer M, Raduan F, Hollander JJ, Knebel A, Kwon JY, Soheil Ashkani-Esfahani, MD, MPH , @bostonfootankle . Radiological safety atlas of minimally invasive midfoot fusion: A cadaver study. Foot Ankle Surg. 2025;31:448–453.
🔗 https://lnkd.in/eJ6KTehN

#FootAndAnkle #Orthopaedics #MinimallyInvasiveSurgery #Midfoot #SurgicalSafety #Anatomy #CadaverStudy #Fluoroscopy @drlyndonmason

🔍 Broström Repair – With or Without Suture Tape Augmentation?

🔍 Broström Repair – With or Without Suture Tape Augmentation?

Lateral ankle instability is a common challenge. The augmented Broström repair, using high-strength suture tape, offers greater initial biomechanical stability in cadaver studies — but does that translate into better patient outcomes in the long term?

This 5-year median follow-up study in @aofas1 compared:
• Broström repair alone (BR)
• Broström repair with suture tape augmentation (BR-ST)

📊 Key findings:
• No significant difference in FAAM ADL, FAAM sport, SF-12 PCS, Tegner score, or patient satisfaction between BR and BR-ST.
• Slightly higher SF-12 mental component scores in the BR-ST group (possibly reflecting greater confidence in the repair).
• Low revision rates in both groups (1 revision for recurrent instability in BR-ST).
• Earlier recovery in the BR-ST group often occurred because surgeons felt more confident in the repair and therefore advised a faster return to activity.

💡 Takeaway: While augmentation may allow for accelerated rehab and weight-bearing due to surgeon confidence, long-term functional outcomes appear similar. The choice may ultimately depend on patient profile, tissue quality, and surgeon preference.

Is it worth the expense?

📄 Full paper: https://journals.sagepub.com/doi/10.1177/10711007231176806

What’s your current go-to for chronic lateral ankle instability — standard Broström, augmentation, or anatomic reconstruction?

#FootAndAnkle #Orthopaedics #SportsMedicine #AnkleInstability #SurgicalOutcomes #EvidenceBased @drlyndonmason

🎓Honoured to receive a Certificate of Commendation

🎓Honoured to receive a Certificate of Commendation from the @livuni @livunimedicine , awarded based on student feedback recognising my contribution to undergraduate medical education.

I’ve always tried to make orthopaedics come alive — whether it’s demonstrating practical aspects, adapting sessions to feedback, or trying to recreat the energy and curiosity of a Royal Society Christmas Lecture. Teaching should feel like discovery, not dictation.

To hear that students found the sessions “engaging, inspiring, and outstanding” means more than any formal title.

Thank you to the students who took the time to give feedback, and to the School of Medicine for valuing that voice. @nhsuhlg @liverpoolfootandankle

🦴📚 #MedicalEducation #Orthopaedics #MSK #UniversityOfLiverpool #TeachingExcellence #RoyalSocietyChristmasLectureVibes #StudentExperience #HigherEducation #FOAMed #InspiringTheNextGeneration

🔬 Can Early Functional Rehab Prevent Heterotopic Ossification After Achilles Rupture?

🔬 Can Early Functional Rehab Prevent Heterotopic Ossification After Achilles Rupture?

In this thought-provoking study from @clinorthop , Magnusson et al. explored whether early weightbearing and ankle mobilization could reduce heterotopic ossification (HO) following surgical repair of Achilles tendon ruptures.

👣 Key findings from the 69-patient cohort:
• HO occurred in 19% of patients—but crucially, it had no negative impact on functional outcomes (ATRS, VISA-A, ROM, tendon strain).
• In fact, those with HO showed a trend towards better heel-raise performance at 1 year.
• HO developed within the first 6 weeks post-op, irrespective of the rehab protocol.
• Early functional rehab (mobilization and weightbearing) did not prevent HO.

📌 Takeaway: Heterotopic ossification is more common than we might expect after Achilles surgery—yet may not impair recovery. And despite animal data suggesting loading can influence HO, this clinical study found no protective effect from early motion.

🧠 Did you know that surgical repair of Achilles tendon ruptures can lead to heterotopic calcification?
❓Has anyone seen this in practice—or used specific methods to prevent HO in tendon repairs?
🧐Does HO occur after conservative treatment of Achilles tendon ruptures?

Let’s start a conversation.

📰 https://lnkd.in/enBd74yB

#AchillesTendon #Orthopaedics #FootAndAnkle #HeterotopicOssification #Rehabilitation #SportsMedicine #TendonRepair #ClinicalResearch #CORR #Achillesrupture #AchillesTendonRupture @drlyndonmason

🔍 Is a Wagstaffe fragment always a sign of syndesmotic instability?

🔍 Is a Wagstaffe fragment always a sign of syndesmotic instability?

This publication in Foot and Ankle Surgery from members of the team offers a unique anatomical and radiological analysis that challenges this long-held assumption.

🦴 In a dual-method study, we:
• Conducted detailed cadaveric dissections to map the fibular footprint of the Anterior Inferior Tibiofibular Ligament (AITFL)
• Analysed over 150 CT scans to characterise Wagstaffe fractures and correlate with intraoperative syndesmotic testing

📌 Key findings:
• The AITFL origin is larger and more distal than the average Wagstaffe fragment
• Fragment size and presence alone do not predict instability — ligamentous failure must also occur
• This questions the reliance on Wagstaffe fragments for decisions about syndesmotic fixation

🧠 This is the first study to combine anatomical dissection and high-resolution imaging to compare the true footprint of the AITFL with actual fracture patterns — offering a more nuanced understanding of syndesmosis injuries.

🖊️ A great collaborative effort with Andrew Fisher, Alistair Bond @philmattpott @andrewmolloyfootandankle @drlyndonmason

@nhsuhlg @livuni

📄 https://lnkd.in/eiqaKkt3

#FootAndAnkle #Orthopaedics #AnkleFractures #Syndesmosis #Anatomy #AITFL #WagstaffeFracture #Radiology #TraumaSurgery #BOFAS #surgicaldecisionmaking

🦶🔬 Does US guided Achilles Rupture Treatment lead to improved results?

🦶🔬 Does US guided Achilles Rupture Treatment lead to improved results?

Two papers from a three arm RCT assessing the Copenhagen Achilles Rupture Treatment Algorithm (CARTA) @maria_swennergen_hansen @university_of_copenhag be en Amager and Hvidovre Hospital team have been published — and they ask a big question:

👉 Does tailoring Achilles tendon treatment based on ultrasound findings improve outcomes?

📊 Patients were randomised to:
1️⃣ CARTA (individualised treatment based on ultrasound-measured tendon gap and elongation)
2️⃣ Surgery for all, regardless of imaging
3️⃣ Non-operative treatment for all, regardless of imaging

🧾 What they found:
There were no statistically significant differences between groups in:

✅ Gait dynamics
✅ Tendon elongation
✅ Muscle volume on MRI
✅ Achilles Tendon Total Rupture Score (ATRS)
✅ Plantarflexor power and moment
✅ Peak dorsiflexion during stance
✅ Deep flexor hypertrophy
✅ Re-rupture rates (although CARTA had none)

📉 All patients — regardless of treatment strategy — showed:
🔹 Significant muscle atrophy (esp. soleus & gastrocnemius)
🔹 Marked tendon elongation (~2–3 cm on average)

📌 Bottom line:
Treating based on ultrasound-measured tendon gap, treating non-operatively by default, or treating all patients surgically led to comparable results at 12 months.

📚
🔗 https://lnkd.in/eCZvc3CV
🔗 https://lnkd.in/eCZvc3CV

#CARTA #AchillesRupture #UltrasoundInOrtho #MuscleAtrophy #TendonElongation #OrthoResearch #RCT #FootAndAnkle #AchillesTendon #PhysioRehab #SportsInjury #EvidenceBasedMedicine #AchillesRecovery #CalfStrength #OrthoTrials #FunctionalOutcomes @drlyndonmason

🦶💥 Is the Posterior Malleolus Reliably Reduced by Fibula Fixation Alone?

🦶💥 Is the Posterior Malleolus Reliably Reduced by Fibula Fixation Alone?

A huge congratulations to Meletis Rozis in publishing this unique paper that answers a lot of questions. I’m also delighted I could be of some assistance to the paper. The prospective CT-based study published in The Journal of Foot and Ankle Surgery 📖:
👉 https://lnkd.in/eC-wsmwk is now available preprint

🔍 What was the study?
It prospectively assessed 71 patients with posterior malleolar fractures that were not directly fixed. None had CT preop, and all were fixed in routine bimalleolar fashion. Using postoperative CT, the accuracy of reduction of the PM fracture was evaluated with the hypothesis being that indirect reduction via fibula fixation and syndesmotic stabilisation was possible.

📊 Key Results:
Anatomical reduction by ligamentotaxis was achieved in:
• 91% of Mason 1 fractures
• 54% of Mason 2A fractures
• 31% of Mason 2B fractures
• 76% of Mason 3 fractures

❗ Conclusion: Ligamentotaxis cannot reliably reduce Mason 2 and 3 fractures, especially type 2B.

🔬 These findings can be partly explained by our previous anatomical study (https://lnkd.in/e8SZzzE7) which showed that the posterior inferior tibiofibular ligament (PITFL) has a broad tibial insertion footprint, far exceeding the typical size of the fracture fragments but does not extend beyond the TiB post sheath (where 2B fractures lie.)
Similarly, it adds to the hypothesis that type 2A and 2B fractures are rotational talar impaction fractures and not PITFL avulsion injuries as described in our original paper https://lnkd.in/e-3Q8Wiv

➡️ Therefore, ligamentotaxis possibly only works when the PITFL insertion is entirely contained within the fragment—a scenario often not present in Mason 2 or 3 injuries.

This study challenges the assumption that the posterior malleolus can be “automatically” reduced and stabilised via fibular fixation alone.

🧠 Authors: @rozismel , Lyndon Mason, Dimitrios-Stergios Evangelopoulos, Eleftherios Stavridis, Spyros Pneumaticos. @liverpoolfootandankle

🚨 Look who’s on the front cover! 🚨

🚨 Look who’s on the front cover! 🚨

Proud to share that one of our illustrations on the transverse tibial translational osteotomy (TTT) has made the front cover of the August issue of @aofas1 Foot & Ankle International!

This image forms part of our systematic review on TTT in the treatment of ischemic ulcers of the lower limb — a technique with growing global interest due to its ability to stimulate angiogenesis and support limb salvage in diabetic foot disease.

📄 The article reviews 924 patients across 13 studies, showing:
✅ 94% ulcer healing rate with TTT
✅ Significant improvements in ABI and VEGF
✅ <3% amputation rate
✅ Low complication rates (especially tibial fractures and pin site infections)

Our thanks to the fantastic team:
@abby.luxon Anxhela Syziu William Harrison Amirul Islam
@nhsuhlg @livuni @liverpoolfootandankle

And to the FAI editorial team for selecting our visual to highlight this work.

📚 https://lnkd.in/em6erQdM

#FootAndAnkle #Orthopaedics #VascularSurgery #DiabeticFoot #Ilizarov #LimbSalvage #Revascularisation #FAI #LiverpoolOrtho #InnovationInSurgery #researchimpact

🦴 What really makes an ankle fracture unstable?

🦴 What really makes an ankle fracture unstable?

In a review published by the team, “Ankle Stability in Ankle Fracture” (Journal of Clinical Orthopaedics and Trauma), the concept of ankle stability was dissected — not just from a bony perspective, but through the vital lens of ligamentous and syndesmotic integrity.

🔑 Key Takeaways from the Paper:
1. Stability is multifactorial
True ankle stability in fractures is not solely dependent on bony architecture. Ligamentous structures — particularly the deltoid complex and syndesmosis — are critical determinants, especially in positions where osseous congruency is reduced (e.g. plantarflexion).
2. Weight-bearing matters
Weight-bearing radiographs more accurately reflect functional stability than gravity or manual stress views. They can reduce unnecessary surgical interventions by revealing a competent deep deltoid ligament when the ankle is loaded in a plantigrade position.
3. Posterior malleolus: more than just size
The posterior malleolus importance is not only in regard to syndesmosis integrity but also on rotational stability of the ankle.
4. Intra-operative assessment is evolving
Traditional stress tests (e.g. Cotton, external rotation) have poor sensitivity for syndesmotic injury. Direct visualization, either by open or arthroscopic means has much greater utility.
5. Instability is contextual
Instability should be defined as the inability to maintain talar centralisation under the tibia during physiological load, not merely based on radiographic clear space or fracture pattern.

📖 Read the full article here: https://lnkd.in/exifSyZd

@livuni @nhsuhlg @drlyndonmason @bone_and_joint_centre

#AnkleFracture #Orthopaedics #FootAndAnkle #TraumaSurgery #LigamentInjury #PosteriorMalleolus #Syndesmosis #OrthopaedicEducation #EvidenceBasedMedicine #WeightBearing #DeltoidLigament #AnkleStability #surgicaldecisionmaking

🔎 Which autograft is best for chronic lateral ankle instability reconstruction?

🔎 Which autograft is best for chronic lateral ankle instability reconstruction?

A new systematic review in Foot & Ankle Specialist by Brasnic et al. explores this critical question by comparing 734 patients across 20 studies.

Key takeaways:
👉 Peroneal tendons (peroneus longus and brevis) demonstrated favourable PROMs and radiographic outcomes, with the lowest complication rates – but no statistically significant superiority was found.
👉 Gracilis and bone-patellar tendon grafts had higher harvest-related and nerve injury risks.
👉 Despite biomechanical strengths, no one graft type emerged as clinically superior.

The authors rightly emphasise that surgeon preference, patient factors, and graft accessibility should guide decision-making – and call for higher-level evidence to support graft selection in CAI. Although some use allograft or synthetic alternatives, this overviews is very informative if autograft is being used.

📖 A must-read for anyone involved in lateral ankle reconstruction surgery:

https://lnkd.in/eWnt9h8W

#FootAndAnkle #Orthopaedics #AnkleInstability #LigamentReconstruction #SportsMedicine #CAI #OrthopaedicSurgery #EvidenceBasedSurgery
@drlyndonmason @sagejournalpublication

Mid-to-Long-term Clinical Outcomes of Ankle Arthroscopy on the Treatment of Chronic Ankle Conditions: Systematic Review and Meta-analysis

Mid-to-Long-term Clinical Outcomes of Ankle Arthroscopy on the Treatment of Chronic Ankle Conditions: Systematic Review and Meta-analysis” by Herrera-Pérez et al. (2025) in Sage journal Foot Ankle Specialist

⸻

🔍 Is ankle arthroscopy effective for chronic ankle pain?
A new systematic review and meta-analysis published in Foot & Ankle Specialist examines mid-to-long-term outcomes across 47 studies and 2,653 patients.

💥 Key findings:
• ✅ Significant pain reduction for osteochondral lesions (VAS ↓ 4.5) and ankle OA (VAS ↓ 2.9)
• 📈 Functional improvement in AOFAS scores up to 35 points in some conditions
• 🔧 Success rates:
• 92.5% – Soft tissue impingement
• 87.5% – Synovitis
• 73.2% – Osteochondral lesions
• 71.5% – Bony impingement
• 54.7% – Ankle OA

⚠️ The review highlights heterogeneity in outcome measures and limited high-level evidence, urging caution in interpretation. Still, for select patients, ankle arthroscopy remains a valuable tool—especially for impingement and chondral lesions.

🔗 Read the full article here: https://lnkd.in/ekUNKmjs

#FootAndAnkle #Orthopaedics #AnkleArthroscopy #SportsMedicine #AnkleSurgery #EvidenceBasedPractice #OrthopaedicResearch @drlyndonmason

🔍 Minimally Invasive vs Open Cheilectomy for Hallux Rigidus: What Does the Evidence Say?

🔍 Minimally Invasive vs Open Cheilectomy for Hallux Rigidus: What Does the Evidence Say?

A new systematic review by Cristofaro et al. (2025) in Foot & Ankle Specialist has compared outcomes following minimally invasive (MIS) and open cheilectomy for hallux rigidus – the most common form of 1st MTP joint arthritis.

📊 Key Findings:
• Both MIS and open cheilectomy achieve similar functional outcomes and high patient satisfaction.
• Open cheilectomy had a higher complication rate (14.7% vs 8.2%, p = .001), especially persistent pain and neuropathic symptoms.
• However, revision surgery was more common after MIS cheilectomy (9.3% vs 5.0%, p = .003) — particularly secondary cheilectomy, possibly due to under-resection.
• Rates of conversion to 1st MTPJ arthrodesis were similar between groups.

🦶🏻 This is the first systematic review directly comparing the two approaches, synthesising data from over 1,200 procedures across 24 studies. It offers real-world insights on surgical decision-making for early-stage hallux rigidus.

⚠️ The authors call for more robust, long-term comparative studies — but this is an important step in understanding how less invasive approaches stack up in the long run.

📖 Read the article - https://lnkd.in/eMceWhtC

#FootAndAnkle #HalluxRigidus #MinimallyInvasiveSurgery #Cheilectomy #Orthopaedics #SurgicalOutcomes #MIS #EvidenceBasedMedicine #FootSurgery #AnkleSurgery #SystematicReview #FASjournal @drlyndonmason #iomfootandankle #liverpoolfootandankle

🦶💥 Tibialis Anterior Tendon Rupture – What’s the Best Approach?

🦶💥 Tibialis Anterior Tendon Rupture – What’s the Best Approach?

A rare but often missed injury, tibialis anterior tendon (TAT) rupture can lead to serious gait dysfunction if left untreated. In a comprehensive literature review, over 80 studies were analyzed to bring clarity to this complex topic.

📚 The result? A practical, evidence-based algorithm tailored to:

🔹 Injury cause (traumatic vs spontaneous)
🔹 Timing (acute vs chronic)
🔹 Tendon gap size
🔹 Muscle quality (fatty infiltration or not)

🔧 Management options ranged from:
• Direct repair 🪡
• Lengthening & rotationplasties
• EHL tendon transfers
• Hamstring or tibialis anterior allografts
• …with or without gastrocnemius recession

Key message? One size does not fit all.

👣 Chronic ruptures with tendon degeneration and muscle fatty infiltration? → EHL transfer preferred.
👣 Acute traumatic tears with small gaps? → Direct repair under low tension works well.
👣 Gaps >5cm? → Tendon grafting or transfer is usually needed.

Well done to the authors @dr.amirreza.vosoughi @heyesgavin @andrewmolloyfootandankle Amir Human Hoveidaei and our @drlyndonmason

📄 https://lnkd.in/eXtBUTji

#TibialisAnterior #FootAndAnkle #TendonRupture #EHLtransfer #Orthopaedics #FootAndAnkleSurgery #AnkleInjury #LiverpoolFootAndAnkle #OrthopaedicResearch #BOFAS #TraumaTips #TATrupture

🔬 When Correction Matters Most: What Predicts Nonunion After MTPJ Arthrodesis?

🔬 When Correction Matters Most: What Predicts Nonunion After MTPJ Arthrodesis?

First MTPJ arthrodesis remains the gold standard for advanced hallux rigidus and salvage hallux valgus surgery — but what causes some to fail?

A paper published from some of our members in the Journal of Foot & Ankle Surgery, explored risk factors for nonunion following first MTPJ arthrodesis using a dorsal locking plate and compression screw constructs. Drawing on a consecutive cohort of 178 fusions over five years, it was found:

➡️ Nonunion rate: 6.2%
➡️ Diabetes was the most significant independent risk factor (OR 7.4, p = .019)
➡️ Residual postoperative hallux valgus (HVA ≥ 20°) was also independently predictive (OR 6.5, p = .015)

Interestingly, preoperative deformity was not a risk factor once residual deformity was controlled for. It’s not how bent they start — it’s how well you finish.

It was also observed a non-significant trend toward lower nonunion rates when a separate compression screw was used outside of the plate construct. But the big take-home message is this:

✅ Meticulous correction of hallux valgus matters.
💬 Fusion site healing relies not only on fixation technique, but on coronal plane alignment.

This paper reflects a real team effort — many thanks to authors @lizzyweigelt @jamesredfearn101 @heyesgavin @andrewmolloyfootandankle and our @drlyndonmason Mason

@nhsuhlg @livuni
🦶 Read the full paper here: https://lnkd.in/eKGWSaqW

#Orthopaedics #FootAndAnkle #MTPJFusion #HalluxValgus #DiabetesCare #BoneHealing #SurgicalOutcomes #LiverpoolFootAndAnkle #BOFAS #AcademicSurgery #Stryker #FixationStrategy #nonunionprevention

📣 Research Spotlight
Is flatfoot a hidden contributor to bunion recurrence after surgery?

📣 Research Spotlight
Is flatfoot a hidden contributor to bunion recurrence after surgery?

The 2020 study, published in @aofas1 Journals Foot & Ankle International, and coauthored by our @drlyndonmason , explored a common but under-recognised question: does pes planus increase the risk of hallux valgus recurrence following scarf osteotomy?

🔍 In a cohort of 164 feet, we found:
• Overall recurrence rate: 16%
• In patients with severe pes planus (Meary angle < –10°): 47% recurrence
• In patients with mild pes planus (–10° to –4°): 29%
• In patients with a normal arch: 1%

🦶 Crucially, deformity progression plateaued after 6 months, suggesting that this is the key window for recurrence.
We also found that recurrence correlated strongly with medial arch collapse at the naviculocuneiform joint, highlighting the importance of evaluating medial column stability in surgical planning.

👣 This work supports closer scrutiny of foot posture in bunion surgery, and may inform decisions on adjunct procedures or postoperative bracing in flatfooted patients.

📄 Read the full paper here: https://lnkd.in/eQ5S7rSW

🔬 Authors: @gavin.heyes @lizzyweigelt @dr.amirreza.vosoughi @andrewmolloyfootandankle
📍 NHS University Hospitals of Liverpool Group

#FootAndAnkle #PesPlanus #HalluxValgus #ScarfOsteotomy #Flatfoot #Orthopaedics #BunionSurgery #Recurrence #LiverpoolFootAndAnkle #ResearchImpact #bofas @bone_and_joint_centre

📚 What classification for Pes Cavus is most useful clinically?

📚 What classification for Pes Cavus is most useful clinically?

A paper recently published by @kmalhotra_83 investigates classifications used in Pes Cavus.

Classifications in Adult Pes Cavus – A Scoping Review
📍Published in The Foot (2024) – Open Access

This is an important review as it addresses whether our current systems of classification in what is a complex deformity with multiple causes, are useful.

👉 This comprehensive scoping review screened over 1,100 articles, yet found only 3 classification systems that proposed operative guidance — all of which were Level V evidence and none of which were prospectively validated or reported outcomes.

🦶 The 3 systems currently in use:
1. Samilson et al. (1983) – Anatomical, apex-based (forefoot/midfoot/hindfoot), simple but lacks guidance for management or 3D understanding
2. Louwerens et al. (2018) – Consensus-based, anatomical staging with qualifiers (flexibility, instability, toe deformities), guides some surgical treatment
3. Usuelli et al. (2019) – Detailed anatomical-clinical-radiological staging, with operative algorithms per stage, but unvalidated and complex

📸 Despite advances in adult foot and ankle research and imaging modalities, pes cavus remains without a universally accepted or validated classification system. The paper suggests that future classifications may benefit from 3D analysis and WBCT technology to better define deformity and guide care.

📌 A call to action for collaborative efforts to define and validate robust surgical algorithms for cavus deformities from the team who are pioneers in pes cavus.

👏 Congratulations to @kmalhotra_83 @cullen.nick @shelain_patel @mattwelck for their excellent work.

📖 Read the full paper: https://lnkd.in/edFfEytw

#PesCavus #FootAndAnkle #Orthopaedics #CharcotMarieTooth #FootSurgery #WBCT #MedicalResearch #ClassificationSystems #Stanmore #RNOH #UCL

@malhotrafootandankle @drlyndonmason

💊 Do NSAIDs really impair fracture healing? This large JBJS study says… not necessarily.

💊 Do NSAIDs really impair fracture healing? This large JBJS study says… not necessarily.

George et al. (2020) analysed 339,864 long bone fractures using US insurance data and explored the associations between analgesic use and nonunion.

🔍 Key findings:
• Nonselective NSAIDs (e.g. ibuprofen, naproxen) were not associated with increased nonunion risk (OR 1.07; 95% CI 0.93–1.23).
• COX-2 inhibitors (e.g. celecoxib) showed a significant association with nonunion (OR 1.84; 95% CI 1.38–2.46).
• Opioid use was also associated with increased nonunion risk (OR 1.69; 95% CI 1.53–1.86), more than non selective NDAIDs

It is difficult however, to know if this relationship is causative given that individuals with nonunion, will be in pain, and thus be taking more analgesia.

💡 Clinical takeaway: Short-term, post-fracture use of traditional NSAIDs appears safe, while COX-2 inhibitors and opioids warrant more caution. This is especially relevant in the context of pain management strategies and efforts to reduce opioid dependency.

📘 https://pmc.ncbi.nlm.nih.gov/articles/PMC7508275/pdf/jbjsam-102-1230.pdf

#Orthopaedics #TraumaSurgery #FractureHealing #NSAIDs #Opioids #Nonunion #BoneHealing #JBJS #EvidenceBasedMedicine #PainManagement
@drlyndonmason @bone_and_joint_centre

🦶📉 Obesity & Ankle Fusion: What’s the Risk?

🦶📉 Obesity & Ankle Fusion: What’s the Risk?
Study in Foot & Ankle International AOFAS Journals highlights a stark rise in complications with severe obesity (BMI >40) following ankle arthrodesis.

🔍 From 527 TTAs:
▪️ Nonunion risk nearly 4x higher in class III obesity
▪️ Revision surgery 3.7x more likely
▪️ Superficial infection risk 9.4x higher
▪️ 30 & 90-day readmissions ~11x more common

✅ No significant differences in:
➡️ Deep infection
➡️ Reoperation rates
➡️ Adjacent joint fusion
➡️ Implant removal

📚 These findings support careful pre-op risk stratification and patient counselling — particularly in those with high BMI — and may influence perioperative optimisation strategies.

🔗 https://lnkd.in/eRa-TrYr

#AnkleFusion #ObesitySurgery #TibiotalarArthrodesis #FootAndAnkle #OrthopaedicSurgery #NonUnion #FAI #SurgicalRisk #BMIMatters #EvidenceBasedMedicine #OrthopaedicResearch #LiverpoolFootAndAnkle #TraumaTips #AnkleArthrodesis #FootAndAnkleInternational Liverpool Foot and Ankle @drlyndonmason

Congratulations to our very own Prof @drlyndonmason

Congratulations to our very own Prof @drlyndonmason for giving his invited lecture at the British Indian Orthopaedic Society Annual Conference in Grantham today. Prof Mason delivered a thought-provoking talk titled “Fibula is easy, right?”, challenging the common assumption that fibular fractures are straightforward.

His presentation highlighted:
🔹 Persistently high malreduction rates despite national awareness
🔹 Biomechanical consequences of fibular shortening and rotation
🔹 Pitfalls in assessing length using radiographs alone
🔹 Evidence-based review of lag screw use in locking plate constructs
🔹 Importance of direct visualisation of the syndesmosis
🔹 Lateral plafond impaction causing malunion, and how to correct

We’re proud to see Prof Mason continue to lead discussions on complex foot and ankle trauma and share cutting-edge insights with the wider orthopaedic community.

Conference details: https://lnkd.in/eR8yiFZT

Research from the department was also presented by @c_wyatt95 , with 3 podium presentations, winning BIOS best paper for the medial wall blowout study. @junaidaamir28 @manchesterfootankle

#FibularFrac t ures #OrthopaedicSurgery #BIOS2025 #TraumaLeadership #FootAndAnkle #Syndesmosis #SurgicalEducation #LiverpoolFootAndAnkle #ProudMoment #teamliverpool1 d

🔩 Fragment-Specific Fixation for Trimalleolar Ankle Fractures – Evidence Growing

🔩 Fragment-Specific Fixation for Trimalleolar Ankle Fractures – Evidence Growing

Fantastic to see two papers from the team at Manchester University NHS Foundation Trust and The University of Manchester examining outcomes of fragment-specific fixation for trimalleolar ankle fractures – first as a case series, and now in a matched comparative study.

✅ Their most recent paper, published in Foot & Ankle Specialist, found that fragment-specific plating (Volition™ @orthosolutionsgroupltd led to statistically significant improvements in pain and activity scores (FADI) compared to conventional fixation methods — with comparable union times and no increase in complications.

💡 Particularly rewarding to see these outcomes using a plating system our @drlyndonmason helped design, based on principles developed through his research and development of the Mason & Molloy classification for posterior malleolar fractures. These implants were purpose-built to address distinct posterior malleolus configurations with low-profile, anatomic contouring — enhancing reduction and reducing soft-tissue irritation.

📈 The studies report:
• Mean FADI activity score: 66.1 (fragment-specific) vs. 33.6 (conventional)
• Mean FADI pain score: 12.5 vs. 8.2
• Radiological union: ~7.5 weeks
• No implant failures or removals reported

🔬 These early results are promising. With further larger, prospective studies, fragment-specific fixation may well become the new standard for managing complex ankle fractures.

Huge credit to authors Danuksha Amarasena, Upamanyu Nath, Abhirun Das, Thomas Collins, and Prof Anand Pillai @manchesterfootankle for carrying this forward.

📄 Read more:
• Case series: Cureus 2024 – https://lnkd.in/gF2RsU3t

• Comparative study: FAS 2025 – https://lnkd.in/gjV3Bh6r

#FootAndAnkle #Orthopaedics #TrimalleolarFracture #PosteriorMalleolus #Volition #FragmentSpecificFixation #OrthoResearch #AnkleTrauma #MasonMolloy #FADI #MOXFQ #BOFAS #EvidenceBasedSurgery
@sheenaeaston7 @manche s terfootankle @drlyndonmason3 d

🔬 Hammertoe Surgery: Open vs MIS

🔬 Hammertoe Surgery: Open vs MIS

This retrospective comparative study by Mateen et al. (2024) compared minimally invasive surgery (MIS) to traditional open techniques for hammertoe deformity correction.

📊 Key Findings from 68 feet (124 toes MIS vs 22 toes Open):
• Union time: MIS 8.76 weeks vs Open 8.42 weeks (p = .65)
• Return to activity: MIS 10.47 weeks vs Open 9.92 weeks (p = .62)
• Recurrence: MIS 3.23% vs Open 0% (NS)
• Unplanned hardware removal: MIS 4.03% vs Open 0% (NS)

Despite more adjunctive procedures in the MIS group (e.g. bunionectomy, DMMOs), there was no significant difference in outcomes.

🦶 While both techniques showed equivalent union rates and functional recovery, the MIS approach offers benefits like:
• Earlier transition to regular footwear (often by 2 weeks post-op)
• Reduced soft tissue dissection
• Potentially shorter operative times (though not assessed in this study)

📚 A thoughtful addition to the growing literature on MIS techniques in forefoot surgery — but as the authors rightly highlight, larger prospective studies with patient-reported outcomes are needed.

📖 Read the full study https://lnkd.in/gN745qtb

#FootAndAnkle #Podiatry #OrthopaedicSurgery #MinimallyInvasiveSurgery #Hammertoe #ForefootSurgery #MISvsOpen #JFAS #EvidenceBasedMedicine #SurgicalInnovation #Orthopaedics #PatientOutcomes @drlyndonmason #liverpoolfootandankle #iomfootandankle

🦶 Why Do Patients Really Want Bunion Surgery? A new study challenges long-held assumptions.

🦶 Why Do Patients Really Want Bunion Surgery? A new study challenges long-held assumptions.

In their insightful paper published in @aofas1 Foot & Ankle International, de Buys et al. explore what motivates patients to undergo hallux valgus correction—and how these motivations shift before and after surgery.

📊 Using a cross-sectional design with 101 patients, they found:

✅ The top reasons (pre- and post-op) were:
• Moving pain-free
• Reducing bunion pain
• Walking long distances or on uneven terrain

❌ The least important?
• Wearing high heels
• Narrower feet
• Reducing orthotic/walking aid use

💡 Interestingly, patients were less likely to cite cosmesis as a primary motivator after surgery, suggesting a disconnect between perceived vs. actual expectations.

This work underscores the critical importance of understanding patient expectations—not just radiographic outcomes. As foot and ankle surgeons, aligning surgical goals with what matters most to patients is essential to drive satisfaction and shared decision-making.

📖 Read the full paper here: https://lnkd.in/ek7aKaZq

@drlyndonmason #BunionSurgery #HalluxValgus #FootAndAnkleSurgery #OrthopaedicResearch #PatientCentredCare #BunionAwareness #SurgicalOutcomes #OrthopaedicSurgeon #FootHealthMatters #PodiatricSurgery #PROMs #MedicalEducation #SurgeonsOfInstagram #Orthopaedics #BunionSurgeryRecovery #PatientExpectations #FAI #OrthoCommunity #ortholife #liverpoolfootandankle #iomfootandankle

🦶💉 GLP-1 Receptor Agonists May Improve Fusion Rates in Foot and Ankle Surgery

💉 GLP-1 Receptor Agonists May Improve Fusion Rates in Foot and Ankle Surgery

An interesting new study published in AOFAS Journals Foot & Ankle International (June 2025) explores the impact of GLP-1 agonist use on fusion outcomes in diabetic patients undergoing tibiotalar, subtalar, or triple arthrodesis.

📊 Using data from the TriNetX Global Collaborative Network, this retrospective study matched 783 patients in each cohort and found:

✅ Lower pseudarthrosis rates in patients using GLP-1 agonists:
• Subtalar fusion: 17.2% vs 23.4% (P = .0292)
• Triple arthrodesis: 12.4% vs 21.9% (P = .0120)
• No significant difference in tibiotalar fusions

❌ No increased infection risk associated with GLP-1 receptor agonist use across all procedures.

📌 As the prevalence of GLP-1 receptor agonist use rises with the global burden of diabetes and obesity, these findings may have important implications for preoperative planning and perioperative care in high-risk patients.

🧪 More prospective studies are needed, but this paper opens new conversations on metabolic optimisation in orthopaedic surgery.

🔗 Full reference:
Levidy MF, Vatsia S, Tucker S, et al. Foot Ankle Int. 2025 Jun;46(6):617-621.
DOI: 10.1177/10711007251328370

#FootAndAnkle #GLP1Agonist #Diabetes #OrthopaedicSurgery #Arthrodesis #Pseudarthrosis #FusionSurgery #Obesity #MetabolicHealth #FAI #OrthopaedicResearch #EvidenceBasedMedicine #SurgicalOutcomes #FootAndAnkleSurgery #DiabetesCare @drlyndonmason

🔍 New systematic review on chronic Achilles tendon rupture reconstruction techniques

🔍 New systematic review on chronic Achilles tendon rupture reconstruction techniques

Chronic Achilles tendon ruptures (CATRs) can be difficult to treat, presenting late and requiring can require complex surgical intervention. A new systematic review and meta-analysis (Karaismailoglu et al, 2025) published in @aofas1 Foot and Ankle Journal provides a comparative overview of three widely used surgical options:

✅ Flexor Hallucis Longus (FHL) transfer
✅ Hamstring tendon transfer
✅ Gastrocnemius-soleus turndown flap

Across 25 studies and 3 surgical cohorts:
• All techniques showed comparable improvements in AOFAS scores
• However, wound complication rates varied markedly:
• 12.5% in turndown flap
• 5.7% in FHL transfer
• 3.5% in hamstring transfer

🔎 The findings emphasise the importance of balancing functional outcomes with risk of surgical complications, especially in a group which maybe prone to delayed healing.

📌 Further work is needed for combination techniques, use of allograft tendons and the use of arthroscopy.

📄 Full article (Foot & Ankle International):
https://journals.sagepub.com/doi/abs/10.1177/10711007251330287

#FootAndAnkle #AchillesTendon #Orthopaedics #SurgicalDecisionMaking #SystematicReview #EvidenceBasedSurgery #FHLTransfer #HamstringTransfer #AchillesRupture #ChronicInjury #SportsMedicine #ReconstructiveSurgery #FAI #MetaAnalysis #OrthopaedicResearch #liverpoolfootandankle #iomfootandankle @drlyndonmason

🦶 Which surgical technique is most effective for symptomatic adult flatfoot?

🦶 Which surgical technique is most effective for symptomatic adult flatfoot?
A recent comparative study published in Foot and Ankle Surgery from the University of Göttingen (Stichnoth et al., 2024) sheds light on this question — directly comparing:
🔹 Subtalar arthroereisis (SA)
🔹 Medializing calcaneal osteotomy (MDCO)
🔹 A combination of both (SA+MDCO)

📄 Comparative study of subtalar arthroereisis, medializing calcaneal osteotomy and the combination of both techniques for the treatment of symptomatic adult flatfeet
🔗 [Open access]: https://lnkd.in/eVAgXTUX

📊 Key outcomes at ~6 years post-op (36 feet, 32 patients):
✔️ All three approaches significantly improved AOFAS/EFAS scores and radiographic alignment
✔️ Pre-op, the SA+MDCO group had the most severe deformity
✔️ Post-op, SA+MDCO had the best radiographic correction
✔️ Dynamic pedobarography showed normal gait lines in all groups

📌 Takeaway:
• SA outperformed MDCO when used alone
• SA+MDCO showed superior correction for more severe deformities
• All techniques provided durable, functional outcomes

This study provides valuable insight into surgical selection for adult acquired flatfoot, suggesting that combination procedures may offer optimal correction in advanced cases.

#AdultFlatfoot #PesPlanovalgus #FootAndAnkleSurgery #SubtalarArthroereisis #CalcanealOsteotomy #MDCO #AOFAS #OrthopaedicResearch #FlatfootCorrection #FootAndAnkle #Orthopaedics #EvidenceBasedSurgery #Biomechanics #GaitAnalysis #FAI #SurgicalTechnique #liverpoolfootandankle #iomfootandankle @drlyndonmason

Will my toe wear out at the next joint?

🦶 Will my toe wear out at the next joint?
That’s a common question after first MTP joint fusion — and now we have reassuring long-term data 📊

📍New study in Foot & Ankle International by Alkaramany et al. (2025)
🔗 [Link in bio or search: 10.1177/10711007251328656]

💡 Key findings from 15,771 patients (10-year data):
✅ Only 1.05% needed hallux IP joint fusion within 10 years
⏱️ Average time to IP fusion: 4 years post-op
⚠️ Data may overestimate slightly due to laterality limitations

💬 Bottom line:
MTP fusion is a durable option with a very low risk of symptomatic IP joint degeneration. A helpful stat for shared decision-making with patients!

#FootAndAnkle #Orthopaedics #MTPFusion #BigToeFusion #JointPreservation #EvidenceBasedMedicine #FAIJournal #PearlDiverData #FootSurgery #OrthopaedicResearch #HalluxRigidus #ToeSurgery #LongTermOutcomes #PatientEducation #SharedDecisionMaking #footandanklesurgeon #liverpoolfootandankle #iomfootandankle

🦶 Can a Zadek osteotomy really relieve insertional Achilles tendinopathy — without touching the tendon?

🦶 Can a Zadek osteotomy really relieve insertional Achilles tendinopathy — without touching the tendon?
A recent Foot & Ankle International study says: YES ✅

📄 Outcomes After Percutaneous Zadek Osteotomy for Insertional Achilles Tendinopathy
👩‍⚕️ Hall SR, Schipper ON, Vulcano E et al. (2024)
🔗 [Link in bio or search DOI: 10.1177/10711007241252803]

📊 In 108 patients with at least 2 years’ follow-up:
📈 FFI: 56.1 ➡️ 11.0
💥 VAS pain: 7.7 ➡️ 0.4
🙌 Satisfaction: 98.1%
⚠️ Complications: just 3.8%
⏱️ Follow-up: 41.2 months

Unlike traditional Achilles debridement + reattachment, the percutaneous Zadek osteotomy avoids direct tendon work — but still delivers big gains in pain relief and function.

📌 A minimally invasive option worth considering in your IAT toolkit.

#AchillesTendinopathy #ZadekOsteotomy #FootAndAnkle #HeelPain #AchillesSurgery #MinimallyInvasiveSurgery #Orthopaedics #FAIJournal #AchillesRelief #OrthopaedicResearch #EvidenceBasedMedicine #FootSurgery #OrthopaedicSurgeon #IAT #PatientOutcomes #lyndonmason #iomfootandankle #liverpoolfootandankle

Is your metalwork MRI safe?

🤘Is your metalwork MRI safe? Let’s break it down.

One of the most common questions after surgery:
“Can I have an MRI with metal in my body?”

Short answer: Yes — usually.
Most modern orthopaedic implants like titanium, stainless steel, or cobalt-chrome are usually MRI-compatible.

But not all metal is equal — and not all MRIs are the same.

What the evidence says:
According to the BMJ (Heart, 2008), injuries or complications during MRI often result from outdated implant information or poor safety screening.
The paper highlights three key risks:
1. Ferromagnetic attraction – older or ferromagnetic implants (like some clips or wires) may move in strong magnetic fields.
2. Heating – metal can warm up with MRI’s radiofrequency pulses.
3. Device malfunction – pacemakers, neurostimulators, and some older implants can fail or cause harm during MRI.

So what’s safe?
• Orthopaedic implants made in the last 20 years are mostly safe.
• Cochlear implants, aneurysm clips, or pacemakers? These need specific checks.
• Tattoo ink, piercings, or old surgical clips? Also worth discussing with the team who are booking the MRI.

Bottom line:
MRI is safe — but only if the team knows what’s inside you.
Always give your implant information to your radiology team, and ask your surgeon if you’re unsure.

#MRI #MRISafety #Orthopaedics #Implants #PatientSafety #MetalImplants #MedicalEducation #MRICompatible #PostOpCare #OrthopaedicSurgery #Radiology #TraumaSurgery #MRIAwareness #SurgicalRecovery #HealthcareEducation #PatientAwareness #SafeScanning #MRIImplants #ModernSurgery #SurgeonTips

🚨📄🦴New publication alert!

🚨📄🦴New publication alert!
Just out in @bonejointj Open — our latest paper explores the morphology of occult posterior malleolus fractures associated with tibial shaft fractures.

We found that:
• Nearly 1 in 4 tibial shaft fractures had an associated PMF
• The rotational pilon (Mason & Molloy type 2A) was the most common PMF (56%)
• These fractures were predominantly undisplaced, in contrast to typical ankle PMFs due to the force dissipating at the PM

We theorize that unlike the force transmission in ankle fractures, where the rotational force is in the axial plane in a distal to proximal direction, in the PMFs related to tibial fractures, the rotational force is in the axial plane progressing from proximal to distal. Therefore, the force transmission exits posteriorly, finally dissipates the force, and is thus unlikely to displace

Big thanks to the whole team behind this work!

@nhsuhlg @livuni @liverpoolfootandankle

@darrenmyatt1 @doctorspeedo @james_chappers Benjamin Fischer

Click link for paper ➡️ https://lnkd.in/ehdhzj5P

#orthopaedics #footandankle #trauma #posteriorMalleolus #tibialfracture #MasonAndMolloy #orthopaedicresearch #boneandjointopen #anklefracture #surgicaleducation #medicalresearch #orthopedics #ankleinjury #tibialfracture #tibialinjury #liverpoolfootandankle #liverpoolfootandankleclinic

We’re thrilled to announce that our @drlyndonmason has been elected a Fellow of the Faculty of Surgical Trainers at the The Royal College of Surgeons of Edinburgh @rcsed

We’re thrilled to announce that our @drlyndonmason has been elected a Fellow of the Faculty of Surgical Trainers at the The Royal College of Surgeons of Edinburgh @rcsed

This prestigious Fellowship recognises Prof Mason’s exceptional commitment to surgical education, leadership, and scholarship. Fellows are selected based on outstanding contributions across three key domains: teaching and training, educational leadership, and educational scholarship.

The Faculty of Surgical Trainers is the first of its kind in the UK, established to promote and enhance the role of the surgical trainer. It supports and develops surgeons in their role as surgical trainers, while promoting and upholding the highest standards of surgical training.

Prof Mason’s election as a Fellow underscores his dedication to mentoring the next generation of surgeons and advancing surgical education. His commitment ensures the delivery of excellent surgical training, which translates to excellent and safe patient care.

Please join us in congratulating Prof Mason on this significant achievement, a well-deserved recognition for your passion, dedication, and impact in surgical training! 👏🎉 @nhsuhlg @livunimedicine

#FFSTEd #RCSEd #SurgicalEducation #SurgicalTraining #Orthopaedics #FootAndAnkle #MedicalEducation #Mentorship #surgicalexcellence #MedEd #FOAMed #Ortho #OrthopedicSurgery #OrthopedicSurgeon #Healthcare #Doctor #Surgeon #MedicalTeaching #ContinuingMedicalEducation #MedicalTraining #OrthopaedicTrauma #OrthopaedicSurgery #OrthopaedicSurgeon #SurgicalLeadership #SurgicalScholarship #SurgicalMentorship #futuresurgeons

It’s #NationalBunionDay – time to talk about that bump on your big toe. Spoiler: it’s not just about shoes.

⸻

Bunions (aka hallux valgus) are more than a cosmetic issue – they’re a progressive foot deformity that can seriously affect your comfort and mobility. At Liverpool Foot and Ankle Clinic, we see them daily – and we treat them with the latest, evidence-based techniques.

Under the care of @drlyndonmason, our team offers advanced options like minimally invasive “keyhole” bunion surgery, helping you recover faster with less scarring.

@drlyndonmason research is internationally regarded with multiple awards and publications, his most cited work being in the causes of bunions. We don’t just treat bunions – we help shape how they’re understood.

If your bunion is limiting your life, don’t wait. Get expert advice and take the first step toward pain-free feet.
#LiverpoolFootAndAnkleClinic #Bunions #HalluxValgus #FootHealth #BunionSurgery #DrLyndonMason #Orthopaedics #HappyFeet #EvidenceBasedCare #FootAndAnkle #misbunion #mishalluxvalgus #keyholebunionsurgery

Does taking semaglutide (Ozempic etc) have any effect on foot and ankle surgery?

Does taking semaglutide (Ozempic etc) have any effect on foot and ankle surgery?

Semaglutide—a GLP-1 receptor agonist widely used for type 2 diabetes and weight loss—has shown promising early signals across several orthopaedic specialties.

In chronic ankle instability (CAI), a prospective cohort study (https://lnkd.in/ettMd42p) found that semaglutide use was associated with significantly better patient-reported outcomes (FAAM, FAOS, CAIT), fewer recurrent sprains, and a reduction in surgery rates from 7.8% to 1.4% over 2 years. A substantial portion of this effect was mediated by weight loss—but not all of it.

Outside foot and ankle, in total knee arthroplasty (TKA) there are reported lower rates of infection and revision (although higher rates of MI and AKI ) in patients using semaglutide (https://lnkd.in/eSHUmx7r and https://lnkd.in/ePRn24Jr) with similar results in THR (https://lnkd.in/e5rB2UdX). In spine, a propensity-matched study demonstrated higher fusion rates and fewer infections among semaglutide users undergoing spinal fusion (https://lnkd.in/eBdiYXpT).

At present, the data are mostly observational or early-phase, but directionally favorable. Whether these benefits stem from weight loss alone, metabolic changes, or inflammation modulation remains an open question.

This new ankle paper is the first in foot & ankle literature. Are you aware of any other data—published or emerging—in this space? Could you decrease the risk of surgery

Drop links, or comment below. Let’s build the evidence together.

@liverpoolfootandankle @hassanridha @the_jbjs
The Journal of Bone and Joint Surgery, Inc.
#Orthopaedics #FootAndAnkle #Semaglutide #GLP1 #MetabolicOrthopaedics #AnkleSurgery #SurgicalOutcomes #DiabetesCare #BoneHealth #TKA #SpineSurgery #ozempic #monjaro #ankleinstability

What are the complications of MIS bunion surgery?

🔬🦶The work by Tom Lewis @ray_anklefoot Ray @thebuniondoctor and Peter Lam have been revolutionary in moving the world evidence base for MIS hallux valgus surgery forward.

By now, most of us are familiar with the promise of minimally invasive bunion correction—but what about the pitfalls?

Third-Generation (MICA)
In a robust series of 292 feet (Lewis et al, @the_jbjs 2021), the overall complication rate was 21.3%, with:
• FHL tendon injury in 1.5%
• Screw prominence in 2.4%
• Deep infection requiring surgery in 1.2%
• Osteotomy site issues (displacement, delayed union) in 3.3%
• Symptomatic recurrence in only 0.9%

Fourth-Generation (META)
The META technique (Lewis et al, @aofas1 FAI 2023) had a smaller cohort of 50 patients, but reported an encouraging 10.1% complication rate:
• No FHL injuries
• No infections or AVN
• 6.7% required screw removal
• 0% recurrence at 12 months

What stands out?
Both studies are exceptional for their transparency—every complication, no matter how minor, is reported. That kind of detail gives real-world insight into risks and helps push MIS techniques forward safely.

META may prove to be the safer evolution, but larger, longer-term studies will tell us more. I know the guys are already on it to produce this evidence. It would be great to see open hallux valgus surgery report this level of transparency.

What technique are you using?

#FootAndAnkle #MIS #HalluxValgus #Orthopaedics #MICA #META #Innovation #BunionSurgery #MedEd #OrthopaedicSurgery #surgicaltechnique BunionCorrection #ChevronOsteotomy #AkinOsteotomy #OrthopaedicSurgery #OrthoFootAndAnkle #SurgicalInnovation #OrthopaedicResearch #MedEd #SurgicalComplications #EvidenceBasedSurgery #JBJS #FootAnkleInternational #OrthopaedicEducation #TraumaAndOrtho #orthocommunity

🦶😫Is 1st MTPJ Fusion just for the elderly? Think again.

🦶😫Is 1st MTPJ Fusion just for the elderly? Think again.

A new 10+ year follow-up study by Scheurer et al. challenges assumptions. https://journals.sagepub.com/doi/10.1177/10711007231205567

Study highlights:
• Compared patients <60 years vs ≥60 years undergoing 1st MTPJ fusion.
No significant differences in:
• Satisfaction
• Pain
• Function (FFI, AOFAS)
• Radiographic outcomes
• Fusion rates and long-term durability were excellent in both groups.

Bottom line:
Age alone shouldn’t be a barrier to offering 1st MTPJ fusion. It works just as well in younger, active patients as in older ones.

Perfect for those with end-stage hallux rigidus who want pain relief and function that lasts.

It even has good results in athletes

https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=isakos+Calder+mtpj&btnG=#d=gs_qabs&t=1744461905465&u=%23p%3DAsYvdYuRfmEJ

#FootAndAnkle #MTPJfusion #HalluxRigidus #Orthopaedics #FootSurgery #FAI #evidencebasedmedicine #liverpoolfootandankle #iomfootandankle #bigtoefusion #bigtoefusionrecovery #bigtoefusionsurgery

🚨‼️New Research on Hallux Valgus: What Do Patients Really Want from Surgery?

🚨‼️New Research on Hallux Valgus: What Do Patients Really Want from Surgery?

Published in Foot & Ankle International, this insightful study by de Buys et al. explores the real reasons patients choose to undergo bunion surgery, comparing preoperative and postoperative perspectives.

Key findings:
• Pain and function top the list—patients primarily seek pain-free movement and the ability to walk longer distances, especially on uneven terrain.
• Cosmetic concerns (e.g., wanting a narrower foot or straighter toe) were consistently low priorities both before and after surgery.
• Interestingly, shoe wear became more important after surgery than before, reflecting the lived experience post-recovery.

Why it matters:
We often focus on radiographs and angles—but patients care about daily comfort, mobility, and getting back to living pain-free.
This study reinforces the importance of aligning surgical planning with patient expectations—a crucial part of shared decision-making and outcome satisfaction.

Takeaway:
Not all bunion surgeries are about looks—most are about function, pain, and quality of life.

https://journals.sagepub.com/doi/pdf/10.1177/10711007251321475?download=true

#HalluxValgus #BunionSurgery #FootAndAnkle #PROMs #Orthopaedics #SharedDecisionMaking #PatientCentredCare #FootSurgery #functionoverform #liverpoolfootandankle #iomfootandankle #bunion #misbunion

Did you know your midfoot can compensate when your ankle can’t?

Did you know your midfoot can compensate when your ankle can’t?

After ankle fusion surgery, many patients worry about losing mobility. For some patients, the body can adapt!

Research highlights (https://pubmed.ncbi.nlm.nih.gov/33458862/) that increased midfoot motion significantly reduces the impact of lost ankle movement, helping maintain function, balance, and a smoother walking pattern. A recent study showed that both ankle fusion and replacement patients experienced similar gait mechanics post-surgery, with the midfoot playing a crucial role in preserving mobility.

Understanding and encouraging midfoot compensation can greatly enhance recovery and improve your quality of life after ankle surgery.

@ruthcooilphysiotherapy @drlyndonmason @bone_and_joint_centre

#AnkleFusion #MidfootMobility #Orthopaedics #FootAndAnkle #RecoveryTips #FootHealth #AdaptAndOvercome #AnkleFusion #AnkleReplacement #MidfootMobility #FootAndAnkle #GaitAnalysis #Orthopaedics #Biomechanics #AnkleArthritis #SurgicalRecovery #MobilityMatters #MovementIsMedicine #PatientEducation #OrthoLife #MedInstagram #RehabJourney #PostOpCare #FootHealth

🧑‍⚕️🥼💉What to Expect from a Nerve Block Before Foot & Ankle Surgery

🧑‍⚕️🥼💉What to Expect from a Nerve Block Before Foot & Ankle Surgery

Thinking about a block for your surgery, or being offered it by your treating physician?

Here’s what it really means:
1. Pain Control Goals: Regional anesthesia (aka “the block”) is used to minimize pain, reduce opioid use, and help you feel more comfortable after surgery.
2. When It Kicks In: The block is typically given pre-op or when you have had a general anesthetic, and can last 12–24 hours depending on the agent used.
3. What You’ll Feel: Expect numbness and weakness in your foot—this is normal! It’s a sign the block is working. Your leg may also feel heavy.
4. Benefits Beyond the operating room: Blocks may help reduce inflammation, improve recovery, and even help you sleep better post-op.
5. What It Doesn’t Do: It may not provide complete anesthesia alone—you might still need sedation or general anesthesia depending on the procedure.
6. Potential Downsides: All rare, but can include prolonged numbness, nerve irritation, nerve damage or a block that wears off sooner than expected.

Ask your surgeon and anesthetist about the plan—it’s a team effort to get you through surgery as smoothly and pain-free as possible.

Knowledge is power. So is comfort.

Source: Vadivelu N. et al, Foot & Ankle Specialist, 2015

#FootAndAnkleSurgery #RegionalAnesthesia #NerveBlock #Orthopaedics #SurgeryRecovery #patienteducation #liverpoolfootandankle #drlyndonmason #iomfootandankle #footanklesurgery #footanklesurgeon #footsurgery #anklesurgery #painrelief #painfreesurgery

Does Footwear Impact Recovery After Ankle Surgery? 🏃‍♂️👟

If you’ve undergone total ankle replacement, ankle arthrodesis (fusion), or tibiotalocalcaneal (TTC) arthrodesis, your choice of footwear could significantly impact your functional recovery. A study in Clinical Biomechanics (https://pubmed.ncbi.nlm.nih.gov/26785386/) investigated how different shoes influence walking mechanics and foot pressure distribution in these patients.

🔬 What the study found:

📉 Barefoot vs. Shoes – Walking function improves with footwear in all surgical groups.
👟 Running Shoes vs. Rocker-Bottom Shoes – Running shoes provided more benefits, while rocker-bottom shoes added little additional advantage.
⚖️ Ankle Replacement vs. Fusion – Both had similar outcomes, but remained inferior to healthy controls.
❌ TTC Arthrodesis Performed the Worst – This group had the lowest functional outcomes regardless of footwear choice.

🏃‍♀️ What this means for patients:

✔️ Choosing supportive, cushioned running shoes could help improve walking speed and balance after ankle surgery.
✔️ Rocker-bottom shoes might not offer additional benefits for most post-op patients.
✔️ If you’ve had a TTC arthrodesis, managing expectations for function and mobility is key.

🔍 Why this matters:

Gait analysis after ankle surgery is often performed barefoot, but that doesn’t reflect real life! This study highlights the importance of evaluating post-op function with proper footwear to optimize rehabilitation strategies.

👣 Have you or your patients experienced changes in mobility with different shoes after ankle surgery? Drop your thoughts below! ⬇️

#AnkleSurgery #FootwearMatters #GaitAnalysis #Orthopedics #TotalAnkleReplacement #AnkleFusion #RunningShoes #Recovery #MobilityMatters #iomfootandankle #liverpoolfootandankle

🦴 The Derry Kidney Dish Test for Syndesmosis Instability 🦴

🦴 The Derry Kidney Dish Test for Syndesmosis Instability 🦴

Introducing the Derry Kidney Dish Test, a simple yet insightful technique described by @dessiegib to assess syndesmosis instability in @bofas_uk 2025! 🔍

💡 The Problem: When examining a suspected syndesmosis injury, placing the foot flat on the bed with the heel supported can hide the instability. The heel support prevents posterior talar subluxation, giving a false impression of a stable ankle. 🚫🔄

✅ The Solution: By removing heel support—using a kidney dish (or similar) under the calf—you allow the talus to drop naturally, exposing any posterior subluxation and syndesmotic instability. A key trick to avoid false negatives! 🎯

👣 Clinical Takeaway: Always check the true stability of the syndesmosis by ensuring the foot is unloaded posteriorly. It’s a small change, but it makes a big difference in detecting hidden instability. 🔬

📢 Have you used this test in your practice? Share your thoughts! 🩺💬

#Syndesmosis #AnkleInjury #FootAndAnkle #DerryKidneyDishTest #Orthopaedics #AnkleInstability #SportsMedicine #OrthoTips #meded #OrthopedicSurgery #TraumaSurgery #FootAndAnkleSurgery #AnkleFracture #SyndesmosisInjury #OrthoTeaching #SurgicalTips #FractureManagement #MedStudentLife #ResidencyLife #OrthoResidency #AnklePain #SportsInjury #MedicalEducation #SurgeonLife #Orthopaedics #OrthoWorld #TraumaOrtho #AnkleStability #SurgicalPearls #clinicalskills #bofas2025

Novel Techniques in Tri-malleolar Fracture Management & Beyond Cadaveric Course

Proud to once again lead the @orthosolutionsgroupltd Novel Techniques in Tri-malleolar Fracture Management & Beyond Cadaveric Course at @keelemedschool again today with Roland Walker! 🦴🔩

An incredible day of surgical education, hands-on cadaveric training, and advanced fixation techniques alongside an outstanding group delegates from all corners of Great Britain. Always a privilege to teach and discuss the latest innovations in foot and ankle trauma!

📍 Keele Anatomy & Surgical Training Centre (KASTC)
📆 28th February 2025

Big thanks to OrthoSolutions UK Ltd for organizing an excellent course and to all the participants for their enthusiasm and engagement!

https://www.orthosol.com

#OrthoSolutions #FootAndAnkle #TraumaSurgery #CadavericTraining #Orthopaedics #AnkleFracture #TriMalleolarFracture #SurgicalEducation #CPD #OrthopaedicSurgery #KeeleUniversity #MedicalEducation #FractureFixation #AnkleSurgery

How footwear choices impact gait and long-term locomotor health

🚨 New publication alert! 🚨 Our latest review, coauthored by our @drlyndonmason and an incredible team led by @kristiaandaout, dives deep into how footwear choices impact gait and long-term locomotor health. @mdpiopenaccess

📖 Key Takeaways:
🔹 Most common shoe features (cushioning, raised heels, arch support) have little evidence supporting health benefits in healthy individuals.
🔹 Minimal footwear or barefoot walking might be the best approach for natural gait and biomechanical aging.
🔹 High heels and restrictive shoes can negatively affect foot anatomy, balance, and joint stress.
🔹 Footwear should be a deliberate health choice, not just a fashion statement!

➡️ Want to learn more? Read the full paper: https://www.mdpi.com/2227-9032/13/5/527

#FootwearScience #Biomechanics #MinimalFootwear #Orthopaedics #GaitAnalysis #BarefootScience #FootHealth #AnkleHealth #Podiatry #OrthopedicResearch #Gait #Walking #FootFunction #ShoeDesign #FootwearMatters #HealthTech #SportsMedicine #InjuryPrevention #Physiotherapy #RehabScience #AnklePain #RunningShoes #HealthyFeet #PlantarFasciitis #BalanceTraining #MedicalResearch #SportsScience #FootwearInnovation #KneeHealth #mobilitymatters

Fixing Ankle Fracture Malunions: Getting Patients Back on Their Feet 🦶🔩

Fixing Ankle Fracture Malunions: Getting Patients Back on Their Feet 🦶🔩

Malunited ankle and pilon fractures can lead to chronic pain, deformity, and early arthritis—but modern reconstructive techniques offer functional restoration and pain relief. @drlyndonmason published a review reporting the key osteotomies and correction strategies for restoring ankle alignment and preventing further joint damage.

🔍 Key takeaways:
✅ Malunions can occur at the supramalleolar, periarticular, or hindfoot level, each requiring a tailored approach.
✅ Supramalleolar osteotomies correct mechanical axis deformities and redistribute joint forces.
✅ Plafond-plasty and fibular osteotomy address intra-articular incongruities to prevent progressive arthritis.
✅ 3D CT planning and patient-specific guides are improving precision in complex deformities.
✅ Early intervention in post-traumatic deformities can delay or prevent ankle fusion or replacement.

💡 Why does this matter?
Leaving malunions untreated increases long-term disability. Recognizing and correcting alignment issues early can restore mobility and reduce pain, offering patients a second chance at a functional ankle. As the illustrated case shows, it is sometimes possible to correct these malunions, and preserve function.

🔗 Read the full study:
Fischer B, Mason LW. Reconstruction of Severe Ankle and Pilon Fracture Malunions. Foot Ankle Clin N Am. 2020. DOI: 10.1016/j.fcl.2020.02.007

#AnkleReconstruction #OrthoSurgery #AnkleFracture #PilonFracture #Osteotomy #FootAndAnkle #Orthopaedics #FixTheFracture #MalunionCorrection #SurgicalInnovation #OrthoResearch

Flat foot reconstruction -Spring Ligament reconstruction

Flat foot reconstruction -Spring Ligament reconstruction
Flatfoot deformity is often linked to medial soft tissue attenuation, but what’s the best way to reconstruct the spring ligament?

In this comparative study published in Foot & Ankle International, @drlyndonmason coauthored a paper comparing the clinical results of two techniques:
✅ Hamstring allograft vs.
✅ Synthetic ligament augmentation (Internal Brace, Arthrex)

🔬 Key Findings:
📈 Both techniques significantly improved radiographic alignment.
💯 Synthetic ligament augmentation showed superior patient-reported outcomes at 12 months.
🦵 Additional procedures (calcaneal osteotomy, gastrocnemius recession, FDL transfer) were often required to optimize results.

🔍 Takeaway:
Spring ligament reconstruction can play a key role in flatfoot correction, and synthetic ligament augmentation may offer better long-term functional outcomes than allograft when reconstructing.

🔗 Read more: DOI: 10.1177/1071100720917375

#Orthopaedics #FootAndAnkle #Flatfoot #SpringLigament #PesPlanus #Surgery #Orthoresearch #Arthrex #SportsMed Here are some additional hashtags to enhance your Instagram post:

#FootSurgery #AnkleSurgery #Podiatry #OrthoSurgery #OrthopaedicResearch #Biomechanics #Rehabilitation #SportsMedicine #OrthoTech #SurgeonLife #OrthoCommunity #MedicalInnovation #EvidenceBasedMedicine #FootAndAnkleSurgery #MedSchool #SurgicalTechniques #MedicalScience #DoctorLife #OrthoEducation #ResearchMatters #ligamentreconstruction

Foot Melanoma – The Hidden Danger

Foot Melanoma – The Hidden Danger

⚠️ Subungual Toe Melanoma: A Deadly Diagnosis

🔬 The Journal of Foot and Ankle Surgery highlights a critical finding: https://doi.org/10.1053/j.jfas.2023.04.012
Melanoma of the foot, particularly when localized under the toenail (subungual melanoma), is associated with a poorer prognosis and advanced disease at diagnosis .

📊 Key Takeaways from the Study:
✅ Late Diagnosis = Worse Outcomes – Subungual melanoma is often misdiagnosed as a fungal infection or trauma, delaying treatment.
✅ Increased Risk of Metastasis – Compared to other foot melanomas, subungual lesions have a higher rate of spread.
✅ Early Detection Saves Lives – Recognizing warning signs can lead to earlier intervention and better survival rates.

🔎 What to Look For:
🔹 Dark streaks or discoloration under the toenail
🔹 A changing or growing nailbed lesion
🔹 Persistent non-healing wounds on the foot
🔹 Nail detachment without trauma

🚨 Don’t Ignore Suspicious Lesions!
If you notice any of these signs, get checked by a specialist ASAP. Early detection can make all the difference.

📢 Have you encountered cases of foot melanoma? Share your experiences below! ⬇️

#FootMelanoma #SkinCancerAwareness #Podiatry #FootHealth #EarlyDetection #MelanomaAwareness #Dermatology #Melanoma #SkinCancer #SubungualMelanoma #FootCare #FootSurgery #PodiatricSurgery #CancerAwareness #Orthopaedics #Oncology #HealthEducation #MedicalResearch #PatientAwareness #NailHealth #ToeMelanoma #EarlyDetectionSavesLives #SurgeonLife #MedicalCommunity #FootAndAnkle #MedicalAwareness #SurgicalOncology #PodiatryLife #OrthoOncology #Healthcare

The Right Orthotic for Achilles Tendon Rupture Recovery

The Right Orthotic for Achilles Tendon Rupture Recovery

Achilles tendon ruptures are often treated conservatively with functional rehabilitation, but are we using the right orthotic to ensure optimal healing?

The seminal paper, coauthored by our @drlyndonmason, published in The Journal of Foot & Ankle Surgery, highlights a critical issue—many commonly used orthoses may not position the ankle in enough equinus (plantarflexion) to properly shorten the healing Achilles tendon.

Their research compared two common orthoses:
🔹 A fixed-angle walking boot with wedges (FAWW)
🔹 An external equinus-corrected brace (EEB)

Results? The FAWW appeared to hold the foot in equinus but actually achieved it through midfoot flexion rather than at the ankle—potentially leading to tendon lengthening and poorer function. The EEB, however, achieved a position much closer to an equinus cast, offering better tendon healing conditions.

Why does this matter? A lengthened tendon means weaker push-off strength, lower patient satisfaction, and delayed return to activity.

Take-home message: Not all orthotics are created equal. Choosing the right brace is key to preventing Achilles tendon lengthening in nonoperative treatment.

Tag a colleague who needs to know this! #AchillesRupture #OrthoticsMatter #FootAndAnkle #SportsMedicine #BOFAS #orthopaedics #FootAndAnkleSurgery #TendonInjury #AchillesRecovery #AnkleFracture #RehabScience #FunctionalRehabilitation #PhysicalTherapy #SurgeonsOfInstagram #OrthoLife #MedEd #MedicalResearch #EvidenceBasedMedicine #SportsInjury #Podiatry #AnkleInjury #OrthoSurgery #Physiotherapy #Biomechanics #MedicalInnovation #SurgicalEducation #OrthoResidency #RehabProtocols #PlantarFlexion #liverpoolfootandankle

🦴 Ankle Fractures: Your Questions Answered! 🦶

🦴 Ankle Fractures: Your Questions Answered! 🦶

Ankle fractures can seriously impact mobility and daily life. From symptoms to treatment options, our Professor Lyndon Mason breaks down the most commonly asked questions about these injuries in his latest @topdoctors_uk article. @drlyndonmason is regarded internationally as an expert in ankle fractures, with multiple national and international prizes, including the #hunterian prize from the @royalcollegeofsurgeons

🔹 What are the signs of an ankle fracture?
🔹 How are they diagnosed?
🔹 When do you need surgery?
🔹 How can you prevent complications?

💡 Whether it’s a simple break or a complex injury requiring surgery, early treatment is key to a smooth recovery! Read the full article now!

📍 for article, https://www.topdoctors.co.uk/medical-articles/common-questions-about-ankle-fractures
#AnkleFracture #Orthopaedics #FractureRecovery #LiverpoolOrthopaedics #FootAndAnkle #DrLyndonMason #AnkleInjury #topdoctor #topdoctors

Gout: An Old Disease with New Insights

Gout: An Old Disease with New Insights

Did you know that gout is one of the most well-described forms of arthritis? It’s caused by uric acid crystal deposits in the joints, leading to intense pain, swelling, and inflammation. But there’s more to the story!

A recent review, Gout: An Old Disease in New Perspective, explores how genetics, imaging advancements, and evolving treatments are reshaping our understanding of this ancient disease.

✅ Diagnosis: The gold standard remains polarized light microscopy, identifying uric acid crystals in joint fluid. However, ultrasound and Dual-Energy CT are emerging as game-changers in detecting early disease.

✅ Management: Beyond traditional medications, new drugs are making waves, alongside lifestyle changes like dietary modifications and weight management to prevent flares.

✅ Prevention & Future: With a deeper understanding of hyperuricemia and its systemic effects, early intervention and patient education are crucial to long-term joint health.

📖 Read more about the latest breakthroughs and treatment strategies in the full article: Gaafar Ragab, Mohsen Elshahaly, Thomas Bardin, Gout: An old disease in new perspective – A review, Journal of Advanced Research, Volume 8, Issue 5, 2017 .

#Gout #Arthritis #JointHealth #Rheumatology
#GoutAwareness #UricAcid #Inflammation #AutoimmuneDisease #ChronicPain #JointPain #ArthritisRelief #MedicalResearch #RheumatologyResearch #ScienceBasedMedicine #HealthcareInnovation #MedEd #GoutDiet
#GoutWarrior #ChronicIllness #PainManagement #WellnessJourney #HealthTips #SelfCareMatters

🚨 Chopart Joint Injuries: Rare, Complex, and Often Missed! 🚨

🚨 Chopart Joint Injuries: Rare, Complex, and Often Missed! 🚨

The Chopart joint plays a crucial role in midfoot stability and function. Yet, injuries here—whether pure dislocations or fracture-dislocations—are frequently missed, with delayed diagnoses leading to poor outcomes.

📌 Key Takeaways from the paper co authored by @drlyndonmason :
🔹 Chopart dislocations are high-energy injuries, often from motor vehicle accidents or falls.
🔹 Up to 41% of cases are missed on initial X-ray—CT scans are essential!
🔹 Early ORIF (Open Reduction and Internal Fixation) results in better outcomes than closed reduction alone.
🔹 Maintaining medial and lateral foot column length is critical for gait and function.
🔹 Compartment syndrome is common—be on high alert!

🔬 Despite being historically under-researched, this paper provides evidence-based recommendations to improve recognition, treatment, and outcomes.

👨‍⚕️ Clinicians: Keep Chopart injuries on your radar and push for early diagnosis & anatomic reduction.
🏃‍♂️ Patients: If you’ve suffered a midfoot injury or an ankle sprain that’s not getting better and are struggling with pain or mobility, don’t hesitate to get a second opinion!

📄 Read the full paper in 🔗https://link.springer.com/content/pdf/10.1007/s00402-023-05040-4.pdf

#ChopartInjury #MidfootTrauma #FootSurgery #Orthopaedics #TraumaSurgery #ChopartFracture #AnkleFracture #ORIF #MedicalResearch #anklesprain #missedinjury @junaidaamir28

What’s causing your medial arch pain after an ankle fracture? It might be tibialis posterior tendon entrapment! 🦶⚠️

@drlyndonmason and colleagues published a study highlighting that 22% of posterior malleolar ankle and pilon fractures resulted in tibialis posterior tendon (TPT) entrapment—a condition that often goes undiagnosed and can lead to persistent pain and dysfunction.

🔍 Key findings:
✅ If the fracture line enters the TPT sheath, there is a 45% risk of tendon entrapment.
✅ Both pilon and posterior malleolar fractures have similar rates of entrapment.
✅ Many cases are missed preoperatively, and residual pain is common at 6 months.
✅ Preoperative CT scans are essential to assess tendon involvement.

💡 Why does this matter?
TPT entrapment can alter foot mechanics, cause medial arch pain, and lead to long-term dysfunction if not addressed. Surgeons should assess pre-op imaging carefully and consider intraoperative exploration for patients with persistent post-fracture pain.

🔗 Read the full study:
Aamir J, Syziu A, Andritsos L, Caldwell R, Mason L. Tibialis posterior tendon entrapment in posterior malleolar and pilon injuries of the ankle: a retrospective analysis. Eur J Orthop Surg Traumatol. 2023. DOI: 10.1007/s00590-023-03714-8

#FootAndAnkle #AnkleFracture #TibialisPosterior #OrthoResearch #AnkleSurgery #MedialArchPain #FixTheFracture #OrthoLife #SurgicalEducation #traumasurgery #anklepain #drlyndonmason #liverpoolfootandankle #iom #iomfootandankle

🚨 Smoking & Ankle Surgery: A Risk You Can Avoid 🚨

A new study highlights the negative impact of smoking on recovery after arthroscopic bone marrow stimulation (BMS or microfracture) for osteochondral lesions of the talus (OLTs). If you’re a smoker undergoing this procedure, you may face poorer outcomes and reduced ankle function.

📌 Key Findings (Cheng et al., 2024):
❌ Smokers had worse postoperative pain and lower AOFAS & Karlsson-Peterson scores (ankle function).
❌ Larger OLTs (>50 mm²) worsened smoking’s negative impact on recovery.
❌ Smokers over 32 years old were less likely to return to high-level activity.
✅ Nonsmokers had significantly better pain relief & functional recovery after surgery.

🔑 Takeaway:
Smoking impairs healing, delays recovery, and worsens outcomes after BMS for OLTs. If you’re considering ankle surgery, quitting smoking could be one of the best decisions for your long-term foot and ankle health!

📖 Reference:
Cheng X, Su T, Dong J, et al. Effect of Cigarette Smoking on Postoperative Outcomes After Arthroscopic Bone Marrow Stimulation for Osteochondral Lesions of the Talus. Foot & Ankle International. 2024;45(8). doi:10.1177/10711007241250007

💬 Do you discuss smoking cessation with your patients before surgery? Let’s talk below! 👇🏼

📍 For more insights, visit @drlyndonmason

#AnkleSurgery #B o neMarrowStimulation #OsteochondralLesion #SmokingCessation #Orthopaedics #FootAndAnkle #SportsMedicine #AnkleInjury #CartilageHealing #SurgicalOutcomes #AnkleRehabilitation #SportsInjury #HealingMatters #QuitSmoking #AnkleHealth #Podiatry #OrthopedicResearch #SurgeonLife #cartilage #cartilagerepair #cartilageregeneration #quitsmoking #quitsmokingtoday

What are the risks of smoking in foot and ankle surgery? 🚬⚠️

Smoking has a significant impact on foot and ankle surgery outcomes. @drlyndonmason published a review of the evidence, showing that smokers face higher rates of wound complications, delayed healing, and non-union—particularly in ankle and hindfoot fusions. 🚨

🔹 Trauma cases: Increased infections and delayed bone healing
🔹 Elective surgery: Higher non-union rates, especially in fusions
🔹 Diabetes patients: Increased ulceration risk and potential for amputation
🔹 Smoking cessation: Even 4 weeks before surgery can significantly reduce risks!

This research reinforces the importance of smoking cessation in optimizing surgical outcomes.

Full reference:
Heyes G, Weigelt L, Molloy A, Mason L. The influence of smoking on foot and ankle surgery: a review of the literature. The Foot. 2020; https://doi.org/10.1016/j.foot.2020.101735

#OrthoResearch #FootAndAnkle #AnkleSurgery #SmokingAndHealing #BoneHealth #OrthoLife #SurgicalOutcomes #FootAndAnkleSurgery #TraumaSurgery #SmokingCessation #OrthoCommunity #FixTheFracture #fracturehealing #drlyndonmason #liverpoolfootandankle #iom #iomfootandankle

The Liverpool Foot and Ankle Clinic is proud to collaborate with Ruth Cooil Physiotherapy & Healthcare Services in the Isle of Man

The Liverpool Foot and Ankle Clinic is proud to collaborate with Ruth Cooil Physiotherapy & Healthcare Services in the Isle of Man, ensuring that patients receive seamless, expert-led rehabilitation and post-operative care close to home.

By working closely with Ruth Cooil and her team, patients benefit from:
✅ Individualized rehabilitation programs
✅ Targeted strength & mobility exercises
✅ Hands-on physiotherapy techniques to optimize recovery

This collaboration ensures that Isle of Man patients receive consistent, high-quality care, reducing the need for frequent travel while maintaining direct specialist oversight from Mr. Hassan Ridha and the Liverpool Foot and Ankle Clinic team.

📍 Private Clinics Now Available!
🔗 For appointments and more info, contact us:
📍 Spire Liverpool
📧 E-mail: admin@liverpoolfootandankle.com
📞 Contact Team: 0151 522 1860

📍 Isle of Man
📧 E-mail: ruth@ruthcooilphysiotherapy.com
📞 Contact Ruth Cooil Team: 07624 244923

📍 For more insights, visit @drlyndonmason

#LiverpoolFootAndAnkle #IsleOfMan #FootAndAnkleCare #Physiotherapy #Orthopaedics #FootPain #SportsMedicine #AnkleInjury #HeelPain #Podiatry #Rehabilitation #RunningInjury #FootHealth #SurgeonLife #MedicalCollaboration #PrivateClinic #PostOpCare #AnkleSurgery #StrengthAndMobility #RecoveryJourney

🔹 Gastrocnemius Release for Chronic Plantar Fasciitis: Long-Term Results 🔹

Chronic plantar fasciitis can be frustrating, especially when conservative treatments fail. But new evidence suggests gastrocnemius release could be the key to long-term relief! A 6-year randomized controlled trial compared proximal medial gastrocnemius recession (PMGR) + stretching vs. stretching alone—and the results are compelling.

📌 Key Findings (Riiser et al., 2024):
✅ Significantly less pain in the surgical group at 6 years (VAS 2.5 vs 5.5, P < .001).
✅ Better function in the surgical group (AOFAS score 88.9 vs 78.6, P = .012).
✅ Improved quality of life (MOxFQ total score significantly better with surgery).
✅ No long-term loss of Achilles complex strength—confirming PMGR is a safe procedure.

❗ What does this mean?
If plantar fasciitis persists beyond 12 months and gastrocnemius contracture is present, surgical calf release may offer lasting relief where stretching alone falls short.

📖 Reference:
Riiser MO, Husebye EE, Hellesnes J, Molund M. Outcomes After Proximal Medial Gastrocnemius Recession and Stretching vs. Stretching as Treatment of Chronic Plantar Fasciitis at 6-Year Follow-up. Foot & Ankle International. 2024;45(1):1-9. doi:10.1177/10711007231205559

📍 For more information book a visit with @drlyndonmason

💬 Would you consider gastrocnemius release for stubborn plantar fasciitis? Share your thoughts! 👇🏼

#PlantarFasciitis #HeelPain #GastrocnemiusRelease #CalfTightness #FootAndAnkle #Orthopaedics #SportsMedicine #AnklePain #Surgery #Biomechanics #PainRelief #AchillesTendon #Rehabilitation #FootHealth #RunningInjury #Podiatry #MedicalEducation #HeelSpurs #GaitAnalysis #Physiotherapy #OrthopedicSurgery #SurgeonLife #plantarfasciitistreatment #liverpoolfootandankle #iom #iomfootandankle

🔹 Calf Release for Plantar Fasciitis: A Game-Changer? 🔹

#plantarfasciitis can be debilitating, affecting daily movement and quality of life. But what if tight calf muscles were a hidden contributor? A new systematic review suggests that gastrocnemius release could be an effective surgical option for chronic cases unresponsive to conservative treatment.

📌 Key Findings (Arshad et al., 2022):
✅ Significant pain relief and functional improvement postoperatively.
✅ Better outcomes than plantar fasciotomy and conservative stretching in some studies.
✅ Increased ankle dorsiflexion and maintained plantarflexion power.
✅ Quick return to weightbearing, work, and sports.
❗ Complications were low (~8.5%), but sural nerve injury is a rare risk.

🔑 Takeaway:
If chronic plantar fasciitis isn’t improving, calf tightness could be the missing link. Surgical calf release may provide a solution—especially for those with gastrocnemius contracture.

📖 Reference:
Arshad Z, Aslam A, Razzaq MA, Bhatia M. Gastrocnemius Release in the Management of Chronic Plantar Fasciitis: A Systematic Review. Foot & Ankle International. 2022;43(4):568-575. doi:10.1177/10711007211052290

📍 Book and appointment with @drlyndonmason to learn more.

💬 Would you consider calf release for plantar fasciitis? Let’s discuss! 👇🏼

#PlantarFasciitis #HeelPain #CalfTightness #GastrocnemiusRelease #AchillesTendon #FootAndAnkle #Orthopaedics #SportsMedicine #Podiatry #AnklePain #HeelSpurs #GaitAnalysis #Physiotherapy #Rehab #FootSurgery #RunningInjury #SportsInjury #FootHealth #AnkleRehab #SurgeonLife #OrthopedicSurgery #MedicalEducation #Biomechanics #painrelief #liverpoolfootsurgeon #isleofman

🔹 Ankle Stabilization & Microfracture: Long-Term Outcomes 🔹

Chronic lateral ankle instability (CLAI) is often associated with osteochondral lesions of the talus (OLTs - areas of cartilage injury). But what happens when both issues are addressed simultaneously? A new study provides long-term evidence on outcomes after open ligament repair surgery combined with arthroscopic bone marrow stimulation (BMS also called microfracture).

📌 Key Findings:
✅ Patients undergoing open ligament repair + BMS had significant pain relief & functional improvement, comparable to those who only had open ligament repair surgery.
✅ Mild osteoarthritis progression was observed in both groups, with no significant differences in long-term joint degeneration.
✅ Return to sports was similar across groups, with high activity levels post-surgery.
❗ However, larger OLTs (>50 mm²) were linked to lower functional scores and greater joint degeneration over time.

🔑 Takeaway:
For CLAI patients with small OLTs, a combined approach of ankle stabilization + microfracture leads to excellent long-term outcomes. However, as lesion size increases, the predictability of good results declines—making OLT size a crucial factor in surgical planning.

📖 Reference:
Su T, Cheng X, Zhu Y, et al. Patients With Chronic Lateral Ankle Instability and Small Osteochondral Lesions of the Talus Obtain Good Postoperative Results: A Minimum 10-Year Follow-up With Radiographic Evidence. Foot & Ankle International. 2025;0(0). doi:10.1177/10711007241311858

💬 Have you managed CLAI cases with OLTs? What’s your preferred approach? Share your thoughts below! 👇🏼

#AnkleInstability #BrostromGould #Microfracture #Orthopaedics #SportsMedicine #FootAndAnkle #OsteochondralLesions #ankleinjury #ankleinstability #cartilageinjury #longtermresults #ligamentrepair #microfracture #microfracturesurgery #bonemarrowstimulation #liverpoolfootandankle #iomfootandankle #sportsinjury

🏃‍♂️Fusion of the Big Toe in Elite Athletes: Can They Return to Sport? 🏆⚽🎾

First metatarsophalangeal joint (MTPJ) fusion is a well-established procedure for pain relief and function restoration, but can elite athletes get back to their peak performance after surgery? A new study sheds light on this question.
Reference: Return to Sport after First Metatarsophalangeal Arthrodesis in Elite Athletes

Dror Maor, Daniel Meyerkort, Salar Sobhi, James Calder
Journal of ISAKOS, 100390, 2025

📊 Key Findings:
✅ 75% of elite athletes returned to their original level of sport after MTPJ fusion.
✅ Significant pain reduction (VAS improved from 5.6 to 0.4, p < 0.001).
✅ Marked functional improvement across all functional scores.
✅ 100% satisfaction reported at final follow-up.

🔹 Who struggled to return out of the 16 patients reviewed?
🔻 2 soccer players dropped a division.
🔻 1 ATP tennis player never regained his original ranking.
🔻 1 badminton player couldn’t return to the same level.

Conclusion:
This is the first study examining elite athlete return to sport after big toe fusion, confirming that most can get back to competition with improved pain and function. While some may face challenges, overall satisfaction is high.

💬 What do you think? Would you opt for fusion if it meant playing pain-free? Drop your thoughts below! 👇 #SportsMedicine #FootAndAnkle #BigToeFusion #AthleteRecovery #orthopedicsurgery #AthleteRecovery #EliteAthletes #SportsPerformance #AthleteHealth #ReturnToPlay #SportsRehab #StrengthAndConditioning #HighPerformanceAthlete
#FootAndAnkleSurgery #BigToeArthrodesis #HalluxFusion #MTPJArthrodesis #Podiatry #liverpoolfootandankle #iomfootandankle

👣 Does a Big Toe Fusion Improve Flatfoot Deformity? 👣

👣 Does a Big Toe Fusion Improve Flatfoot Deformity? 👣

Flatfoot deformity, or pes planus, is often thought of as a problem with the medial longitudinal arch. But what role does the distal aspect of the arch—like the big toe joint—play in its correction?

📚 Our @drlyndonmason and his team, published after reviewing 511 cases of first metatarsophalangeal joint (MTPJ) fusion, showing the procedure can indeed improve certain flatfoot parameters, though it doesn’t fully restore the arch to “clinically normal” levels.

🔑 Study Findings:
After first MTPJ fusion, patients with flatfoot deformity showed statistically significant improvements in:
• Meary Angle: Reduced by 3.75° (indicating less arch collapse).
• Talonavicular Coverage Angle: Reduced by 1.48° (better alignment).
• Calcaneal Pitch Angle: Increased by 2.32° (suggesting a raised arch).
• Medial Cuneiform Height: Increased by 1.25 mm (a subtle but measurable improvement).

🔎 What Does This Mean?
• In patients with bunions, and flat feet, fusion of the big toe joint can play a role in stabilizing the distal medial longitudinal arch and improving flatfoot deformity.
• Choosing fusion of the big toe may have unrealized advantages of fusion of more proximal joints in first ray instability.

💬 Considering a fusion for big toe arthritis or bunions with a flat foot? Book to see @drlyndonmason to understand how this procedure might benefit you.

📚 Reference: Association of Fusion of the First Metatarsophalangeal Joint and Pes Planus Deformity Correction James Chapman et al. Foot Ankle Int. 2023 May

#Flatfoot #PesPlanus #BigToeFusion #FootAndAnkleSpecialist #LiverpoolFootAndAnkle #Orthopaedics #MedialLongitudinalArch #FootHealth #CuttingEdgeCare #ArchSupport #DrLyndonMason #OrthopaedicResearch #StayActive #footsurgery #worldclasscare

👣 What is Plantar Fibromatosis (Ledderhose Disease)? 👣

👣 What is Plantar Fibromatosis (Ledderhose Disease)? 👣

Plantar fibromatosis (PF), also known as Ledderhose disease, is a rare but often frustrating condition affecting the plantar fascia—the connective tissue in the arch of the foot. It involves the growth of benign, fibrous nodules on the bottom of the foot, which can range from painless to significantly painful and debilitating.

🔑 Key Facts About Plantar Fibromatosis:
1️⃣ Origins and History: First described by George Ledderhose in 1897, this condition is related to Dupuytren’s contracture in the hand and Peyronie’s disease in the penis. Co-occurrence with these conditions is not uncommon.
2️⃣ What Happens? Fibroblasts in the plantar fascia overproduce, forming nodules that may grow larger over time, potentially leading to toe contractures in severe cases.
3️⃣ Risk Factors: PF is more common in middle-aged Caucasian males and may be associated with heredity, repetitive trauma, diabetes, chronic liver disease, and long-term alcohol use.

💡 Symptoms to Watch For:
• Slow-growing nodules along the arch of the foot.
• Pain when walking, particularly during the toe-off phase of gait.
• Possible tenderness, redness, or difficulty wearing shoes.

🔍 Diagnosis and Imaging:
• Ultrasound or MRI can confirm the presence and size of nodules.
• Imaging also helps rule out other conditions like fibromas, liposarcomas, or neurofibromas.

🔑 How Is It Treated?
1️⃣ Conservative Management (First Line):
• Orthotics or custom insoles to offload pressure.
• Soft-soled shoes or rocker-bottom footwear for shock absorption.
• Activity modifications and NSAIDs to manage pain.
2️⃣ Advanced Options:
• Corticosteroid injections or radiation therapy may reduce inflammation and slow progression.
• Surgery (wide excision or plantar fasciectomy) is reserved for severe, persistent cases but carries risks of recurrence and complications.

💬 Have painful nodules in your feet? Contact us at the Liverpool Foot and Ankle Clinic to discuss your symptoms and explore treatment #plantarfibroma #plantarfibromatosis #plantarfasciitis

👣 What is Keyhole bunion surgery, and is it better than traditional surgery? 👣

🔑 Traditional Open Surgery (Scarf and Akin Osteotomy):
• Widely used in the UK with good clinical and radiological outcomes
.• Corrects the bunion by reshaping the bone and soft tissues
.• Associated with high patient satisfaction, even in varying degrees of deformity
.• Concerns include potential for recurrence (especially in people with flat feet) and larger scars due to open incisions

.

🔑 Minimally Invasive (Keyhole) Surgery (MIS):
• Performed through small incisions, leading to smaller scars and less early postoperative pain.
• Fourth-generation MIS emphasizes multiplanar deformity correction with stable fixation.
• May offer superior correction for severe deformities by addressing the bone alignment directly, rather than relying on soft tissue adjustments.
• Evidence is promising but currently relies on single-surgeon case series, making standardization a challenge.

💡 Key Comparisons:
1️⃣ Outcomes: Both techniques achieve similar clinical and radiological results, but MIS may reduce recovery time and improve scar appearance.
2️⃣ Recurrence Rates: MIS shows potential for lower recurrence rates in severe deformities although more long term evidence needed in specific populations.
3️⃣ Postoperative Pain: MIS tends to result in less pain early on due to reduced soft-tissue trauma.

💬 Curious about which option might suit you? At the Liverpool Foot and Ankle Clinic we offer both procedures, book and appointment with @drlyndonmason for personalized advice and expert care!

📚 Reference: @profmangwani Bone Joint J 2025;107-B(1):10–18

#BunionSurgery #KeyholeSurgery #MinimallyInvasiveSurgery #HalluxValgus #FootAndAnkleSpecialist #LiverpoolFootAndAnkle #Orthopaedics #ScarfAndAkin #CuttingEdgeCare #BunionRelief #FootHealth #MISFootSurgery #PatientCare #StayActive #keyholebunion

👣 Metatarsophalangeal Joint Injuries: Turf Toe and Sand Toe 👣

Injuries to the metatarsophalangeal (MTP) joint—the joint at the base of your big toe—can be painful and debilitating, particularly in active individuals and athletes. Two common injuries are turf toe and sand toe, both of which involve trauma to the first MTP joint but with distinct mechanisms.

📚 As detailed by @drlyndonmason in “Turf Toe and Disorders of the Sesamoid Complex” (Clin Sports Med, 2015), these injuries cover a wide spectrum of trauma that ranges from mild to severe.

🔎 What Are Turf Toe and Sand Toe?
• Turf Toe: Caused by hyperextension of the big toe, often seen in athletes playing on hard surfaces like turf. It can lead to ligament sprains, sesamoid injuries, cartilage damage, and even traumatic hallux valgus (a bunion-like deformity).
• Sand Toe: Occurs with hyperflexion, often seen in activities like beach volleyball or barefoot sports, resulting in similar but opposite strain to the joint.

💡 Key Symptoms:
• Pain, swelling, and tenderness at the base of the big toe.
• Difficulty walking or pushing off during movement.
• Limited joint motion or visible deformity in severe cases.

🔑 Treatment Options:
1️⃣ Conservative Management:
• Rest, ice, and NSAIDs to manage inflammation.
• Taping or stiff-soled shoes to limit movement and protect the joint.
• Physical therapy to regain strength and range of motion.
2️⃣ Surgical Intervention: Reserved for severe injuries with sesamoid fractures, joint instability, or when conservative treatments fail.

If you’re experiencing pain or instability in your big toe, don’t wait—reach out to a foot and ankle specialist for accurate diagnosis and personalized care.

📚 Reference: Mason LW, et al. Turf Toe and Disorders of the Sesamoid Complex. Clin Sports Med. 2015.

#TurfToe #SandToe #MetatarsophalangealJoint #FootAndAnkleInjuries #SportsMedicine #Orthopaedics #FootAndAnkleSpecialist #LiverpoolFootAndAnkle #InjuryPrevention #CuttingEdgeCare #StayActive #DrLyndonMason #FootHealth #AthleteCare #SportsInjuryRecovery

👣 What is the Sesamoid Bone in the Foot, and Why Does Mine Hurt? 👣

The sesamoid bones in the foot are small, sesame seed (and thus the name!!) bones located beneath the joint of your big toe. Embedded within the tendons of the flexor hallucis brevis, they play a critical role in weight distribution, stabilization of the big toe, and enhancing the mechanical advantage of tendons during movement. There are two of them, and they act like pulleys, ensuring smooth toe function during activities like walking, running, and jumping.

🔎 Why Is My Sesamoid Painful?
As highlighted in the study by Sims and Kurup (World J Orthop, 2014), sesamoid pain can arise from various conditions:
• Overuse Injuries: High-impact activities like running or dancing can cause sesamoiditis (inflammation of the sesamoids).
• Fractures: Acute or stress fractures can occur, especially in the medial sesamoid, which bears the most weight.
• Avascular Necrosis: A lack of blood supply can lead to bone death, resulting in chronic pain.
• Bipartite Sesamoids: A normal anatomical variant where the sesamoid fails to fuse, which can mimic a fracture.
• Arthritis or Trauma: Joint degeneration or direct injury can also cause discomfort.

💡 Diagnosis and Management:
1️⃣ Early Imaging: An MRI or bone scan is often crucial to distinguish between conditions like fractures, bipartite sesamoids, or avascular necrosis.
2️⃣ Conservative Treatment:
• Rest and reduce weight-bearing activities.
• Use custom orthotics to offload pressure from the sesamoids.
• NSAIDs can help reduce inflammation.
• Steroid injections under radiological guidance may provide relief in some cases.
3️⃣ Surgical Options: Reserved for persistent cases, options include sesamoidectomy (removal of one sesamoid) or fixation for fractures.

🔑 Key Takeaway: Most sesamoid pain can be managed conservatively. Early evaluation, imaging, and review by a foot and ankle specialist can help identify the cause and guide treatment effectively.

💬 Struggling with sesamoid pain? Book in with @drlyndonmason for expert diagnosis and personalized care!
#sesamoid #sesamoiditis😧 #sesamoidpain #liverpoolfootandankle #iomfootandankle

👣 Achilles Tendon Ruptures: The Weekend Warrior Effect 👣

Did you know that Achilles tendon ruptures are most common in the general population after the age of 40, especially among those with low-activity occupations (like desk jobs) who only engage in physical activity about once a week? This phenomenon is often referred to as the “weekend warrior” effect.

When we spend most of the week being sedentary and then engage in intense activity without proper conditioning, it can strain the Achilles tendon, leading to a rupture. The combination of age-related changes in tendon strength and the sudden demand of high-intensity sports, like football or tennis, creates the perfect storm for injury.

🎉 A Winning Research Insight!
This was highlighted in the prize winning research “Mechanisms of Achilles Tendon Rupture in the Normal Population” by @drlyndonmason team. Natalie Limaye presented and won the research prize @rsm.ortho future orthopaedic surgeon conference with coauthors @junaidaamir28 and @loukas

💡 Tips to Prevent Achilles Ruptures:
• Gradually build up activity levels with regular exercise.
• Warm up and stretch properly before sports.
• Strengthen your calf muscles to reduce strain on the tendon.

Congratulations again to Natalie for shedding light on this critical topic and helping us better understand how to prevent these injuries!

#AchillesTendon #WeekendWarrior #AchillesRupture #FootAndAnkleSpecialist #LiverpoolFootAndAnkle #OrthopaedicResearch #RoyalSocietyOfMedicine #rsmwinners #SportsInjuries #StayActive #InjuryPrevention #HealthyFeet #OrthopaedicCare #CuttingEdgeResearch #FootHealth

🚨 Misinformation Alert: Orthopaedic Conditions on TikTok & Instagram

A recent study titled “Misinformation About Orthopaedic Conditions on Social Media: Analysis of TikTok and Instagram” by Oluwadamilola Kolade et al. (Cureus, 2023) highlights a critical issue: the prevalence of low-quality, inaccurate information about common orthopaedic conditions on social media platforms.

🔑 Key Insights from the Study:
• Platforms Analyzed: TikTok (165.7M views) and Instagram (9.6M views) were reviewed for posts related to six common orthopaedic conditions:
• Achilles tendon tears
• ACL injuries
• Meniscus tears
• Tennis elbow
• Rotator cuff tears
• Ankle sprains
• Accuracy Gap: Physician-generated posts were significantly more accurate compared to non-physician content.
• Engagement Imbalance: Despite being more accurate, physician content attracted only 16.1% of total engagement, compared to 83.9% for non-physician posts.

📉 What Does This Mean for Patients?

Millions of viewers are being exposed to misleading information, which can affect treatment decisions and patient outcomes. Non-expert creators often prioritize entertainment and engagement over accuracy, leading to misinformation about diagnosis, treatment, and recovery.

🩺 How Can We Combat This?

1️⃣ Healthcare Professionals on Social Media: Increased participation from physicians is essential to ensure the availability of reliable, evidence-based content.
2️⃣ Patient Awareness: Patients must critically evaluate health information online and prioritize advice from certified professionals.
3️⃣ Tools like DISCERN: Use instruments like the DISCERN scale to assess the reliability and quality of medical content. 📢 Call to Action:

Healthcare professionals, let’s bridge the gap between accuracy and engagement! Use platforms like TikTok and Instagram to share trustworthy, patient-centered content and counteract the misinformation trend.

#OrthopaedicEducation #HealthMisinformation #TikTok #Instagram #PatientSafety #EvidenceBasedMedicine #liverpoolfootandankle #iomfootandankle #britishorthopaedicassociation #spirehealthcare

💥 Stress Fractures of the Foot and Ankle: A Hidden Challenge for Athletes 👣

💥 Stress Fractures of the Foot and Ankle: A Hidden Challenge for Athletes 👣

Stress fractures are a common but often underdiagnosed injury in recreational and elite athletes. These micro-injuries occur when repetitive stress on the foot and ankle overwhelms the bone’s ability to repair itself, leading to fractures that can sideline athletes for weeks or months.

🔍 What Causes Stress Fractures?

Stress fractures develop due to an imbalance between bone repair and stress from:
• Intrinsic factors: Bone health, hormonal imbalances, or age.
• Extrinsic factors: Sudden changes in training, poor biomechanics, or improper footwear.

🩺 Diagnosis & Treatment
• Low-risk fractures (e.g., tibia, fibula, calcaneus, metatarsal shafts):
• Treated conservatively with activity modification and gradual return to sport.
• Weight-bearing is usually allowed as pain resolves.
• High-risk fractures (e.g., navicular, talus, medial malleolus, proximal 5th metatarsal):
• Require proactive management due to poor healing potential.
• May involve casting, restricted weight-bearing, or surgical fixation.

💡 Prevention Tips

1️⃣ Gradual Training Progression: Avoid sudden increases in activity.
2️⃣ Nutrition: Ensure adequate calcium, vitamin D, and overall caloric intake.
3️⃣ Biomechanics: Address alignment issues or foot deformities with orthotics if needed.
4️⃣ Recovery Time: Prioritize rest and recovery to prevent overuse injuries.

⚠️ Why It Matters

If left untreated, stress fractures can lead to complications like non-union or chronic pain, requiring more invasive treatments. Early diagnosis with tools like MRI and careful management can ensure a quicker return to sport and daily activities.

📖 Reference: Stress Fractures of the Foot and Ankle in Athletes, Philip B. Kaiser, Daniel Guss, Christopher W. DiGiovanni, Foot & Ankle Orthopaedics, 2018.

#StressFractures #FootAndAnkleHealth #AthleteInjury #SportsMedicine #Orthopedics #BoneHealth #injuryprevention #liverpoolfootandankle #iomfootandankle #stressfracture #footpain #femaletriad #healthyfeet

👣 Top Internet Searches for Foot & Ankle Conditions 🩺

👣 Top Internet Searches for Foot & Ankle Conditions 🩺

Ever wondered what foot and ankle issues people are googling the most? Here’s a list of the most commonly searched conditions and what you should know about them:

1️⃣ Plantar Fasciitis: Heel pain, especially on first step out of bed in the morning, caused by inflammation of the thick tissue connecting the heel@and the ball of the foot.
2️⃣ Ankle Sprains: Ligament injuries from twisting or turning the ankle.
3️⃣ Bunions: A bony bump at the base of the big toe that can cause pain and swelling with outward deviation of the big toe.
4️⃣ Achilles Tendinitis: Pain and stiffness at the back of the heel either at the mid portion of the Achilles or where it attaches to the calcaneum.
5️⃣ Morton’s Neuroma: Pain in the ball of the foot from thickened tissue around a nerve.
6️⃣ Stress Fractures: Small bone cracks, often due to overuse or repetitive stress.
7️⃣ Flat Feet: Collapsed arches leading to discomfort or misalignment.
8️⃣ Heel Spurs: Calcium deposits causing a bony protrusion on the heel, often linked to plantar fasciitis.
9️⃣ Hammertoes: Toes bent downward at the middle joint, causing pain or difficulty walking.
🔟 Gout: Sudden attacks of pain and swelling, commonly affecting the big toe.

💡 Why This Matters: These conditions impact millions and often lead to discomfort, mobility issues, and a reduced quality of life. Early awareness and treatment are key to staying active and pain-free.

👟 Tip: If you’re experiencing any of these issues, book a consultation with @drlyndonmason and don’t rely solely on Google for solutions! Check other posts from the clinic for further information on these conditions and our website or YouTube channel.

#FootHealth #AnkleCare #PlantarFasciitis #AnkleSprain #Bunions #AchillesTendinitis #StressFractures #FlatFeet #HeelPain #GoutAwareness #HealthyFeet #liverpoolfootandankle #iomfootandankle #mortonsneuroma #achillespain

💡 Second-Line Treatments for Plantar Fasciitis: What Works? 👣

💡 Second-Line Treatments for Plantar Fasciitis: What Works? 👣

Plantar fasciitis (PF) is a common cause of persistent heel pain, often managed conservatively. But what happens when first-line treatments like rest, stretching, changing sleep position and NSAIDs don’t work? A recent study sheds light on extracorporeal shock wave therapy (ESWT) and its comparison to other second-line options.

🛠️ Study Insights

📊 ESWT vs. Placebo
• ESWT significantly outperformed placebo in reducing pain and improving foot function.

📊 ESWT vs. Other Treatments
• PRP (Platelet-Rich Plasma): Showed better outcomes for pain relief and foot function but is technically more complex.
• Custom Orthotics: Provided greater improvement in foot function compared to ESWT.
• Other Modalities: No significant differences were found when compared with ESWT.

⚖️ Key Takeaways
• ESWT is a proven and effective option for patients who don’t respond to initial treatments.
• PRP offers superior results but involves a more invasive and challenging procedure.
• Custom Orthotics remain a valuable tool for improving foot function in PF patients.

💡 What Does This Mean for You?

If you’re struggling with persistent heel pain, consider discussing these second-line options. @drlyndonmason is an expert in the field and has run the a tertiary referral #heelpainclinic for over a decade. At @spire.healthcare in Liverpool we have all options of treatment including #shockwave and #prpinjections. Each treatment has its strengths, and the choice depends on your condition, goals, and lifestyle.

📖 Reference: Extracorporeal Shock Wave Therapy Shows Comparative Results with Other Modalities for the Management of Plantar Fasciitis: A Systematic Review and Meta-Analysis, Wei Shao Tung et al., Foot Ankle Surg, 2024.

#PlantarFasciitis #HeelPain #ESWT #PRPTherapy #Orthotics #FootHealth #ChronicPainManagement #SportsMedicine #conservativetreatment #shockwave #liverpoolfootandankle #iomfootandankle #heelpain #prp

🩺 Infection Risks After Foot & Ankle Surgery: What the Research Says 🦶

Infection after surgery is an unwanted complication which can be minor, but in rare instances can cause major issues. A recent systematic review and meta-analysis involving over 10,000 patients sheds light on the risk of surgical site infections (SSI) in patients undergoing foot and ankle surgery. Here are the key findings:

🔎 Risk of SSI:
• Overall risk: 4.2%
• Higher risk in fractures of the hindfoot (ankle/calcaneum/talus): 4.9%
• Men are at greater risk compared to women (Odds Ratio: 1.335).

📊 Risk higher in certain instances :
• Diabetes Mellitus (DM): 9.1%
• Hypertension (HTN): 5.5%
• Tobacco use: 6.6%

⚠️ These findings highlight the significant role of other medical conditions and lifestyle factors in increasing infection risks.

Reducing Infection Risk

📌 Address modifiable risk factors like smoking and optimize management of chronic conditions such as diabetes and hypertension.
📌 Strict adherence to surgical protocols and early identification of at-risk patients can reduce complications.
📌 Personalized care plans for high-risk groups are essential.

🧑‍⚕️ For patients and healthcare professionals alike, awareness is the first step toward prevention. Let’s work together to reduce post-surgical complications and improve outcomes!

📖 Reference: Prevalence of surgical site infection and risk factors in patients after foot and ankle surgery: A systematic review and meta-analysis, Jiaguo Cheng et al., International Wound Journal, January 2024.

#FootAndAnkleSurgery #SurgicalSiteInfection #SSI #Orthopedics #DiabetesCare #HypertensionAwareness #SmokingCessation #SurgicalComplications #PatientSafety #infectioncontrol #liverpoolfootandankle #iomfootandankle #diabeticfoot #infection #infectionprevention

The Hidden Risk of Long-Haul Flights: Deep Vein Thrombosis (DVT)

The Hidden Risk of Long-Haul Flights: Deep Vein Thrombosis (DVT)

Each year, nearly two billion people travel by air, with over 300 million taking long-haul flights. While air travel is generally safe, it can pose a serious health risk: venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE).

What Increases the Risk?

Long flights, particularly those lasting over 8 hours, can double the risk of VTE. Factors contributing to this include:
• Stasis: Prolonged sitting restricts blood flow in the legs.
• Hypoxia: Reduced oxygen levels in airplane cabins can activate blood coagulation.
• Dehydration: Low cabin humidity and diuretics like caffeine or alcohol can thicken the blood.

Who is at Higher Risk?
1. Age >40
2. Female gender (especially those on hormonal contraceptives or HRT)
3. Obesity
4. Varicose veins
5. Genetic thrombophilia
6. Pregnancy or recent childbirth
7. Recent surgery or injury

Prevention Tips for All Travelers
1. Stay Hydrated: Drink plenty of water and avoid alcohol or caffeine.
2. Move Often: Walk the aisle every 2-3 hours and stretch your legs while seated.
3. Exercise Your Calves: Perform ankle circles or leg lifts in your seat.
4. Wear Compression Stockings: Proven to reduce the risk of DVT by improving blood flow.

High-Risk Passengers

For those at higher risk, specific treatments can help:
• Low-Molecular-Weight Heparin (LMWH): A single dose before the flight can significantly lower VTE risk.
• Aspirin: In certain cases, low-dose aspirin may be recommended to reduce clotting risk. However, this should be used only after consulting with a healthcare provider.

Why It Matters

While symptomatic VTE is rare (affecting about 1 in 500 passengers on flights over 12 hours), asymptomatic cases are more common. Preventative steps are essential, as the risk can persist for up to 4 weeks after landing.

For further information, see Air travel and the risk of thromboembolism, Israel Gavish et al., Internal and Emergency Medicine, 2011.
#liverpoolfootandankle #dvt #clot #flight

“My New Year’s Resolution Was to Run Every Morning. Now My Heels Hurt!” 🏃‍♂️🌄

“My New Year’s Resolution Was to Run Every Morning. Now My Heels Hurt!” 🏃‍♂️🌄

Starting the year with morning runs is a fantastic resolution, but heel pain can quickly derail your progress. Here’s why it might be happening and how to fix it:

1️⃣ Post-Holiday Weight Gain
• Overindulgence during the holidays can lead to extra weight, increasing pressure on your feet.
• This added stress can irritate your plantar fascia (the ligament running from your heel to your toes), causing plantar fasciitis.

2️⃣ Sudden Intensity
• If you haven’t been running regularly, jumping straight into daily runs can strain your feet and calves.
• This overuse can lead to microtears in the plantar fascia, resulting in heel pain.

3️⃣ Tight Calves and Sleeping Position
• Belly or side sleepers often rest with their feet in plantar flexion (pointed down), leaving calf muscles and the plantar fascia tight in the morning.
• Using the Foot-zz pillow from @putnamscomfort can keep your feet in a neutral position overnight, reducing strain on your plantar fascia and calves.

How to Fix It?

✔️ Warm-Up First: Stretch your calves and plantar fascia before every run. Use exercises like calf stretches and rolling your foot over a ball.
✔️ Start Gradually: Ease into your running routine. Begin with shorter runs and low intensity, increasing distance and pace over time.
✔️ Choose the Right Shoes: Invest in proper running shoes with good arch support and cushioning.
✔️ Improve Sleep Position: Avoid plantar flexion during sleep by using the Foot-zz pillow for better foot alignment and comfort.
✔️ Recovery Is Key: After your run, stretch, foam roll, and ice your heels to reduce inflammation.

If heel pain persists, consult an expert like @drlyndonmason, who has over a decade of being a the consultant lead for a heel pain clinic. With the right approach, you can stick to your resolution and run pain-free!

#HeelPain #PlantarFasciitis #MorningRuns #RunningResolution #HealthyFeet #Orthopaedics #LiverpoolFootAndAnkle #IOMFootAndAnkle #TightCalves #FitnessGoals #FootPainRelief #ExpertCare #PutnamsComfort #FootzzPillow #achilles #achillestendon #achillespain

“Will My Orthopaedic Implants Set Off Airport Alarms?” ✈️🦴

“Will My Orthopaedic Implants Set Off Airport Alarms?” ✈️🦴

If you’ve had orthopaedic surgery, you might be wondering whether your implants will trigger airport security metal detectors. Here’s what the research says:

What Are the Chances?

According to a study by Kunasuntiwarakul & Poopitaya (2020):
• 86.78% of implants were detected by airport-level hand-held metal detectors.
• Total joint prostheses (like hip or knee replacements) are almost always detected (99.35% for prosthetic replacements).
• Plates, nails, and large implants in the lower limb or spine are highly likely to trigger alarms.
• Small screws, Kirschner wires, and upper limb implants are less likely to be detected.

Why Are Some Implants Detected?
• Implants made of cobalt-chromium or titanium are more likely to set off detectors than stainless steel.
• The location and size of the implant also influence detection rates (lower extremity implants are detected twice as often as upper extremity implants).

What Can You Do?

✔️ Travel Prepared: A letter or medical card from your surgeon detailing your implants is not mandatory, but can save time at security.
✔️ Be Transparent: Inform security staff about your implants before screening.
✔️ Expect Extra Screening: If your implant triggers the alarm, you may be asked for further checks like a pat-down.

Remember, airport security is designed to ensure safety, and being prepared can make the process smooth and stress-free.

Reference:
Kunasuntiwarakul P, Poopitaya S. Detection of Orthopedics Implants in Vivo by Hand-Held Metal Detectors. J Med Assoc Thai 2020;103(9).

#OrthopaedicSurgery #AirportSecurity #TravelTips #Implants #MetalDetector #MedicalTravel #KneeReplacement #HipReplacement #Orthopaedics #LiverpoolFootAndAnkle #IOMFootAndAnkle #BoneHealth #ProstheticLife #AirportAlarms #medicalpreparedness #FAQorthopaedics

“When Can I Drive After Foot and Ankle Surgery?” 🚗🦶

“When Can I Drive After Foot and Ankle Surgery?” 🚗🦶

Recovering from foot or ankle surgery and wondering when it’s safe to return to driving? Here’s what the evidence and guidelines say:

Key Considerations

1️⃣ UK DVLA Guidelines 🇬🇧
• You must be able to perform an emergency stop safely and without pain before driving again.
• Notify the DVLA if you’re unable to drive for more than 3 months post-surgery.
•. Contact the DVLA for further information especially on not driving if still using a splint.

2️⃣ Evidence from Research 📖
A systematic review by Lundy et al. (2022) highlights that:
• Right Foot Surgery: Reaction times may be significantly impaired for 6–8 weeks post-surgery. This aligns with general advice to avoid driving for at least 6 weeks for safety.
• Left Foot Surgery: If you drive an automatic car, you may return to driving sooner, provided pain and function allow it.
• The review emphasizes individual assessment and surgeon advice as crucial for safe return to driving.

What You Can Do

✔️ Test Your Ability: Practice an emergency stop in a controlled, safe environment.
✔️ Consult Your Surgeon: Always get clearance from your healthcare provider before returning to driving.
✔️ Prioritize Safety: Ensure you are pain-free, mobile, and confident in your ability to drive safely.

Key Takeaway

Driving after foot and ankle surgery is highly individualized. While general timelines exist, the final decision should be based on your recovery progress and the advice of your medical team.

Reference:
Lundy A, Piscoya A, Rodkey D, Bedrin M, Eckel T. Return to Driving after Elective Foot and Ankle Surgery: A Systematic Review. Osteology 2022;2(3):121-128.

#FootSurgery #AnkleSurgery #DrivingAfterSurgery #DVLA #RoadSafety #PostSurgeryRecovery #LiverpoolFootAndAnkle #IOMFootAndAnkle #Orthopaedics #SystematicReview #SafeDriving #PatientCare #drivingpostsurgery

“What Is a Morton’s Neuroma?”

“What Is a Morton’s Neuroma?”

Despite its name, a Morton’s neuroma isn’t actually a neuroma (a tumor of nerve tissue). It’s a painful condition caused by irritation or thickening of the nerve between the toes, most commonly between the 3rd and 4th toes. This irritation can cause burning pain, numbness, or the feeling of a pebble in your shoe.

What Causes It?
👉 Tight or high-heeled shoes that squeeze the toes
👉 Repeated trauma or pressure on the foot
👉 Foot shape, like flat feet or high arches and tight calf’s

Treatment Options
1️⃣ Conservative Management:
• Changing footwear to wider, supportive shoes
• Orthotic insoles to offload pressure and physiotherapy to reduce calf tightness
• Corticosteroid injections to reduce inflammation

2️⃣ Advanced Treatments:
• Cryosurgery: Minimally invasive freezing of the nerve to stop pain
• Excision: Surgical removal of the damaged nerve for long-term relief

Left untreated, Morton’s neuroma can worsen and significantly impact your quality of life. If you’re experiencing persistent foot pain, don’t hesitate to seek help from the team. Our Dr Lam is one of the few in the country offering cryosurgery for the condition.

#MortonsNeuroma #FootPain #NeuromaTreatment #Cryosurgery #FootAndAnkleCare #LiverpoolFootAndAnkle #IOMFootAndAnkle #NervePain #HealthyFeet #Orthopaedics #FootSpecialist #ToePain #FootHealth #MortonsNeuromaRelief #SurgicalTreatment

“I Twisted My Ankle and Now It Hurts All the Time—What Can I Do?”

“I Twisted My Ankle and Now It Hurts All the Time—What Can I Do?”

An ankle sprain can feel like a minor injury, but for some people, the pain doesn’t go away. If your ankle hurts long after the initial injury, it could be due to:

1️⃣ Lingering Ligament Damage
A sprain stretches or tears the ligaments in your ankle. If they don’t heal properly, you might experience chronic instability or pain.

2️⃣ Cartilage Injury
Twisting your ankle can damage the cartilage in the joint, leading to conditions like osteochondral lesions or early arthritis.

3️⃣ Scar Tissue Build-Up
As your ankle heals, scar tissue can form. Excessive scar tissue can restrict movement and cause ongoing pain or stiffness.

4️⃣ Undiagnosed Fracture
Sometimes, a small fracture is missed during the initial injury, causing persistent pain and swelling if it doesn’t heal.

5️⃣ Tendon or Nerve Injury
Tendons or nerves around the ankle can also be injured during a sprain, leading to ongoing discomfort or weakness.

What Can You Do?
✔️ See a Specialist: A thorough assessment (including imaging like X-rays or MRIs) can help identify any underlying issues. Book with @drlyndonmason for expert advice
✔️ Rehabilitation: Physical therapy can strengthen your ankle, improve balance, and address scar tissue or stiffness.
✔️ Bracing or Orthotics: Using ankle supports can reduce strain and prevent further injury, although overuse can give weakness.
✔️ Consider Further Treatment: Persistent pain may require targeted interventions, like injections or surgery, to address cartilage damage or instability.

Don’t ignore ongoing ankle pain—it’s your body’s way of telling you something isn’t right. Early intervention can help prevent long-term issues and get you back on your feet!

#AnkleSprain #ChronicAnklePain #TwistedAnkle #AnkleInjury #ScarTissue #FootAndAnkleCare #LiverpoolFootAndAnkle #IOMFootAndAnkle #SportsInjury #Rehabilitation #AnkleSupport #Orthopaedics #PersistentPain #InjuryRecovery #AnkleInstability #CartilageInjury #AnkleHealth #healthyfeet

“I Have Flat Feet—Why Do They Hurt?”

“I Have Flat Feet—Why Do They Hurt?”

Flat feet, or pes planus, are quite common, with about 1 in 4 people having them. For many, flat feet are normal and don’t cause any problems. However, developing flat feet in adulthood (adult-acquired flatfoot) is less common and more likely to lead to pain. Here’s why:

1️⃣ Overloading the Soft Tissues
Flat feet can strain the ligaments, tendons, and muscles that support your foot. The posterior tibial tendon and ligaments, which helps lift your arch, are often overworked and can become inflamed, leading to pain along the inner side of your ankle or arch.

2️⃣ Misalignment
Without proper arch support, your foot may roll inward (overpronation), altering your gait. This misalignment can cause pain in your ankles, knees, hips, and even your lower back.

3️⃣ Increased Pressure
A flat foot may distribute pressure unevenly, leading to sore spots on the sole or impingement pain on the outer ankle, especially during long periods of standing or walking.

4️⃣ Underlying Conditions
Developing flat feet in adulthood can sometimes signal conditions like posterior tibial tendon dysfunction, arthritis, or joint and ligament instability, which can result in pain and stiffness.

What Can You Do?
✔️ Wear Supportive Shoes: Choose footwear with good arch support and cushioning.
✔️ Use Orthotics: Custom or off-the-shelf insoles can help realign your foot and reduce strain with arch support and heel cup.
✔️ Strengthen and Stretch: Exercises like toe curls, calf stretches, and posterior tibial tendon strengthening can help.
✔️ Seek Professional Advice: If pain persists, make an appointment with @drlyndonmason for a tailored treatment plan.

Pain isn’t inevitable with flat feet. While it’s normal for some to have flat arches without issues, adult-onset flat feet should be evaluated to ensure your feet stay healthy and pain-free!

#FlatFeet #FootPain #HealthyFeet #Orthopaedics #FootAndAnkleCare #LiverpoolFootAndAnkle #IOMFootAndAnkle #FootSpecialist #PesPlanus #ArchSupport #AnklePain #FlatFootPain #HealthyLiving #FootHealth #PosteriorTibialTendon #AdultFlatFeet #FootPainRelief #GaitAnalysis #CustomOrthotics #FlatFootSupport #archpain

🌟 Big Toe Arthritis: What’s the Best Treatment? 🌟

If you’re struggling with big toe arthritis, you’re not alone—this is a common condition that can cause pain, stiffness, and difficulty with everyday activities. But what’s the best treatment?

👉 For Early Arthritis:
If caught early, non-surgical treatments can often help:
✅ Activity modification: Avoid high-impact activities that aggravate the joint.
✅ Custom orthotics: These can reduce pressure on the big toe and improve pain.
✅ Anti-inflammatory medications: Oral or topical NSAIDs can help manage symptoms.
✅ Steroid injections: Temporary relief for inflammation and pain.
✅ Joint-preserving surgery: Options like cheilectomy (removing bone spurs) and osteotomy can improve mobility and reduce pain.

👉 For Advanced Arthritis:
When arthritis progresses and the joint becomes too damaged to salvage, fusion surgery is the gold standard. Fusion provides reliable pain relief, long-term durability, and excellent functional outcomes.

👨‍⚕️ With over a decade of experience and multiple research publications in the subject, @drlyndonmason is here to guide you through all stages of treatment. Book an appointment if you want to discuss further, from early interventions to advanced surgical options tailored to your needs.

#ToeArthritis #HalluxRigidus #FusionSurgery #Orthopedics #DrLyndonMason #ArthritisTreatment #BigToePain #ArthritisCare #HalluxRigidusTreatment #ToeFusion #FootAndAnkleSpecialist #LiverpoolFootClinic #IOMFootClinic #FootArthritis #ToeArthritisSolutions #FootPainRelief #FusionSurgeryExperts #OrthopedicSpecialist #FootAndAnkleCare #LiverpoolOrthopedics #IsleOfManFootClinic #HalluxSurgery #FootHealthMatters #AdvancedArthritisCare #FusionSurgeryGoldStandard #BigToeSurgery #ToeArthritisHelp

👣 “I Keep Going Over on My Ankle – What Can I Do?” 👣

👣 “I Keep Going Over on My Ankle – What Can I Do?” 👣

Repeatedly rolling or twisting your ankle might be a sign of Chronic Ankle Instability (CAI), a condition where the ankle feels unstable and is prone to sprains. This can occur after multiple injuries that weaken the ligaments or due to poor rehabilitation after an initial sprain.

📚 @drlyndonmason published on “Chronic Ankle Instability” (Orthopaedics and Trauma, 2011), writing that CAI occurs due to a combination of mechanical instability (weakened or stretched ligaments) and functional instability (poor neuromuscular control).

⚠️ Did you know?
Certain foot shapes, such as high arches, can predispose you to ankle instability. High arches limit the surface area of the foot that contacts the ground, reducing stability and increasing the likelihood of rolling the ankle.

🔑 What Can You Do?
1️⃣ Strengthening Exercises: Work on your ankle’s strength and stability with targeted exercises like resistance band work or single-leg balance drills.
2️⃣ Proprioception (your brain and spinal reflex knowing where the limb is in space) Training: Balance and coordination exercises can improve your body’s ability to sense and stabilize the joint.
3️⃣ Supportive Footwear: Proper footwear, and sometimes orthotics, can help stabilize high-arched feet and reduce the risk of ankle injuries.
4️⃣ Physical Therapy: A specialist can tailor a rehab program to address your unique needs.
5️⃣ Surgical Options: If conservative measures fail, surgery may be required to repair or reconstruct the damaged ligaments.

💡 Early intervention is key! If you’re struggling with ankle instability, book a consult a with @drlyndonmason to explore your treatment options and prevent further injuries.

#ChronicAnkleInstability #AnklePain #AnkleSprains #FootAndAnkleSpecialist #Orthopaedics #AnkleRehabilitation #AnkleStability #SportsInjuries #HighArches #FootShapeMatters #AnkleInjury #LiverpoolFootAndAnkle #OrthopaedicCare #CuttingEdgeCare #AnkleRecovery #StayActive #FootHealth #BalanceTraining #Proprioception #AnkleStabilitySolutions #DrLyndonMason #iomfootandankle

👣 Why Does the Ball of My Foot Hurt? 👣

👣 Why Does the Ball of My Foot Hurt? 👣

Pain under the ball of your foot, also known as metatarsalgia, can make walking and daily activities uncomfortable. This condition isn’t a diagnosis on its own but rather a symptom of various underlying issues.

📚 According to “Differential Diagnosis of Metatarsalgia” by Afonso et al. (Semin Musculoskelet Radiol, 2023), the causes of metatarsalgia can vary widely, requiring careful evaluation.

🔑 Common Causes of Metatarsalgia:
1️⃣ Mechanical Overload: Excess pressure on the metatarsal heads due to high arches, flat feet, tight calf’s or improper footwear.
2️⃣ Toe Deformities: Conditions like #hammertoes or #bunionscan alter weight distribution.
3️⃣ Fat Pad Atrophy: Thinning of the protective fat under the ball of the foot.
4️⃣ #mortonsneuroma: A nerve entrapment causing burning or tingling pain.
5️⃣ Inflammatory Arthritis: #Rheumatoidarthritis or #gout can lead to inflammation and discomfort.
6️⃣ #stressfracture or #frieburgsdisease : Overuse injuries in athletes or those with repetitive impact activities or uncommonly loss of blood supply to metatarsal head

🔎 Accurate diagnosis is essential, as treatment depends on the root cause. Imaging, such as X-rays, US or MRIs, is often needed to rule out specific conditions.

💡 Tips for Relief:
• Choose supportive footwear with a cushioned sole.
• Use custom orthotics to redistribute pressure.
• Consider physical therapy or stretches to improve foot mechanics and calf tightness.

If you’re struggling with foot pain, book a consultation with our foot and ankle specialist, @drlyndonmason to find the right solution for your needs!

#Metatarsalgia #BallOfFootPain #FootHealth #FootAndAnkleSpecialist #MortonsNeuroma #PlantarPain #Orthopaedics #FootPainRelief #liverpoolfootandankle #IOMfootandankle #FlatFeet #FootMechanics #PainFreeLiving #OrthopaedicCare #LiverpoolFootAndAnkle #SportsInjury #CustomOrthotics #CuttingEdgeCare #FootWellness #footpainawareness #worldclasscare #isleofmann #iom

👣 Why Do My Heels Hurt in the Morning? 👣

👣 Why Do My Heels Hurt in the Morning? 👣

If you experience heel pain when you get out of bed, you’re not alone! This is a common issue, often linked to a condition called plantar fasciitis or the Achilles, but did you know your sleep position might also play a key role?

📊 A recent survey by @drlyndonmason revealed that forced plantar flexion during sleep (when your feet point downward due you sleeping on your front or side) can tighten the gastrocnemius muscle (calf muscle). This tightness leads to strain on the plantar fascia when you take your first steps in the morning and throughout the day.

🔑 The Solution:
To address this, @drlyndonmason designed a special foot pillow, now available through @putnamscomfort ,
which helps keep your feet in a neutral position overnight. By reducing plantar flexion, it prevents calf muscle tightness and relieves morning heel pain.

💡 This simple adjustment can make a world of difference for your morning comfort and is already helping many people wake up pain-free!

📩 For further treatments on heel pain book an appointment with @drlyndonmason and to purchase a pillow (Foot-ZZ) go to @putnamscomfort to learn more about this innovative product.

#HeelPain #MorningHeelPain #PlantarFasciitis #FootPainRelief #SleepPositionMatters #GastrocnemiusTightness #FootHealth #OrthopaedicInnovation #wakeuppainfree #FootCare #PutnamComfort #PainFreeMornings #FootAndAnkleSpecialist #LiverpoolFootAndAnkle #OrthopaedicSolutions #SleepComfort #PlantarFasciitisRelief #CuttingEdgeCare #footwellnessmatters #achillies

🌦️ Why Does Arthritic Pain Feel Worse in Cold Weather? 🌡️

🌦️ Why Does Arthritic Pain Feel Worse in Cold Weather? 🌡️

Many people living with arthritis often report that their pain worsens during cold weather. But what does the research say?

📚 A recent study, “Come rain or shine: is weather a risk factor for musculoskeletal pain?” by Ferreira et al. (Seminars in Arthritis and Rheumatism, 2024), systematically reviewed data on weather’s impact on pain. While anecdotal reports suggest weather plays a role, the study found no significant link between cold temperatures, humidity, or precipitation and increased pain for conditions like rheumatoid arthritis, knee pain, or low back pain.

However, gout sufferers may experience more pain during high temperatures combined with low humidity, linked to joint swelling and redness.

So why do we feel worse in the cold?
❄️ Cold Weather and Arthritis:
• Joint Stiffness: Cold temperatures can make muscles and tissues less elastic, increasing stiffness.
• Barometric Pressure Drops: Lower air pressure may allow joints to expand slightly, increasing sensitivity.
• Reduced Activity: Cold weather often means less movement, which can worsen stiffness and pain.

👉 While weather may not be the primary cause, it’s clear that perception and other indirect factors (like reduced circulation and lifestyle changes in colder months) can contribute to discomfort.

If you struggle more in winter, consider gentle stretching, staying warm, and keeping active to ease symptoms!

#Arthritis #ColdWeatherPain #JointPain #ArthritisRelief #MusculoskeletalHealth #GoutPain #Orthopaedics #Rheumatology #ArthritisAwareness #PainManagement #ChronicPain #FootAndAnkleSurgeon #LiverpoolFootAndAnkle #FootAndAnkleClinic #SpecialistCare #LiverpoolSpecialist #FootPainRelief #WinterHealth #LiverpoolOrthopaedics #StayActiveLiverpool #SportsInjuryLiverpool #FootSurgeryLiverpool #AnkleSurgeryLiverpool #LiverpoolDoctors #orthopaedicspecialist #footandankledoctor #footsurgery #orthoinsta #footandanklecare #liverpoolfootclinic

👣 What Causes Bunions (Hallux Valgus)? 👣

👣 What Causes Bunions (Hallux Valgus)? 👣

Bunions, or hallux valgus, are a common foot condition where the big toe drifts towards the smaller toes, causing a bony bump on the side of the foot. But what actually causes them?

📖 According to @drlyndonmason and the landmark paper he co-authored, The Pathogenesis of Hallux Valgus (Perera AM et al., J Bone Joint Surg Am, 2011), bunions develop due to a complex interplay of biomechanics, anatomy, and genetics:

🦵 Biomechanics
• Instability in the joint at the base of the big toe (first metatarsophalangeal joint) is a key driver.
• Faulty foot mechanics like overpronation can put extra strain on the joint, contributing to its misalignment.

👣 Anatomical Factors
• A flat or unstable arch can predispose the big toe to drift.
• An abnormal shape of the first metatarsal bone or a misaligned sesamoid complex can also contribute.

🧬 Genetics
• Family history plays a major role! Certain foot shapes and mechanical tendencies are inherited, making some people more prone to developing bunions.

👠 External Factors
• While tight, narrow footwear (like high heels) doesn’t cause bunions outright, it can accelerate their progression in someone predisposed.

Understanding the causes is the first step in effective treatment! If you’re struggling with bunions, consult a foot and ankle specialist for advice tailored to your condition.

📚 Reference: Perera AM, Mason LW, et al. The Pathogenesis of Hallux Valgus, JBJS Am. 2011.

#Bunions #HalluxValgus #FootHealth #Biomechanics #Podiatry #orthopaedicspecialist #bunion #liverpoolfootclinic #footsurgery #footpain #footandankledoctor #footandanklesurgeons #footandankleclinic #liverpool

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