Journal of the International Foot & Ankle Foundation <p>The Journal of the International Foot &amp; Ankle Foundation (JIFAF) is an open-access peer-reviewed international journal with a focus on foot and ankle medicine and surgery. It is the official publication of the <strong><a href="">International Foot &amp; Ankle Foundation</a></strong>. Established in 2022, the journal is the continuation of the <strong><a href="" target="_blank" rel="noopener">Foot and Ankle Online Journal (FAOJ)</a></strong>, which ran from 2008 through 2020. </p> <p>Since its inception, the FAOJ and later the JIFAF have been dedicated to fostering open-access peer-reviewed publications, serving as a platform for the dissemination of cutting-edge research and clinical insights. From case studies to original research articles, the journal has been at the forefront of advancing knowledge and innovation in foot and ankle medicine.</p> <p>However, after careful consideration and reflection, the editorial board has made the difficult decision to cease operations of JIFAF. As the landscape of academic publishing continues to evolve, we recognize the need to adapt and reallocate resources to better serve the needs of our community.</p> <p>We extend our deepest gratitude to all who have contributed to the success of JIFAF over the years – authors, reviewers, editors, and readers alike. Your dedication and support have been invaluable, and we are profoundly grateful for the trust you have placed in us.</p> en-US (Craig E. Clifford, DPM, MHA, FACFAS, FACPM) (International Foot & Ankle Foundation) Fri, 01 Dec 2023 00:00:00 +0000 OJS 60 Use of 3-D printed total talus implant in a challenging case of post-traumatic arthritis and avascular necrosis of the talus <p><span style="font-weight: 400;">Post-traumatic osteoarthritis and avascular necrosis (AVN) of the talus are both challenging problems to treat independently but in conjuncture pose a very complex pathology. In this study, we utilized a novel technique of using a prosthetic talar implant in conjecture to a total ankle tibial implant for the treatment of arthritis with talar AVN. A 60-year-old female with a past medical history of diabetes and hypertension presented with an ankle dislocation secondary to fall. Radiographs and Computed Tomography (CT) scans revealed a trimalleolar ankle fracture with comminution of the talus. Patient underwent primary open reduction with internal fixation (ORIF) of the left ankle. Two years post-ORIF, the patient's arthritic pain continued to worsen and rated her pain as a 9/10 on the Visual Analog Scale (VAS). Physical examination revealed limited ankle and subtalar joint range of motion with pain to the left ankle. Conservative treatment was employed but was unsuccessful. CT of the left ankle was ordered which indicated severe osteoarthritic of the tibiotalar joint with AVN of the talar body. Due to the level of the AVN and cystic changes, it was decided that the talus was non-viable and a total talar prosthesis with a tibial ankle implant was appropriate. After the procedure, the patient was able to ambulate with complete resolution of pain. She rated her pain as a 0/10 at one year follow-up with no failure or subsidence of the implant. This procedure indicates the effectiveness of a prosthetic talar implant to improve a patient’s symptoms.</span></p> Anas Siddiqi, DPM, Lawrence Fallat, DPM, FACFAS Copyright (c) 2023 Journal of the International Foot & Ankle Foundation Fri, 01 Dec 2023 00:00:00 +0000 The effect of Medicare coverage on access to bunionectomies among the elderly population: A secret shopper study <p><span style="font-weight: 400;">Hallux Valgus (HV) deformity, commonly known as a bunion, is a prevalent foot condition and a highly performed procedure across various insurance demographics. With the continuous growth of the Medicare population and its working share, the financial burden of incapacitating injuries like HV becomes more significant. Given the substantial proportion of bunionectomy surgeries performed on Medicare beneficiaries, it is imperative to explore how a significant shift from Traditional Medicare (TM) to Medicare Advantage (MA) coverage might impact patient access to bunionectomy surgeries. This study aims to evaluate the effect of Medicare type on patient access to bunionectomy procedures within Miami-Dade County, where the population is predominantly enrolled in Medicare and Medicare Advantage plans. The research seeks to understand potential differences in access to care, as disparities in access to podiatric care. The findings of this research will shed light on whether Medicare Advantage beneficiaries have greater access to bunionectomy procedures compared to Traditional Medicare beneficiaries in Miami-Dade County. By understanding the impact of Medicare type on access to care, policymakers, healthcare providers, and insurance companies can make informed decisions to improve patient outcomes and address potential disparities in healthcare access. The implications of this study are of great importance, considering the prevalence of HV and the rising Medicare population. Enhancing access to bunionectomy surgeries for Medicare beneficiaries can alleviate the financial burden on patients and the healthcare system and improve health outcomes in Miami-Dade County. </span><span style="font-weight: 400;">Of the 100 clinics, 50 (50 %)</span> <span style="font-weight: 400;">accepted new patients for HV deformity evaluation, although only 31 (31%) had podiatric specialists currently performing bunionectomy surgeries. Traditional Medicare (TM) had the highest appointment success rate of 96.67%, and commercial coverage was comparable at 93.33% (p = .55). Our study found that patients in Miami-Dade County with Medicare Advantage (MA) have decreased access to Hallux Valgus deformity correction surgery (bunionectomy) compared to those with Traditional Medicare or commercial insurance; this could be a potential reason for lower rates of bunionectomy utilization in the MA population.</span></p> Luis Rodriguez Anaya, DPM, Patricia Toledo, Juan C. Alvarez Jr. B.S., Andrea Delgado, Malachi Brown, Hansel Viera Copyright (c) 2023 Journal of the International Foot & Ankle Foundation Fri, 01 Dec 2023 00:00:00 +0000 The 5-minute Tightrope: A guide to efficient placement of flexible Lisfranc fixation <p><span style="font-weight: 400;">Ligamentous Lisfranc injuries can be a challenging pathology for foot and ankle surgeons to diagnose and treat. When surgical intervention is warranted, dynamic flexible fixation is a widely used option that continues to popularize. We present a technique guide that can increase efficiency, decrease operative time and decrease fixation malposition when using flexible fixation devices for ligamentous Lisfranc injuries.</span></p> Nevin Joseph, DPM, Zachary P. Hill, DPM, Robert W. Mendicino, DPM, FACFAS Copyright (c) 2023 Journal of the International Foot & Ankle Foundation Fri, 01 Dec 2023 00:00:00 +0000