Diabetic foot ulcers (DFUs) represent a major complication of diabetes, frequently culminating in infection, limb amputation, and increased healthcare burden. Silver-based dressings have been used in chronic wound care because of their broad-spectrum antimicrobial and anti-inflammatory properties. Despite their widespread use, the clinical efficacy of silver dressings in DFU management remains inconclusive, and their use in diabetic foot care has not been available in Korea. A systematic review and meta-analysis were conducted to evaluate the effectiveness of silver-based dressings for the treatment of DFUs. Randomized controlled trials comparing silver dressings with standard or non-silver dressings were identified through a comprehensive search of PubMed, Embase, and the Cochrane Library, following the PRISMA guidelines. The primary outcome was the complete healing rate; secondary outcomes included ulcer size reduction, time to healing, infection control, and adverse events. Meta-analysis revealed a significantly higher complete healing rate in the silver dressing group compared to controls (risk ratio=1.28; 95% CI, 1.03-1.60; p=0.03). Although the trends toward improved ulcer area reduction and shorter healing duration were observed, statistical significance was not uniformly achieved. Owing to insufficient data, the infection control outcomes were synthesized narratively, revealing potential clinical benefits. No severe adverse events were reported across studies. Silver-based dressings may confer therapeutic benefit in the management of DFUs, particularly in high-risk or infected wounds. These findings provide important evidence to inform the clinical guidelines and reimbursement decisions regarding the use of silver dressings in diabetic foot care in Korea. This meta-analysis has limitations because of factors such as the heterogeneity across studies and the small number of included studies. Therefore, further research is needed in the future.

Ankle osteoarthritis, often arising from previous trauma, is characterized by progressive cartilage loss, joint space narrowing, and functional impairment, predominantly affecting younger, active individuals. A supramalleolar osteotomy (SMO) offers a joint-preserving surgical approach for cases with varus or valgus malalignment, aiming to redistribute the load across the tibiotalar joint. This review outlines the main surgical techniques (medial opening wedge, lateral closing wedge, and dome osteotomy) while addressing the debated role of a concomitant fibular osteotomy. The clinical outcomes from recent systematic reviews indicate significant improvement after an SMO in pain, function, and radiographic parameters, with relatively low complication and failure rates. Despite this, evidence remains limited by the retrospective study designs and inconsistent methodologies. Further high-quality prospective studies will be needed to standardize the indications, correction targets, and long-term outcomes for SMO.

Purpose: This study compared the quality of reduction between the minimally invasive sinus tarsi approach (STA) and the extensile lateral approach (ELA) for Sanders type III calcaneal fractures, using postoperative computed tomography (CT) and plain radiographs. Materials and Methods: Sixty-five patients (71 cases) with Sanders type III calcaneal fractures treated with an open reduction and internal fixation using STA (38 cases) or ELA (33 cases) between January 2015 and December 2020 were reviewed retrospectively. The Böhler's and Gissane's angles were measured on the final follow-up weight-bearing lateral radiographs. The reduction quality of the posterior facet was assessed using semi-coronal CT images taken at least 6 months postoperatively and classified as excellent, good, fair, or poor based on the step-off and gap. Results: The mean Böhler's angle in the STA and ELA groups was 25.6° and 27.0°, respectively (p=0.538). The mean Gissane's angle in the STA and ELA groups was 116.7° and 120.0°, respectively (p=0.168). The CT evaluation of posterior facet reduction showed excellent or good results in 23 fractures (60.5%) in the STA group and in 29 fractures (87.9%) in the ELA group, showing a significant difference favoring ELA (p=0.018). Conclusion: Plain radiographic parameters showed no significant difference between the two approaches. On the other hand, CT-based assessment revealed that ELA achieved superior posterior facet reduction compared to STA in Sanders type III calcaneal fractures. Hence, ELA may be more effective in achieving anatomic reduction in Sanders type III calcaneal fractures.

Charcot arthropathy is a progressive joint-destructive condition occurring in patients with peripheral neuropathy. Tibiotalocalcaneal (TTC) arthrodesis may be required in severe cases involving the ankle and hindfoot. Although retrograde intramedullary nailing is used widely for TTC fusion, it may be insufficient in cases of severe angular deformity and extensive bone loss. This paper reports a case of TTC arthrodesis using a lateral distal femoral locking plate in a patient with Charcot arthropathy accompanied by significant varus deformity and talar body collapse. Satisfactory correction of the alignment and bony union were achieved. This approach may serve as a viable surgical alternative in cases where intramedullary fixation is limited.

Gouty arthritis involving extensive soft tissue deposition around the ankle joint can clinically and radiologically mimic pigmented villonodular synovitis (PVNS). This paper presents the case of a 35-year-old man initially suspected of having diffuse PVNS based on the clinical features such as swelling, pain, and restricted ankle motion, and the magnetic resonance imaging findings suggestive of soft tissue masses and diffuse synovitis around multiple tendons. The patient underwent surgical intervention with a planned extensive synovectomy, the gold standard treatment for diffuse PVNS. The intraoperative examination revealed the widespread deposition of gout tophi rather than hemosiderin-laden tissue, and histopathological analysis confirmed gouty arthritis. Diagnostic uncertainty arose because of mildly elevated serum uric acid levels, along with the absence of typical inflammatory signs such as redness or a heating sensation, and imaging characteristics overlapping with PVNS. This case shows that extensive gouty arthritis may closely mimic diffuse PVNS, highlighting the importance of including tophaceous gout in the differential diagnosis of patients presenting with joint effusion and diffuse synovitis involving the joints and tendons, particularly in the presence of underlying metabolic syndrome risk factors.

Sparganosis is a rare parasitic infection caused by the plerocercoid larvae of the Spirometra species. It can present as nonspecific calf pain and swelling, often mimicking deep vein thrombosis (DVT), especially in postoperative patients. This paper reports a case of a 78-year-old male with a history of total ankle arthroplasty who presented with recurrent calf pain and swelling. The initial clinical evaluation raised suspicion for DVT, and Doppler ultrasound was performed. Imaging revealed a hypoechoic, serpiginous structure suggestive of a parasitic infection. Surgical exploration confirmed sparganosis through the removal of the larvae. The patient's symptoms resolved completely after the procedure. This case highlights the need to consider sparganosis in the differential diagnosis of unexplained calf symptoms, particularly in patients with potential exposure to endemic areas or sources of a parasitic infection, regardless of the coexisting surgical history.

An anterior tibial artery pseudoaneurysm is a very rare complication after ankle arthroscopy using standard anteromedial and anterolateral portals. This paper reports the case of a 34-year-old male on anticoagulant (apixaban) treatment due to hypertrophic cardiomyopathy who underwent arthroscopic debridement 3 months earlier for acute gout arthritis of the ankle. The patient had sustained pulsatile, painful swelling of the anterior ankle after an arthroscopic procedure. Magnetic resonance imaging showed a pseudoaneurysm of the left anterior tibial artery at the ankle joint. The patient underwent surgical intervention, including evacuation of the pseudoaneurysm and hematoma.