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Introduction/Purpose: Few studies have assessed the long-term outcomes of the Ponseti technique and none have utilized 3-dimensional weightbearing analysis. The goal of this study was to understand how potential residual 3D deformities and abnormalities influence patient reported outcomes (PROs). This was accomplished by assessing anatomical foot and ankle alignment in adult clubfoot patients treated with the Ponseti method using 3D weightbearing CT (WBCT) imaging and then correlating residual foot and ankle malalignment with PROs. Methods: There were 37 consecutive patients (57 feet) included and 14 volunteers healthy controls (28 feet) included in this study. Every participant was evaluated using a WBCT (HiRise©) in a bipedal standing position. From these scans Cavus, Adductus, and Varus components were evaluated using multiple 3D measurements calculated using the semi-automatic segmentation software Bonelogic®. Specific Cavus related measurements included sagittal talus-first metatarsal angle and the calcaneal inclination angle. Varus related measurements included talocalcaneal angle in both the sagittal and axial planes as well as the hindfoot moment arm and the hindfoot alignment angle. Adductus deformity was evaluated using talonavicular coverage angle. These measurements were then correlated with patient reported outcome surveys, which included Visual Acuity Scale for pain, PROMIS general health, PROMIS physical function, PROMIS pain interference, pain catastrophic scale, and European foot and ankle society score. Results: There was no significant overall residual 3D-deformity observed in clubfoot patients when compared to controls, with similar FAO measurements observed between the groups, clubfoot=2.63% (95%CI=1.41%-3.85%) and control=3.2% (CI=1.6%-4.8%,P=0.58). The sagittal talus-first-metatarsal in the clubfoot-patients had a mean-value of -0.12 compared to the controls, - 5.2. Clubfoot patients also had a decreased calcaneal-inclination-angle relative to the controls, 13.01° and 21.5° respectively. Talocalcaneal-angle for clubfoot patients in both the sagittal-plane, 44.28°, and axial-plane, 17.74°, were reduced compared to the controls, 57.51° and 25.78°. Talonavicular-coverage-angle in the clubfoot-group (18.63°) was less than the controls (29.19°). Talusfirst-metatarsal-angle in the sagittal-plane was significantly correlated with VAS-scores (RSquare=0.19,P=0.0118) and the EFASScore (RSquare=0.27,P=0.0025). Talocalcaneal-angle in the sagittal plane was also significantly correlated with the PROMIS-Pain-Interference-score (P=0.038) and PROMIS-Physical-Function-score (RSquare=0.32,P=0.0007). Conclusion: The Ponseti technique is an effective nonsurgical treatment for the overall three-dimensional foot and ankle alignment of Clubfoot. While mild, but statistically significant residual Varus and Adductus deformities were observed in adult clubfoot patients, the overall 3D alignment (FAO) was found to be similar between clubfoot patients and controls. These findings highlight the efficacy of the Ponseti technique and potentially explain the overall good PROs. The results of this study could potentially provide insight into treatment targets that may be applied to help optimize patient outcomes when treating children with Clubfoot in the future. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: Interpositional arthroplasty (IPA) is a motion-preserving surgery in patients with advanced hallux rigidus. Literature displays several complications after the procedure including transfer metatarsalgia, cock-updeformity and infection. In a finite element model, shortening of the first metatarsal was associated with increased plantar pressure on lateral rays during gait. Additionally, there are reports of a positive correlation between first metatarsal shortening after hallux valgus surgery and transfer metatarsalgia of the second, third and fourth metatarsophalangeal joints. The goals of this study were to report the outcomes and complications of IPA using acellular dermal allograft (IPA-ADA) as well as study the changes in the length of the proximal phalanx of the hallux (P1) and the first metatarsal (M1) following the procedure. Methods: In this IRB-approved retrospective study, we assessed patients who underwent IPA-ADA in a single academic institute from 2019-2022. All patients' demographic data, surgical details, complications, and patient-reported outcomes (PROs) were extracted. On standing conventional anteroposterior (AP) foot views, we measured the lengths of the first metatarsal (M1), the second metatarsal (M2), the proximal phalanx of the big toe (P1), and the entire length of the hallux (HX). The ratio of M1/M2 and P1/HX were calculated. The first metatarsophalangeal joint space was measured at the medial and lateral aspects of the joint on the APview. All measurements were recorded pre-operatively, at six weeks follow-up, and at the final follow-up. Descriptive statistics were performed, and comparison between groups was performed using analysis of variance(ANOVA) or Kruskal Wallis test according to data normality. The Dunn-Bonferroni test was then performed for pairwise group comparisons. A p-value < 0.05 was considered significant. Results: Eleven patients were included, 9 being females (81.81%). Six were hallux rigidus Coughlin grade III (54.55%), and 5 were grade IV (45.45%). The average age was 59 years (SD±6.78), and the body mass index (BMI) was 26 (SD±4.79). At the final followup, there was significant shortening of the first ray in comparison to the pre-operative length evidenced by lower M1/M2 (82.63 SD±2.29 versus 75.42 SD±5.1; p=0.001) and P1/HX ratio53.38 ± 2.29 versus 48.98 SD ± 7.92; p=0.001). Although there was no significant difference between M1/M2 at 6 weeks and at the final follow-up (p=0.716), there was a significant negative correlation between follow-up length and M1/M2 (r= -0.76, p=0.003). Follow-up was (19.95 months; range 3-39). Complications and PROs are listed in Figure 1. Conclusion: Interposition arthroplasty using dermal allograft for HR is associated with progressive shortening of the first ray at the level of the first metatarsal as well as the proximal phalanx. Although the study did show shortening of the first ray, the small sample size didn't allow for a correlation between this shortening and complications such as transfer metatarsalgia and cock-up toe deformity. The potential shortening should be considered in the selection of patients, particularly in the setting of an already short first metatarsal or when simultaneous Akin/Moberg osteotomy is planned. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: Evidence in the literature suggests the negative effects of using High Heels (HH), becoming a challenge for clinicians and researchers since they are welcomed by women worldwide, mainly due to the subjective power of attractiveness given to them. Although some people blame HH as one of the causes of Hallux Valgus (HV), until now, there are no studies in the literature that effectively prove a cause-effect relationship between HH and HV. The objectives of this study are: (1) to analyze whether the increase in heel height can lead to HV and (2) to evaluate whether HV can increase in severity with increasing heels. We hypothesized that an increase in heel height could cause and increase the severity of HV deformity. Methods: Comparative cross-sectional study. Forty-one feet from twenty-one participants (11 males and 10 females, aged 30.8 ± 8.9 years, and with Body Mass Index 25.5 ± 2.0 m kg2) were recruited. HH shoes were designed for this study with three heights for each participant: 3, 6, and 9 cm. The inclusion criteria were: no regular wearing of heels. The exclusion criteria were: Hallux Valgus diagnosis and/or any orthopedic conditions that affect the Foot and Ankle joints. Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), First-Metatarsal Phalangeal Angle, 1st-to-5th Intermetatarsal Angle, First Tarsometatarsal Angle (axial), Second tarsometatarsal angle (axial), Hindfoot Moment Arm (HMA) (mm), Saltzman 45 angle and, Foot Ankle Offset (FAO) were measurement using semiautomated software analysis. Multiple comparisons were performed (Bonferroni's for normal distributions and Wilcoxon test for no normal distributions) when there was a main effect on an outcome (p < 0.05). Results: With the increase in HH, we noticed a progressive increase in HVA (p < 0.001), IMA (p < 0.001), First-Metatarsal Phalangeal Angle (p < 0.001), First Tarsometatarsal Angle (axial) (p < 0.001), and the Second tarsometatarsal angle (axial) (p < 0.001). The Hindfoot Moment Arm (HMA) (mm), Saltzman 45 angle, and Foot Ankle Offset (FAO) had hindfoot varization behavior. When we stratified the groups and compared them, we noticed that an increase of 3 cm in heels slightly increased HVA and IMA (p > 0.05). However, heel increases above 6 cm significantly increased HVA and IMA (p > 0.001). Based on Coughlin's classification, a 3 cm heel increase promoted a mild HV and increases above 6 cm caused a moderate HV. Conclusion: Based on data from our study with patients without Hallux Valgus through analysis with WBCT versus high heels, we conclude that increasing heel height can lead to Hallux Valgus and can progressively increase the severity with increasing high heels. High heels above 6 cm can lead to moderate Hallux Valgus. These findings may be an essential step toward a better understanding of the effects of increasing high heels on Hallux Valgus pathology. [ABSTRACT FROM AUTHOR]

The article presents a roundtable related to story transatlantic from the Anthropocene. It mentions history connected to the problems ecological, planetary, and perhaps to the question of climate change. It also mentions forests, agriculture and livestock, biodiversity and extraction of flora and fauna, dynamics urban and industrial, Regions, territories and socio-diversity, thought environment and environmentalism.

An introduction is presented in which editor discusses various articles within the issue on topics including long-term analysis of a characteristic "agro-ecological system" a region of Mexico; globalization of food consumption and history of energy and hydroelectric dams in Brazil.

This article aims to identify new historical causes for the making of the Anthropocene (the rise of humans to a geological force) by addressing Brazil's transformation into an oil producer and an oil-dependent country between 1930 and 1975. This example allows an escape from the essentialist explanation of the Anthropocene as the result of humans' insatiable appetite for consumption, commonly rooted in an analysis of Western industrial society, and to focus instead on the notion of freedom in a former colony. Indeed, in the context of nation-building and modernization debates, petroleum appeared to many Brazilians as an opportunity to emancipate the country from its peripheral role as global raw material provider. The rise of petroleum gave a post-colonial sense to the nation-founding myth of Brazil's exceptional nature, which served as romantic background for a movement towards resource sovereignty embedded into a global anti-imperialist context. In Brazil specifically, oil production became an opportunity for a process of ecological transformation that promised to rid the country of colonial landscapes of exploitation, and even appeared as a solution for stopping the unsustainable destruction of tropical forests. Ultimately, these petro-ideals of emancipation, by positively linking nature and the nation, also hindered fully detecting the scope of the pollution problems that oil was generating. As argued in the article's conclusion, this example should rekindle the discussion about the unintended link between freedom and geological change in the analysis of Anthropocene causalities. [ABSTRACT FROM AUTHOR]

Nature in Brazil has been the subject of debates, competing representations and historical ruptures. This article argues that the period of the military regime (1964-1985) was that of a shift in the delimitation between culture and nature, which became clear by means of media, artistic, intellectual and political representations. During the 1970s, in particular, the "nature" envisaged by the military regime, a hostile nature which the nation must conquer in order to exploit resources, gave way to a fragile nature. In diverse sectors of society, environmental protection came to be seen as necessary to preserve national identity and sovereignty. The debate about the future of the Amazon proved crucial in this transformation. This article analyzes the reasons for this change and gives some illustrations of it. It begins with a perspective of the different visions of nature that existed prior to the arrival of the military in power. Then, it explains how the developmentalist ideology of the military regime, based on an anthropocentric idea of nature, was challenged in the context of the rise of environmentalist discourse in the 1970s. Subsequently, it analyzes the transversal character that ecological thought managed to adopt in Brazilian society during these years. And finally, it explores the diversification of the environmental movement in the context of the transition towards democracy and its aftermaths. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including industrialization, Brazil history of Great Acceleration and energy infrastructure.

The article discusses the environmental controversy generated by forest fires in the Brazilian Amazonia linked to the cattle ranch Companhia Vale do Cristalino (also known as Cristalino) in 1973, which was a project funded by the automobile manufacturer Volkswagen. Topics addressed include the discourse of development promoted by the military government in Brazil, the project of colonization of the Brazilian Amazonia, and the issue of forced labor in the Cristalino ranch.