Anatomical Description of the Spring Ligament Articular Facet.

Background: The spring ligament fibrocartilaginous complex (SLFC), which is essential for stabilizing the medial longitudinal arch, features a little-explored fibrocartilaginous facet within its superomedial aspect, articulating with the talar head. This research aimed to provide a detailed anatomical description of this facet, designated as the spring ligament articular facet (SLAF).

Methods: Nine normally aligned cadaveric lower limbs were dissected, approaching the SLFC from a superior direction.

Treatment of Stage 4 Flatfoot.

Stage 4 flatfoot represents only a small proportion of flatfoot cases and is likely to become even rarer. The evidence base to guide treatment is limited to case series and expert opinion. Therefore, a pragmatic approach to treatment must be taken.

The Use of Percutaneous Screw Fixation Without Fracture Site Preparation in the Treatment of Fifth Metatarsal Base Nonunion.

Nonunion after a proximal fifth metatarsal fracture can cause considerable pain, with high morbidity and loss of work. Although many authors advocate early surgical management of zone 3 injuries (Jones fractures), zone 1 and 2 fractures are generally expected to heal with conservative management. Uncommonly, zone 1 and 2 fractures can develop nonunions.

Cost-Effectiveness of Surgical Techniques in Hallux Valgus.

Health care costs are increasing. Funding is not increasing at a commensurate rate. Demonstrable cost-effectiveness is critical when selecting operation and implant type.

How Do I Use the Scarf Osteotomy to Rotate the Metatarsal and Correct the Deformity in Three Dimensions?

The scarf osteotomy has become the workhorse procedure for a large proportion of foot and ankle surgeons, especially in Europe, in the treatment of hallux valgus. Such a versatile procedure should not be underestimated, and planning and thought should precede any such procedure. The angle of bone cuts and magnitude of translation dictate the final position, and all movement axes should be given equal attention.

Searching for consensus in the approach to patients with chronic lateral ankle instability: ask the expert.

Purpose: The purpose of this study is to propose recommendations for the treatment of patients with chronic lateral ankle instability (CAI) based on expert opinions.

Methods: A questionnaire was sent to 32 orthopaedic surgeons with clinical and scientific experience in the treatment of CAI. The questions were related to preoperative imaging, indications and timing of surgery, technical choices, and the influence of patient-related aspects.

The modified Broström-Gould procedure--early results using a newly described surgical technique.

Ankle lateral ligament injuries are one of the most common sporting injuries, with the majority being successfully treated conservatively. However, reconstruction is required if this fails. We present the clinical results of a newly described surgical technique of triple-breasting the lateral ligament complex using suture anchors.

Rotational and peak torque stiffness of rugby shoes.

Objective: Sports people always strive to avoid injury. Sports shoe designs in many sports have been shown to affect traction and injury rates. The aim of this study is to demonstrate the differing stiffness and torque in rugby boots that are designed for the same effect.

Scarf osteotomy.

The term scarf osteotomy was first used by Weil when presenting his results from more than 1000 cases. Scarf is a carpentry term describing beveling the ends of 2 pieces of wood and securely fastening them so that they overlap to create one continuous piece. This technique was popularized by Weil and Barouk as a versatile method of correcting hallux valgus while maintaining the blood supply to the metatarsal head.

An evaluation of retrospective outcome scores in elective foot and ankle surgery.

Background: Patient reported outcome measures are becoming more popular in their use. Retrospective scoring is not yet a validated method of data collection but one that could greatly decrease the complexity of research projects. We aim to compare preoperative and retrospective scores in order to assess their correlation and accuracy.

The effect of preoperative foot and ankle physiotherapy group on reducing inpatient stay and improving patient care.

Background: Benefits of day case foot and ankle surgery include reduced hospital stay, cost savings, high patient satisfaction, quicker recovery with no increased complications. The preoperative foot and ankle group was set up in 2007 to reduce inpatient hospital stays and increase the rate of day case procedures.

Methods: We evaluated length of stay and physiotherapy intervention for all our patients during the first three months of 2007-2011.

Is there a learning curve in foot and ankle surgery?

Background: Previous studies of orthopaedic learning curves have largely described the introduction of new techniques to experienced consultants. End points have usually involved technical considerations. A paucity of evidence surrounds foot and ankle surgery.

Hindfoot arthrodesis for management of bone loss following calcaneus fractures and nonunions.

Massive bone loss following calcaneal fractures is a challenging condition to treat, especially if nonunion is present. Meticulous preoperative examination and imaging are crucial for accurate preoperative planning. If performed, successful outcomes can be achieved with the strategies outlined in this article.

Complications of the treatment of Achilles tendon ruptures.

Since the first reports in the medical literature of treatment of the Achilles tendon, complications have been recognized from both non-operative and operative techniques. These include tendon rerupture, sural nerve morbidity, wound healing problems, changes in tendon morphology, venous thromboembolism, elongation of the tendon, complex regional pain syndrome, and compartment syndrome. This article delineates the incidence for each of these complications, with differing techniques, methods of avoiding these complications and treatment methods if they occur.

Sagittal plane motion of the hindfoot following ankle arthrodesis: a prospective analysis.

Background: The progression of subtalar and midfoot arthritis is well documented following ankle arthrodesis, and gait analysis has suggested that a functional gait pattern following arthrodesis may be due to tarsal hypermobility compensating for lost tibiotalar motion. We present a prospective radiographic study comparing the pre- and postoperative range of motion of the foot following ankle arthrodesis utilizing reliable anatomic landmarks to measure the sagittal range of motion.

Materials And Methods: Between 2002 and 2006, we performed 154 arthrodesis procedures of the ankle.

Scarf osteotomy for the correction of hallux valgus: midterm clinical outcome.

We prospectively reviewed 22 patients (31 feet) who underwent a scarf osteotomy between January 2001 and March 2002. There were 20 females and 2 males. Ages ranged from 35 to 77 years (mean = 57 years).