Exploring the Relationship Between Clinical Presentation in Hallux Valgus and Response to AbobotulinumtoxinA Treatment.

The relationship between pain/disability and angular deviation of the hallux valgus (HV), and the impact of orthotic use, laterality, and pain variability on treatment outcomes remain unclear. This was explored in post hoc analyses of a placebo-controlled trial of abobotulinumtoxinA (aboBoNT-A; Dysport®) for HV-associated pain (NCT03569098). The primary endpoint was not met in this study (change from baseline Numeric Pain Rating Scale [NPRS] score vs placebo at week 8); however, there was a greater reduction from baseline in mean NPRS score at week 12 with aboBoNT-A 500U versus placebo (p = .

Pain Reduction With AbobotulinumtoxinA for the Treatment of Hallux Valgus in Adult Participants: Results of a Randomized and Placebo-Controlled Phase 2 Trial.

AbobotulinumtoxinA (aboBoNT-A, Dysport® [Ipsen, Paris, France]) inhibits acetylcholine release at the neuromuscular junction and may modulate pain signaling in hallux valgus (HV). This randomized study (NCT03569098) included a double-blind phase (aboBoNT-A 300U, 500U or placebo injections into forefoot muscles) and an open-label aboBoNT-A treatment period in participants with an HV diagnosis and no HV surgery. The primary endpoint was change from baseline in numeric pain rating scale (NPRS) score at week 8.

Pediatric and adult flatfoot reconstruction: subtalar arthroereisis versus realignment osteotomy surgical options.

One of the most common presenting problems to most foot and ankle surgical practices is the painful flatfoot. Often, the problem is treated with excellent outcomes through a combination of conservative options. In certain cases, conservative care may not alleviate the associated symptoms of foot, ankle, knee, and possibly even back fatigue, pain of the foot and leg, and arthritis of the midfoot, rearfoot, or ankle.

Surgical decompression for painful diabetic peripheral nerve compression and neuropathy: a comprehensive approach to a potential surgical problem.

Diabetic nerve decompression is not for every patient. There is a definite learning curve to the surgery and recovery process and the surgeon must be available to the patient for concerns during the recovery period. The surgery itself is not very complex and can be mastered over time.

Tarsal tunnel syndrome: a compression neuropathy involving four distinct tunnels.

Tarsal tunnel syndrome is a complex and often under-diagnosed or misdiagnosed condition that affects the foot and ankle. It is a compression neuropathy of the posterior tibial nerve as it passes in the anatomic tarsal tunnel in the medial ankle under flexor retinaculum. This article reviews diagnosis, conservative treatment, and surgical outcomes, which have dramatically improved with more comprehensive release of the foot nerves in addition to the tibial nerve.

Intermetatarsal compression neuritis.

Intermetatarsal compression neuritis can be a disabling condition. Individuals who don't respond well to initial treatments are left with persistent pain and frustration. The conservative approach to the treatment of neuromas includes shoe modifications, padding, orthotics, cortisone injections, and serial alcohol sclerosing injections.

Arthrodesis of the Charcot foot and ankle.

The unstable Charcot foot remains a challenge to even the most experienced surgeon. Reconstructive surgical management of the neuropathic Charcot foot is a valuable treatment option for the patient who has severe musculoskeletal deformity. Frequently, the unstable nature of this deformity prevents successful use of therapeutic shoes or braces.

Block distraction arthrodesis for the treatment of failed calcaneal fractures.

We had excellent results with our procedure and had only one unsatisfied patient. This patient's fusion site had an undersized graft; therefore, he had continued pain. Because he had no further intra-articular pain, he did not feel the need for further surgery.

Lapidus bunionectomy: arthrodesis of the first metatarsocunieform joint.

Fusion of the first metatarsocunieform (MC) joint allows for correction of the first metatarsal in three planes, including adduction, plantarflexion, and rotation. It also allows for decreased jamming of the great toe joint and increased medial column stability. As knowledge about other medial column procedures grows, fusion of the first MC joint will continue to grow in popularity.

Use of the Cobb procedure in the treatment of posterior tibial tendon dysfunction.

Numerous surgical procedures have been described for the treatment of the adult acquired flatfoot deformity. The surgeon should review in detail all the clinical, radiographic and imaging tests and propose the best surgical procedure for the patient. Although flexor tendon transfer has shown excellent results, the split anterior tibial tendon transfer is a second option.

Soft-tissue disorders of the ankle: a comprehensive arthroscopic approach.

Ankle arthroscopy has dramatically advanced in the past decade. Many ailments of the ankle joint that were previously treated through open approaches are today treated with arthroscopic techniques. Arthroscopy allows for a more rapid recovery, better visualization of soft tissue lesions within the ankle joint and a more thorough examination of intracapsular ankle pathology.