Anatomy and Physiology of the Lesser Metatarsophalangeal Joints.

Knowledge and command of anatomy is paramount to effectively treating disorders of the lesser metatarsophalangeal (MTP) joints. The osseous structures consist of the proximal phalanx of the toe and the metatarsal head. The soft tissues on the dorsum of the MTP joint include the joint capsule and the tendons of extensor digitorum longus and extensor digitorum brevis.

Safe Zone for Neural Structures in Medial Displacement Calcaneal Osteotomy: A Cadaveric and Radiographic Investigation.

Background: We aimed to define reference lines on standard lateral ankle radiographs that could be used intraoperatively to minimize iatrogenic nerve injury risk in medial displacement calcaneal osteotomy.

Methods: Forty cadaveric specimens were used. In 20 specimens, the sural, medial plantar (MP), and lateral plantar (LP) nerves were sutured to radiopaque wire, and a lateral ankle radiograph was obtained.

Use of a Percutaneous Pointed Reduction Clamp Before Screw Fixation to Prevent Gapping of a Fifth Metatarsal Base Fracture: A Technique Tip.

Intramedullary screw fixation has become widely accepted as the standard of care for operative treatment of Jones fractures, allowing not only accelerated rehabilitation but also reduction of the risk of repeat fracture. The unique anatomy of the fifth metatarsal--mainly its inherent lateral curvature--makes fixation technically challenging. In general, surgical fixation should be performed with the largest screw possible, in both diameter and length, which will provide the strongest possible construct.