Dorsomedial fracture dislocation of the tarsal navicular: A rare orthopaedic injury.

Dorsomedial fracture dislocations of the tarsal navicular are extremely rare injuries which commonly occur secondary to high energy, complex multidirectional forces involving an abduction force to a pronated and plantar-flexed foot. A 44-year-old female presented in the emergency room following a motor vehicle accident with a dorsomedial fracture dislocation of her navicular. Management required acute fusion of the talonavicular joint.

LisFranc Fusion.

Lisfranc injuries remain a frequently missed pathology and may present as an isolated injury or as a component of a polytrauma case. Weight-bearing films or advanced imaging such as CT may be imperative in identifying or further classifying the injury. Common indications for fusion after lisfranc injury include primarily ligamentous injuries, delayed/chronic presentations, or post-traumatic arthritis, although primary fusion in the setting of acute fracture may be considered as an alternative to open reduction internal fixation techniques.

Tibiotalocalcaneal Fusion for Severe Deformity and Bone Loss.

Tibiotalocalcaneal fusion is an effective salvage procedure for combined end-stage ankle and subtalar arthrosis and for the management of severe planar deformities of the ankle and hindfoot. Although the procedure results in a rigid ankle and hindfoot, it is often the only means of providing patients with a stable and painless foot and ankle for ambulation. Some patients who require the procedure have substantial bone loss that can be managed with a variety of autograft and allograft options.

Transparency to Reduce Surgical Implant Waste.

Background: Rising health care costs and emphasis on value have placed the onus of reducing healthcare costs on the surgeon.

Methods: Financial data from 3,973 hip, knee, and shoulder arthroplasties performed at a physician owned orthopedic hospital was retrospectively reviewed over a two-year period. A wasted implant financial report was posted starting the second year of the study.