Management of hallux limitus with distraction of the first metatarsophalangeal joint.

This article describes a joint-preserving and joint-restoring procedure for the management of hallux limitus and hallux rigidus. The procedure uses a minirail external fixator to obtain distraction with or without arthrotomy of the first metatarsophalangeal joint. This procedure aims to restore joint function through elimination of the pathologic forces involved in hallux limitus and hallux rigidus.

Management of displaced intraarticular calcaneal fractures by using external ring fixation, minimally invasive open reduction, and early weightbearing.

Twenty-three patients with 25 intraarticular fractures of the calcaneus were treated during a 7-year period with minimally invasive open reduction of the posterior facet, external ring fixation, and early weightbearing. Skeletal traction and a minimally invasive lateral approach were used to elevate the posterior facet. Percutaneous wires, which were secured to an external ring fixator, were used to stabilize the reduction.

Triple arthrodesis using external ring fixation and arched-wire compression: an evaluation of 87 patients.

From January 1995 to December 2000, 87 patients at a single medical center underwent triple arthrodesis using external rings and arched-wire compression as the method of fixation. A retrospective evaluation was conducted to assess the clinical results of this technique. Eighty-four patients (97%) achieved clinical and radiographic fusion in 6 to 8 weeks.

A modified technique for Morton's neuroma. Decompression with relocation.

Interdigital nerve decompression with relocation was performed on 82 feet in 78 patients. The primary indication for surgery was chronic neuritic symptoms that did not resolve with conservative treatment. All but four patients (95%) achieved complete resolution of preoperative symptoms within an average of 7 days following surgery, with full sensation restored at an average of 5 weeks.

Use of external fixation to correct deformities of the lower leg.

With the development of modern external fixation by Ilizarov and the modifications that have been made to his method, we now have another tool with which to surgically address a deformity of the lower extremity. It is widely recognized that a malaligned lower extremity is a major cause of the development and progression of arthrosis of the hip, knee and ankle. Early recognition of a [figure: see text] malaligned limb or joint, coupled with proper preoperative planning and realistic patient expectations, may significantly reduce the incidence of arthrosis and improve the overall quality of life for the patient.