Determining the strongest orientation for "Lisfranc's screw" in transverse plane tarsometatarsal injuries: a cadaveric study.

Unlabelled: The treatment of tarsometatarsal joint fracture-dislocations generally consists of realignment followed by stabilization with rigid internal fixation. The purpose of this study was to determine the strongest orientation for the "Lisfranc's screw" for repair of disruption of the articulation between the first and second metatarsals and the medial and intermediate cuneiforms. To this end, Lisfranc's ligament was sectioned in 6 pairs of fresh-frozen, human cadaver feet, after which a 3.

Pan-metatarsophalangeal joint arthrodesis for the severe rheumatoid forefoot deformity.

The standard approach for correction of severe painful rheumatoid forefoot deformities has involved resection of the metatarsal heads with realignment of the lesser toe deformities and first metatarsophalangeal joint (MTPJ) arthrodesis. Modifications of this procedure may include a pan-metatarsal head resection, including the first metatarsal head, or resection of the lesser metatarsal heads in conjunction with an interpositional arthroplasty of the first MTPJ. The authors describe a novel surgical approach that involves the correction of severe rheumatoid forefoot deformities through a pan-MTPJ arthrodesis.

Salvage of the first ray with concomitant septic and gouty arthritis by use of a bone block joint distraction arthrodesis and external fixation.

Gouty arthropathy about the first metatarsal-phalangeal joint with a superimposed deep infection poses a great challenge to the foot and ankle surgeon. The inflammatory nature of gout compromises the soft-tissue envelope and vasculature to the area. Acute gouty arthropathy is usually a contraindication to surgical intervention secondary to wound-healing complications and possible vasospasm leading to tissue necrosis.

Surgical treatment of Charcot neuropathy.

Charcot neuroarthropathy, a chronic progressive destruction of joint integrity, is believed to result from a disturbance in pain and proprioceptive sensation. It is most commonly treated in patients with uncontrolled diabetes mellitus and dense peripheral neuropathy. Prevention, early diagnosis, and early treatment are key to a patient's successful outcome.