First metatarsophalangeal arthrodesis for hallux valgus.

Arthrodesis of the first metatarsophalangeal joint is a reliable operation in the treatment of selected cases of hallux valgus. It corrects deformity of hallux valgus and metatarsus primus varus, leading to good functional results with a low complication rate. It is a technique well suited to patients with hallux valgus associated with degenerative changes or severe deformity, and those for whom primary hallux valgus surgery has failed.

Management of the varus arthritic ankle.

Treatment of the arthritic varus ankle presents a significant surgical challenge. The recognition of the causes and associated deformities directs the treatment of the individual patient and optimizes functional outcome. Arthrodesis and total ankle replacement often will need to be augmented by corrective hind- and midfoot procedures and by careful soft tissue balancing.

Noninsertional Achilles tendinopathy.

The treatment of noninsertional Achilles tendinopathy remains, to a large extent, empirical. Neither different operative techniques nor nonoperative regimes have been subjected to controlled trials. Rather, the condition is still treated on the basis of anecdotal evidence combined with personal experience.

Osteochondral fracture of the fourth metatarsal head treated by open reduction and internal fixation.

Fracture of the metatarsal head is uncommon, and reports of isolated osteochondral fracture of the metatarsal head are rare. Because of the distal location of the fracture, it is difficult to achieve and maintain reduction, and potential complications include avascular necrosis and subchondral fatigue fracture. The authors present a case of an osteochondral fracture in a 40-year-old man, which was treated by open reduction and internal fixation with a single twist-off screw, with good results 12 months postoperatively.

Treatment of mucous cysts of the toes.

The outcome of surgically treated mucous cysts of the foot is poorly documented in the orthopaedic literature. This study reports on the treatment of mucous cysts of the toes by simple excision and joint debridement. This is in contrast to treatment of similar lesions in the fingers which is often treated by excision of the cyst, joint debridement, and rotational flap.