Revision of the Chronic Syndesmotic Injury.

Optimal healing for fractures requires anatomic reduction and stable fixation. This optimizes not only bone healing, but optimal function within the limb including joint functioning. Proper ligamentous healing is also crucial for optimal functioning.

Revision Surgery for Failed Lateral Ankle Stabilization.

Although most primary lateral ankle ligament repairs have a high success rate, as with any surgery, failures and the need for revision can occur. Nonanatomic lateral ankle ligament repairs have fallen out of favor because of the increased stiffness and resultant change in mechanics of the functioning tendon that is normally used. Allograft anatomic lateral ankle ligament reconstruction for revision surgery has gained popularity over the last few years.

The Role of Lesser Metatarsophalangeal Joint Arthrodesis for Revision Surgery.

Revision hammertoe surgery can be extremely challenging for the foot and ankle surgeon given the scar tissue and available osseous and soft tissue. Although not a common procedure, lesser metatarsophalangeal joint arthrodesis is an option for the patient especially in lieu of an amputation. This article describes the current literature and the surgical technique for a lesser metatarsophalangeal joint arthrodesis.

Joint Clinical Consensus Statement of the American College of Foot and Ankle Surgeons® and the American Association of Nurse Practitioners®: Etiology, Diagnosis, and Treatment Consensus for Gouty Arthritis of the Foot and Ankle.

Gout is a condition that commonly affects the foot and ankle, and practitioners who treat these structures should be aware of the methods to diagnose and treat this form of arthritis. Practitioners also need to recognize extra-articular manifestations of the disease. Although the acutely red, hot, swollen joint is a common presentation, chronic tophaceous gout can be associated with pain, nodule formation, and cutaneous compromise.

Arthroscopic Management of Osteochondral Lesions of the Talus.

Osteochondral fractures of the ankle are typically caused by traumatic injuries of the ankle. Repetitive trauma can lead to further cartilage damage with subsequent increasing size of the lesion, ultimately leading to severe cartilage disorder and degenerative arthritis of the ankle. Arthroscopic bone marrow stimulation has been shown to be a highly successful option for patients with small osteochondral lesions.

Imaging of Common Arthroscopic Pathology of the Ankle.

Arthroscopy of the ankle is used in the treatment and diagnosis of a spectrum of intra-articular pathology including soft tissue and osseous impingement, osteochondral lesions, arthrofibrosis, and synovitis. To help identify the correct pathology, imaging techniques are often used to aid the surgeon in diagnosing pathology and determining best treatment options. This article discusses the use of imaging in various ankle pathologies.

A Multicenter, Retrospective Study of Early Weightbearing for Modified Lapidus Arthrodesis.

The modified Lapidus arthrodesis is a long-established surgical technique for management of hallux valgus that provides reproducible results and quality patient outcomes. The data from 367 consecutive patients undergoing unilateral modified Lapidus arthrodesis from January 1, 2007 to December 31, 2008 at participating centers were retrospectively evaluated. The included patients were categorized into early weightbearing (≤ 21 days) and delayed weightbearing (> 21 days) groups.

Hibbs Tenosuspension.

Hibbs tenosuspension is an underutilized procedure when it comes to dealing with lesser toe pathology in conditions such as Charcot-Marie-Tooth disease. This article describes the procedure to transfer the extensor digitorum longus tendons into the peroneus tertius tendon to eliminate a deforming force and create a stabilizing force.

Sports medicine and platelet-rich plasma: nonsurgical therapy.

A Cochrane Review was performed to assess the effects of platelet-rich therapies for treating musculoskeletal soft tissue injuries. Selection criteria were randomized and quasirandomized controlled trials (RCTs) that compared platelet-rich therapy with either placebo, autologous whole blood, dry needling, or no platelet-rich therapy for people with acute or chronic musculoskeletal soft tissue injuries. Primary outcomes were functional status, pain, and adverse effects.

Preoperative evaluation and testing for arthroscopy.

Understanding when to proceed with an arthroscopy of the ankle and foot can at times be difficult. Proper preoperative planning will ensure that the correct surgical procedure is selected. Although most surgeons can determine the correct diagnosis and treatment options for the patient based on the subjective and objective examinations, advanced imaging and diagnostic injections are useful tools in difficult cases.

Naviculocuneiform dislocations treated with immediate arthrodesis: a report of 2 cases.

The authors report on 2 patients who sustained naviculocuneiform dislocations and intercuneiform diastasis, and who were treated with immediate arthrodesis of the midfoot complex. Injury patterns in both cases involved damage to the medial facet of the distal navicular articular surface, separation of the first and second cuneiforms, and an unstable first ray. At the 15- and 18-month follow-up, respectively, both patients attained a stable, solid fusion with maintenance of the medial longitudinal architecture.

X-ray evaluation using the X-PODite digital radiograph analyzer. A preliminary study.

The traditional methods of manual radiograph measurement lack standardization and are often inaccurate and time consuming. By addressing the documented variables that create these inaccuracies, the X-PODite Digital Radiograph Analyzer appears to maximize the accuracy, reproducibility, and usefulness of radiographic measurements. Additionally, the time required for an evaluation, ease of use, and database capabilities of the X-PODite system facilitate thorough clinical evaluations and important outcomes research.

Common office emergencies.

Office medical emergencies are at best unpredictable. They can occur at any time and to any patient without much warning. It is the physician's responsibility to be prepared for such an emergency.