Psychological differences between toilet trained and non-toilet trained 4-year-old children.

Objective: Late to complete toilet training has been associated with many psychological factors including behavior and mood problems. Unfortunately, the majority of the research is specific to children with elimination disorders or children identified as incontinent after the age of 7 years. The current study addressed gaps in the literature by comparing the psychological functioning of children not toilet trained by their 4-year-old well child care visit with their toilet trained peers.

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.

Orthoplastic Approach for Surgical Treatment of Diabetic Foot Ulcers.

Diabetic foot ulcers remain a challenge to practitioners and costly to health care systems. They range from simple to complex and many treatment options are available. By following standard wound care protocols to ensure adequate blood supply, infection control, debridement, wound management, and offloading many diabetic foot ulcers heal in a timely fashion.

Comparison of Radiographic Measurements Before and After Triplane Tarsometatarsal Arthrodesis for Hallux Valgus.

We present a comparison of preoperative and final postoperative first ray measurements in 109 feet after triplane tarsometatarsal arthrodesis at a mean follow-up time of 17.4 months. Preoperative and final postoperative first ray variables including intermetatarsal angle (IMA), hallux valgus angle (HVA), tibial sesamoid position (TSP), distal metatarsal articular angle (DMAA), Seiberg index, metatarsal rotation angle (MRA), sesamoid subluxation, osseous union, and hardware failure were evaluated.

Hallux Valgus.

Hallux valgus is a common condition that results from a complex positional deformity of the first ray. The bunion or medial prominence that results from the lateral deviation and pronation of the hallux is only one component of the 3-dimensional deformity. Hallux valgus can lead to considerable pain and altered joint mechanics.

Triplane Hallux Abducto Valgus Classification.

One of the most common procedures performed in the foot and ankle is correction of hallux abducto valgus deformity or "bunion surgery." Most foot and ankle surgeons recognize the challenges associated with defining each patient's individual deformity and selecting the optimal procedure for the best long-term results. Using current 2-dimensional algorithms that focus on the severity of the transverse plane deformity, surgical outcomes have varied.

Biomechanical Characteristics of Biplane Multiplanar Tension-Side Fixation for Lapidus Fusion.

Although plating on the plantar, tension-side of the metatarsocuneiform joint provides an inherent biomechanical advantage for Lapidus arthrodesis, it has not been widely adopted owing to the morbidity associated with plantar application. To overcome these limitations, a modification to 90-90 locked biplanar plating was developed to provide the biomechanical advantages of multiplanar fixation and tension-side fixation, allowing application through a conventional incision. We tested the hypothesis that biplanar plating with tension-side fixation (low-profile straight dorsal plate and anatomic medial-plantar plate) would demonstrate improved mechanical stability compared with a previously tested 90-90 biplanar construct (small straight plate dorsally and medially) under cyclic loading.

American College of Foot and Ankle Surgeons Clinical Consensus Statement: Diagnosis and Treatment of Adult Acquired Infracalcaneal Heel Pain.

Adult acquired inferior calcaneal heel pain is a common pathology seen in a foot and ankle practice. A literature review and expert panel discussion of the most common findings and treatment options are presented. Various diagnostic and treatment modalities are available to the practitioner.

Understanding Frontal Plane Correction in Hallux Valgus Repair.

Hallux-abducto-valgus or "bunion" surgery is one of the most common surgical procedures for the foot and ankle specialist. As our understanding of the hallux-abducto-valgus deformity has grown, it is becoming clear that the anatomic CORA of the deformity may lie at the tarsometatarsal joint. There is also the component of the 3-dimensional nature of the deformity that may be best addressed at this CORA.