Tibiocalcaneal arthrodesis in the high-risk foot.

The present case series outlines the history and surgical treatment of 6 patients who underwent tibiocalcaneal arthrodesis from April 2002 to May 2012, all with external fixation as the primary or secondary fixation. Surgical intervention was performed by the same surgeon at the same facility. The indication for surgery was a nonbraceable Charcot deformity in 5 (83.

A biomechanical comparison of internal fixation techniques for ankle arthrodesis.

The purpose of the present study was to compare the primary bending stiffness characteristics of 5 different ankle arthrodesis fixation techniques: 3 compression screws, an anterior locking plate, a lateral locking plate, an anterior locking plate with a compression screw, and a lateral locking plate with a compression screw. A total of 25 full-scale anatomic models consisting of fourth-generation composite tibiae and tali were tested using an Instron 4505 Universal Testing System. We hypothesized that the use of a compression screw with a locking plate would add considerable stiffness to the fixation construct compared with the use of a locking plate alone.

Medial Column Arthrodesis Using an Anatomic Distal Fibular Locking Plate.

The medial column fusion is performed for a multitude of etiologies, including peritalar subluxation deformity, Charcot arthropathy, trauma, post-traumatic degenerative joint disease, and rheumatoid arthritis. Various surgical techniques have been described for medial column arthrodesis. We describe a new fixation method using an anatomic distal fibular locking plate for medial column arthrodesis.

Dorsal Approach for Plantar Plate Repair With Weil Osteotomy: Operative Technique.

Unlabelled: In recent years, the role of the plantar plate in lesser metatarsophalangeal joint stability has increasingly been recognized. Tearing or attenuation of the plantar plate often will result in crossover or hammertoe deformity with hyperextension of the MTP joint. Some patients are able to have resolution of painful symptoms with conservative treatment but for those that fail these measures, surgical fixation of the plantar plate is indicated.

Sensory Nerve Dysfunction and Hallux Valgus Correction: A Prospective Study.

Background: Sensory nerve dysfunction in patients with hallux valgus has been described as both a symptom of the deformity and a complication of the treatment. The purpose of this study was to quantify nerve dysfunction in hallux valgus patients and to prospectively evaluate whether the trauma of surgery or the correction of the deformity had any effect on the sensory nerve function.

Methods: Fifty-seven consecutive feet undergoing operative correction for hallux valgus were prospectively enrolled.

Effectiveness of the dorsal thermoplastic locking orthosis to prevent floating toes in postoperative follow-up of Weil osteotomies: pilot study.

Background: The Weil oblique distal metatarsal osteotomy is regularly used in the treatment of primary metatarsalgia. The most frequent complication is the floating toe, which occurs in up to 36% of postoperative follow-up. The theory of reducing the plantar flexor mechanism tension associated with the retraction of the dorsal structures during the healing process of the surgical procedure may explain this negative evolution.

Osteochondral Lesions in Surgically Treated Hallux Valgus.

Background: Patient dissatisfaction following surgical correction of hallux valgus remains a clinical problem. The aim of this study was to investigate articular erosion patterns of the first metatarsal head in patients with hallux valgus, to evaluate if the cartilage damage was associated with the degree of hallux valgus deformity, and to prospectively evaluate the effect on patient outcomes.

Methods: Fifty-six consecutive feet undergoing surgical correction for hallux valgus were prospectively enrolled and followed for 24 months postoperatively.

Tibial Stress Fracture Secondary to Half-Pins in Circular Ring External Fixation for Charcot Foot.

Background: There is an increasing trend for surgical correction of the deformity associated with Charcot neuroarthropathy of the foot and ankle (Charcot foot) in order to allow ambulation with commercially available therapeutic footwear. The significant rate of surgical and medical morbidity associated with extensive conventional operative correction has led many surgeons to use limited surgical dissection and stabilization with circular ring external fixation.

Methods: A retrospective chart review was performed on 254 patients at 2 academic medical centers who underwent surgical correction for diabetes-associated Charcot foot deformity with limited soft tissue dissection and stabilization accomplished with a statically applied circular external fixator.

Physical therapy post-hallux abducto valgus correction.

This article discusses physical therapy considerations after hallux valgus correction. Hallux valgus is a fairly common occurrence, and corrective surgery is an option when conservative measures fail. Symptoms such as pain, swelling, and difficulty walking may persist after surgical correction of bunion deformity that addresses soft tissue and bone structure.

Contemporary approaches and advancements to the Lapidus procedure.

The Lapidus procedure as evolved over the last 50 years. What originally was a difficult procedure with poor outcomes has changed to a procedure that allows for ideal realignment of the deformity at its source, improved foot alignment, and minimal to no need for further surgery. The authors now use a weight bearing plate which has improved overall patient care, with a minimized risk of nonunions, and more rapid return to early weight bearing and range of motion.

Revision hallux valgus: causes and correction options.

The need for revision hallux valgus surgery is a problem all surgeons encounter. Revision of a failed hallux valgus surgery is often difficult, and very little research exists and few papers have been presented on the topic. Hallux valgus failure has multiple causes, including reoccurrence, avascular necrosis, malunion, nonunion, and hallux varus.

First metatarsophalangeal joint arthrodesis in the treatment of hallux valgus.

First metatarsophalangeal joint arthrodesis is a reliable procedure with predictable outcomes in the treatment of moderate-to-severe hallux valgus with degenerative changes of the joint. It offers better functional outcome compared to arthroplasty with or without prosthesis in appropriate patient populations. Recent studies have shown that with appropriate fixation, early weight bearing may be initiated without an increase in nonunion.

Fixation updates for hallux valgus correction.

Fixation options for hallux valgus correction vary. Although some methods are newer and more advanced, even the older techniques are successful in appropriate situations. Kirschner wires and cerclage wiring have their place in proximal phalanx and first metatarsal osteotomies.

First metatarsal base osteotomies for hallux abducto valgus deformities.

Proximal first metatarsal osteotomies have historically been associated with and limited to treatment of severe hallux valgus deformities. These procedures are powerful in deformity correction and overall realignment of first ray function because of their ability to correct closer to the deformity's origin. When considering all factors in bunion correction, they are good options for correction of a wide range of hallux abducto valgus deformities.

First metatarsal head osteotomies for the correction of hallux abducto valgus.

An array of distal first metatarsal osteotomies has been described over the decades for the correction of hallux valgus. No one procedure is proficient in correcting all forms and severities of hallux valgus deformities. To optimize results, it is imperative for the surgeon to match a procedure and its modifications to the patient's deformity.

Peroneal tendon displacement accompanying intra-articular calcaneal fractures.

Background: Peroneal tendon displacement (subluxation or dislocation) accompanying an intra-articular calcaneal fracture is often undetected and under-treated. The goals of this study were to determine (1) the prevalence of peroneal tendon displacement accompanying intra-articular calcaneal fractures, (2) the association of tendon displacement with fracture classifications, (3) the association of tendon displacement with heel width, and (4) the rate of missed diagnosis of the tendon displacement on radiographs and computed tomography (CT) scans and the resulting treatment rate.

Methods: A retrospective radiographic review of all calcaneal fractures presenting at three institutions from June 30, 2006, to June 30, 2011, was performed.

Low-Level Laser Therapy for the Treatment of Chronic Plantar Fasciitis: A Prospective Study.

Background: Plantar fasciitis affects nearly 1 million people annually in the United States. Traditional nonoperative management is successful in about 90% of patients, usually within 10 months. Chronic plantar fasciitis develops in about 10% of patients and is a difficult clinical problem to treat.

Management of failures of total ankle replacement with the agility total ankle arthroplasty.

Background: Few studies have focused on treatment following failed total ankle replacement. The purpose of this study was to report the outcomes of patients undergoing revision total ankle replacement and to propose a talar component subsidence grading system that may be helpful in making decisions regarding how to revise failed total ankle replacements in the future.

Methods: A retrospective review was performed of fifty-three patients who underwent revision total ankle replacement and had been followed for a minimum of two years.

Popliteal blocks for foot and ankle surgery: success rate and contributing factors.

The purpose of the present study was to evaluate the factors contributing to the success of popliteal nerve blocks performed by podiatric surgical residents in various stages of training. A retrospective review was conducted of 143 consecutively performed blocks during a 2-year period. A total of 29 blocks using a lateral approach and 114 blocks using a modified posterior approach were performed.

Clinical examination of plantar plate abnormality: a diagnostic perspective.

Background: Plantar plate tears can cause pain and deformity in the forefoot but are frequently missed on initial examination. The purpose of this article was to evaluate the diagnostic statistics of common clinical examination parameters using observed intraoperative abnormality as the referenced standard.

Methods: Medical records of 90 patients (109 feet) who underwent a plantar plate repair were reviewed for the presence and onset of pain, plantar edema, instability of the second metatarsophalangeal (MTP) joint (drawer sign), pain with range of motion of the lesser MTP joint, first MTP joint range of motion, crossover toes, previous first ray surgery, and previous corticosteroid injections.

Body mass index and achilles tendonitis: a 10-year retrospective analysis.

Introduction: High body mass index (BMI) has been implicated as an etiologic agent in Achilles tendonitis (AT) and may contribute to poorer treatment outcomes. The purpose of this study was to better elucidate the role of BMI in both the development and treatment of AT.

Methods: A matched case-control (1:1) study design was used.

Surgical correction of the ball and socket ankle joint in the adult associated with a talonavicular tarsal coalition.

Background: Ball and socket ankle (BASA) deformity is a rare condition. Little is known about outcomes and treatments in the adult population.

Methods: Retrospective comparative review was performed of 13 patients treated for BASA with a minimum follow-up of 2.