Arthroscopic Treatment of Anterior Ankle Impingement.

Arthroscopic reduction of tibiotalar osteophytes results in good to excellent results in the vast majority of patients. Pain is primarily due to synovial hypertrophy and anterior tibiotalar entrapment associated with the osteophytes. Osteophytes may be due to repetitive trauma such as sports, or associated with subtle or overt ankle instability.

Comparison of Dynamic Versus Static Locked Retrograde Tibiotalocalcaneal Arthrodesis With Intramedullary Nail Fixation: Evaluation of the RAIN Database.

Hindfoot osteoarthritis (OA) or deformity involving the ankle and subtalar joint is a disabling condition. Tibiotalocalcaneal (TTC) fusion is an effective salvage option in pathologies where total ankle replacement is contraindicated. The purpose of this study is to compare the union rate of the ankle joint in proximal static versus dynamically locked retrograde intramedullary nail fixation for tibiotalocalcaneal arthrodesis.

Deformity Correction of the Midfoot/Hindfoot/Ankle.

The correction of the deformed arthritic foot and ankle is a complicated and somewhat controversial topic. After conservative methods fail, there is a wide range of possible bony procedures and arthrodesis that maybe performed. The appropriate work up and understanding of the pathomechanics is vital to the correct choice of procedures to correct these deformities.

Lapidus Arthrodesis.

There has been significant enhancement in surgical management of hallux valgus deformity. Recognition of the role of medial column hypermobility has resulted in better functional outcomes with decreased risk of recurrence. Modern techniques have evolved to include enhanced fixation in a move toward minimal postoperative downtime.

High Utility of the 1st Metatarsal Phalangeal Joint Fusion.

Fusion of the first metatarsophalangeal joint has been used by foot and ankle surgeons as a reproducible and useful means of treating end-stage arthritis of the great toe. However, the overall utility and successful outcomes of this procedure have led to its incorporation into the treatment of more significant bunion deformities, reconstruction forefoot, and salvage procedures. The authors review surgical fixation methods, offer insightful technical pearls for challenging cases and share examples of complex reconstructive and salvage procedures.

The Holstein-Lewis humerus shaft fracture in children: are they different from adults?

Spiral fractures in the distal third humerus shaft (Holstein-Lewis fracture pattern) have been associated with high risk of radial nerve palsy in adults and surgical treatment is recommended as the treatment of choice to remove the entrapped nerve from the fracture site. But this association and treatment approach has not been evaluated in pediatric humerus shaft fractures. In a retrospective study, 38 pediatric patients with Holstein-Lewis fracture configuration were identified after a review of radiographs of 1609 patients with humerus shaft fracture.

Arthroscopic Synovectomy and Excision of a Sesamoid in the Management of an Atypical Presentation of Avascular Necrosis of Bone: A Case Report.

Avascular necrosis of a sesamoid bone is a rare and incompletely understood entity. Furthermore, associated lesions secondary to sesamoid pathology have seldom been described in the literature. We report a case of avascular necrosis of the medial sesamoid, accompanied by severe synovitis of the first metatarsophalangeal joint, that was successfully managed with arthroscopic synovectomy and open excision of the sesamoid.

Rate of Subtalar Joint Arthrodesis After Retrograde Tibiotalocalcaneal Arthrodesis With Intramedullary Nail Fixation: Evaluation of the RAIN Database.

Background: Hindfoot arthritis or significant deformity involving the ankle and subtalar joint (STJ) is a disabling condition with few salvage options. Many surgeons note a decreased STJ fusion rate compared with ankle union when a retrograde nail construct is used. The purpose of this study was to report the STJ fusion rate of tibiotalocalcaneal (TTC) arthrodesis with retrograde nail.

Factors influencing the decision to use nurse practitioners in the emergency department.

Introduction: Emergency department overcrowding is a serious problem nationwide. Of an estimated 14 million visits to hospital emergency departments, only 12.9% are considered emergent.