Transfer Metatarsalgia Post Hallux Valgus Surgery
Metatarsalgia, pain around the metatarsophalangeal joints, may arise from mechanical causes spontaneously or iatrogenically. Nonunion or malunion of the first metatarsal can transfer weight-bearing forces and overload the lesser metatarsals. Transfer metatarsalgia after failed hallux valgus surgery is troublesome and more prevalent than would be expected. Clinical examination of the patient allows identifying the type of transfer metatarsalgia and pathomechanics involved. This review focuses on transfer metatarsalgia after hallux valgus surgery and provides a basic understanding of the pathomechanics, clinical examination,...
Source: Foot and Ankle Clinics - May 30, 2014 Category: Orthopaedics Authors: Ernesto Maceira, Manuel Monteagudo Source Type: research

Pediatric Hallux Valgus
Hallux valgus in children is a relatively uncommon deformity, also known by several other names such as juvenile or adolescent bunion, metatarsus primus varus, and metatarsus primus adductus. The presence of an open growth plate is considered by most to be part of the definition of this condition. However, others include patients up to age 20 years, owing to the plastic nature of the various components of the condition. The presenting complaint is invariably of the bunion and its cosmetic appearance. Treatment should be conservative and surgery avoided till skeletal maturity is achieved due to the high incidence of recurre...
Source: Foot and Ankle Clinics - May 30, 2014 Category: Orthopaedics Authors: Julian Chell, Sunil Dhar Source Type: research

Rotational and Opening Wedge Basal Osteotomies
This article describes modified techniques with modern fixation of these 2 osteotomies, which offer stable fixation and reproducible results. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 30, 2014 Category: Orthopaedics Authors: Paulo N. Ferrao, Nikiforos P. Saragas Source Type: research

Minimally Invasive Osteotomies
As orthopedic surgery continues to head in the direction of less invasive surgical techniques, this article explores the application and evolution of minimally invasive/percutaneous techniques in the surgical correction of hallux valgus deformities. Modern techniques are described and available literature is reviewed. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 30, 2014 Category: Orthopaedics Authors: David Redfern, Anthony Michael Perera Source Type: research

Management of Primary and Revision Hallux Valgus
Hallux valgus is one of the most common conditions we treat as foot and ankle orthopedic surgeons. It can have significant impact on patients’ lives through effects on stance, walking, sporting activity, and ability to fit into footwear. It represents a large spectrum of pathologic abnormality ranging from the pediatric hallux valgus to the development of secondary arthritic changes. As with all surgery, there are a range of complications, including recurrence, varus, and shortening. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 30, 2014 Category: Orthopaedics Authors: Andy Molloy Source Type: research

Forthcoming Issues
Managing Complications of Foot and Ankle Surgery Chris Coetzee, Editor (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 30, 2014 Category: Orthopaedics Source Type: research

Contents
Andy Molloy Andy Molloy and James Widnall (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 30, 2014 Category: Orthopaedics Source Type: research

Contributors
MARK S. MYERSON, MD Director, The Institute for Foot and Ankle Reconstruction, Mercy Medical Center, Mercy Hospital, Baltimore, Maryland (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 30, 2014 Category: Orthopaedics Source Type: research

Recurrence of Hallux Valgus: A Review
This article discusses these challenges, complications, causes, and techniques. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - March 31, 2014 Category: Orthopaedics Authors: Steven M. Raikin, Adam G. Miller, Joseph Daniel Source Type: research

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. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - March 24, 2014 Category: Orthopaedics Authors: Edward V. Wood, Christopher R. Walker, Michael S. Hennessy Source Type: research

The Modified Lapidus Fusion
This article provides an overview of the procedure with special focus on the surgical technique. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - March 24, 2014 Category: Orthopaedics Authors: Timo Schmid, Fabian Krause Source Type: research

Correction of Moderate and Severe Hallux Valgus Deformity with a Distal Metatarsal Osteotomy Using an Intramedullary Plate
More than 200 surgeries have been described for hallux valgus correction. The distal V-shape chevron-type osteotomy was described with no more than 50% translation of the distal fragment in relation to the metatarsal shaft. This concept of high, powerful correction for distal chevron osteotomy fixed by the Mini MaxLock Extreme ISO gives the surgeon the possibility of a mini-invasive rapid solution. A new technique of fixation is based on the Murawski and Beskin concept, because a powerful correction can be performed with a minimally invasive approach, but, in contrast to other studies, with stable osteotomy fixation. (Sour...
Source: Foot and Ankle Clinics - March 24, 2014 Category: Orthopaedics Authors: Ezequiel Palmanovich, Mark S. Myerson Source Type: research

Scarf Osteotomy
This article addresses the surgical technique of the scarf osteotomy together with the results and complications of hallux valgus correction. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - March 24, 2014 Category: Orthopaedics Authors: Andy Molloy, James Widnall Source Type: research

The Treatment of Iatrogenic Hallux Varus
Though uncommon, iatrogenic hallux varus is most often the result of overresection of the medial eminence, overtranslation of an osteotomy, overrelease of the lateral soft tissues, or overtightening of the medial tissues. It is not always symptomatic, as the degree of deformity can be well tolerated. For soft-tissue reconstructions, releases have little role to play unless minor deformity is detected early on and the longevity of tendon transfer and tenodesis remains unknown. For bony reconstruction, arthrodesis is the recommended salvage technique. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - March 13, 2014 Category: Orthopaedics Authors: Mark B. Davies, Chris M. Blundell Source Type: research

Index
Note: Page numbers of article titles are in boldface type. AAFD. See Adult acquired flatfoot deformity (AAFD). (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 18, 2014 Category: Orthopaedics Source Type: research

Forefoot Tendon Transfers
Flexible forefoot deformities, such as hallux varus, clawed hallux, hammer toes, and angular lesser toe deformities, can be treated effectively with tendon transfers. Based on the presentation of the flexible forefoot deformities, tendon transfers can be used as the primary treatment or as adjuncts to bony procedures when there are components of fixed deformities. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 18, 2014 Category: Orthopaedics Authors: Andrea Veljkovic, Edward Lansang, Johnny Lau Source Type: research

Spastic Foot and Ankle Deformities: Evaluation and Treatment
Spastic foot and ankle deformities can occur from various causes and have profound effects on individuals and society. Presentations can vary clinically and a thorough clinical evaluation, potentially with a dynamic electromyogram, is essential to selecting the most appropriate treatment. Nonoperative treatments, such as orthotics, casting, oral medications, and nerve blocks, can be effective but surgery is indicated if they are no longer effective. Of the various operative procedures to treat this condition, split anterior tibialis tendon transfer and tendo Achilles lengthening are the most commonly performed. Multiple su...
Source: Foot and Ankle Clinics - February 18, 2014 Category: Orthopaedics Authors: Brandon W. King, David J. Ruta, Todd A. Irwin Source Type: research

Tendon Transfers for the Drop Foot
The paralytic drop foot represents a challenging problem for even the most experienced orthopedic surgeon. Careful patient selection, thorough preoperative examination and planning, and application of tendon transfer biomechanical and physiologic principles outlined in this article can lead to successful results, either through a posterior tibialis tendon transfer, Bridle transfer, or variations on these procedures. Achilles lengthening or gastrocnemius recession may also be needed at the time of tendon transfer. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 18, 2014 Category: Orthopaedics Authors: Karl M. Schweitzer, Carroll P. Jones Source Type: research

Tendon Transfers in the Treatment of the Adult Flatfoot
Tendon transfers are critical to successful surgical correction of adult flexible flatfoot deformity and may be beneficial in correcting rigid deformities as well. Patients with refractory stage I and II deformities often require selective osteotomies in addition to tendon transfer. Patients with stage III and IV deformities typically require hindfoot arthrodesis. One of several tendons can be used for transfer based on surgeon's preference. Flexor digitorum longus (FDL) and flexor hallucis longus (FHL) transfers have been shown to have good results. A peroneus brevis transfer is typically used to supplement smal...
Source: Foot and Ankle Clinics - February 18, 2014 Category: Orthopaedics Authors: Jonathon D. Backus, Jeremy J. McCormick Source Type: research

Forthcoming Issues
Management of Primary and Revision Hallux Valgus Andy Molloy, Editor (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 18, 2014 Category: Orthopaedics Source Type: research

Contents
Bruce E. Cohen Kenneth J. Hunt and Jessica H. Ryu (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 18, 2014 Category: Orthopaedics Source Type: research

Contributors
MARK S. MYERSON, MD Director, The Institute for Foot and Ankle Reconstruction, Mercy Medical Center, Baltimore, Maryland (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 18, 2014 Category: Orthopaedics Source Type: research

Neuromuscular Problems in Foot and Ankle: Evaluation and Workup
It is essential to determine the functional goals of the patient during the workup and treatment planning stages of neuromuscular disorders involving the foot and ankle. Accurate diagnosis, and informed discussion of treatment options, must be in the context of the patient’s disease, cognition, comorbidities, functional attributes, and family environment. A thorough history and physical examination aid in appropriate diagnostic workup and optimal orthopedic management of each patient. In this article, general considerations in the workup of suspected neuromuscular disorders and issues pertinent to specific congenital...
Source: Foot and Ankle Clinics - December 26, 2013 Category: Orthopaedics Authors: Kenneth J. Hunt, Jessica H. Ryu Source Type: research

Hallux Claw Toe
This article describes diagnosis and treatment of this condition. Particular attention is given to surgical techniques such as Jones technique and modified Jones technique. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - December 23, 2013 Category: Orthopaedics Authors: Mostafa Abousayed, John Y. Kwon Source Type: research

Tendon Transfers—How Do They Work? Planning and Implementation
The purpose of this article is to update the orthopedic community on the planning and implementation of tendon transfers in the foot and ankle. This information will serve to reinforce those principles and factors that are inherent in successful performance of tendon transfer. In addition, the authors highlight recent updates that impact decision-making for these procedures. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - December 23, 2013 Category: Orthopaedics Authors: Thomas Dowd, Eric M. Bluman Source Type: research

Preface
I am very pleased to serve as the guest editor for this issue of Foot and Ankle Clinics of North America. We have a great lineup of authors who have done a fantastic job covering our topic: Tendon Transfers and Treatment Strategies in Foot and Ankle Surgery. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - December 23, 2013 Category: Orthopaedics Authors: Bruce E. Cohen Source Type: research

Tendon Transfers in Cavovarus Foot
The use of tendon transfers in the cavovarus foot is a common surgical procedure because of the muscular imbalance present in this pathologic condition. Therefore, deforming forces are transferred to obtain movement and function. General principles must be followed for transfers to work; depending on the muscle deficiency and the function to restore, different tendon transfer options exist. The authors do not recommend tendon transfers for forefoot deformities in this setting. Postoperatively tendon transfers should be protected in a removable boot, but early protected weight bearing and motion is stimulated to obtain a we...
Source: Foot and Ankle Clinics - December 19, 2013 Category: Orthopaedics Authors: Cristian Ortiz, Emilio Wagner Source Type: research

Tendon Transfers in the Treatment of Achilles' Tendon Disorders
This article explores the use of tendon transfers and supplementation in the treatment of insertional and noninsertional Achilles tendinosis as well as in cases of neglected or chronic ruptures of the tendoachilles. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - December 9, 2013 Category: Orthopaedics Authors: Steven K. Neufeld, Daniel C. Farber Source Type: research

Salvage Options for Peroneal Tendon Ruptures
Reports have demonstrated that peroneal tendon tears can be successfully treated by direct repair or debridement and tubularization, based on the extent and nature of the pathology. Irreparable peroneal tendon tears or completely unsalvageable tendons after failure of previously attempted repairs are rare, and as a result there is a lack of high-level evidence to guide the management of these complex injuries. When irreparable tears are encountered the salvage options include tenodesis, bridging of the defect using allografts or autografts, and tendon transfers. The choice of treatment strategy depends on the presence of a...
Source: Foot and Ankle Clinics - December 2, 2013 Category: Orthopaedics Authors: Emmanouil D. Stamatis, Georgios C. Karaoglanis Source Type: research

Percutaneous Techniques for Tendon Transfers in the Foot and Ankle
This article describes percutaneous techniques for tendon transfer procedures used to address foot and ankle disorders. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - November 27, 2013 Category: Orthopaedics Authors: Vinod Kumar Panchbhavi Source Type: research

Index
(Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - November 14, 2013 Category: Orthopaedics Source Type: research

The Indications and Technique for Surgical Correction of Pes Cavus with External Fixation
Cavovarus is a deformity commonly associated with a variety of underlying disorders, and treatment of severe cavovarus foot with an underlying progressive disorder is very challenging. Often patients have undergone some prior surgery at least once, with increased potential risk of neurovascular injury and breakdown of soft tissue. In addition, concomitant problems such as torsional malalignment and leg-length discrepancy should also be addressed to prevent recurrence and treatment failure. In this article, indications and an algorithmic approach with various osteotomies for the treatment of cavovarus deformity using extern...
Source: Foot and Ankle Clinics - November 14, 2013 Category: Orthopaedics Authors: Kang Lee, Jae-ho Cho, Woo-Chun Lee Source Type: research

Joint Sparing Correction of Cavovarus Feet in Charcot-Marie-Tooth Disease: What Are the Limits?
Charcot-Marie-Tooth disease is an inherited neuropathy that results in lower limb muscle imbalance and a resultant cavovarus deformity of the foot. With recognized poor outcomes of triple arthrodeses in the young patient, joint sparing surgery is preferred, which takes the form of osteotomies, soft-tissue releases, and tendon transfers to achieve a plantigrade and balanced foot. Due to the variability in muscle involvement and the presence of both mobile and fixed deformities, surgery must be individualized to each patient. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - November 14, 2013 Category: Orthopaedics Authors: Tristan Barton, Ian Winson Source Type: research

The Idiopathic Cavus Foot–Not So Subtle After All
Idiopathic cavus deformity even in its mild form can result in several associated symptoms. Management of these symptoms without addressing the underlying biomechanical abnormality may result in failure of treatment. A careful clinical assessment is paramount. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - November 14, 2013 Category: Orthopaedics Authors: Ali Abbasian, Gregory Pomeroy Source Type: research

Clinical and Radiographic Evaluation of the Cavus Foot: Surgical Implications
The key to successful management of the cavovarus foot is identifying the pathoanatomy and dysfunction that are driving the deformity and producing the symptoms. There is no substitute for a thorough clinical evaluation of the foot, evaluating the static alignment and dynamic function. Plain films alone are not sufficient to determine the diagnosis, but they are necessary for procedure selection and correction planning. This is especially true for assessing the degree of hindfoot varus. Some issues are difficult to diagnose, and imaging plays an important role. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - November 14, 2013 Category: Orthopaedics Authors: Anthony Perera, Abhijit Guha Source Type: research

Erratum
An error was made in the September 2013 issue of Foot and Ankle Clinics (Volume 18, number 3) in the Contributors List, Table of Contents, and on pages 481–502. One of the author names for “Joint-preserving surgery of valgus ankle osteoarthritis” was listed incorrectly. The correct author name is Monika Horisberger. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - November 14, 2013 Category: Orthopaedics Source Type: research

Forthcoming Issues
(Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - November 14, 2013 Category: Orthopaedics Source Type: research

Contents
(Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - November 14, 2013 Category: Orthopaedics Source Type: research

Contributors List
(Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - November 14, 2013 Category: Orthopaedics Source Type: research

Arthrodesis for the Cavus Foot: When, Where, and How?
When the cavus foot has become rigid, midfoot and triple arthrodesis may be the only reasonable surgical options left. The apex of the deformity is multiplanar and some deformities may have more than one apex. The best outcomes are achieved with minimal shortening of the foot, so correction should be by rotation and translation and with minimal wedge resection wherever possible. Posterior tibial tendon transfer and peroneus longus transfer are nearly always required for correction. If the principles of soft tissue balancing are followed, arthrodesis is an excellent procedure despite the literature that states to the contra...
Source: Foot and Ankle Clinics - October 8, 2013 Category: Orthopaedics Authors: Jacob R. Zide, Mark S. Myerson Source Type: research

What is the Role of Tendon Transfer in the Cavus Foot?
Cavovarus deformity results from an imbalance of the foot’s extrinsic musculature. Conditions leading to weakness of an isolated muscle result from nerve injury or sequelae of a compartment syndrome. When weakness of a muscle group presents, an underlying neurologic disorder must be suspected. Patients with hereditary sensory motor neuropathy present with a progressive pattern of imbalance and deformity. The deformity starts out flexible but becomes rigid over time. Rebalance muscle pull to realign the foot and ankle is important. Osteotomies and arthrodesis to realign the hindfoot will not maintain alignment as long...
Source: Foot and Ankle Clinics - October 8, 2013 Category: Orthopaedics Authors: Martin Huber Source Type: research

Joint-Sparing Correction for Idiopathic Cavus Foot: Correlation of Clinical and Radiographic Results
Adult cavovarus deformity patients present with rigid cavovarus deformity, where the correction can no longer be obtained using soft tissue procedures alone, and corrective arthrodesis or osteotomy must be performed to realign the deformity. Reconstructive surgeries for cavovarus foot deformities are variable and include hindfoot or midfoot osteotomy or arthrodesis, soft tissue release or lengthening, and tendon transfers. Recently adult cavovarus foot deformities have been more commonly addressed with joint preservation osteotomies and adjunctive soft tissue surgeries and less with triple arthrodesis. Clinical and radiogr...
Source: Foot and Ankle Clinics - October 8, 2013 Category: Orthopaedics Authors: Hong-Geun Jung, Jong-Tae Park, Sang-Hun Lee Source Type: research

Treatment of Ankle Instability with an Associated Cavus Deformity
This article reviews the role of cavus in foot and ankle injury and summarizes the current surgical and nonsurgical treatments. Recognition of foot position is crucial in the management of ankle instability associated with cavovarus. Correcting foot alignment with orthoses or surgery improves the mechanics of the ankle, reducing the risk of instability and potentially delaying the onset of posttraumatic ankle arthritis. Progressive steps in the correction alignment are described, with technical tips and strategies for dealing with chronic instability. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - October 8, 2013 Category: Orthopaedics Authors: Hilary A. Bosman, Andrew H.N. Robinson Source Type: research

Flexible Cavovarus Foot in Children and Adolescents
Flexible cavovarus feet in children and adolescents can be challenging. A careful history and physical examination are paramount for determining the best treatment strategy and a multitude of options are available. Specific treatment strategies should be individualized and any bony correction must be in conjunction with a muscle balancing procedure. Well-timed soft tissue and occasionally bony procedures can delay the progression of deformity. These patients are monitored long term because further treatment may be required. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - October 7, 2013 Category: Orthopaedics Authors: Kelly L. VanderHave, Robert N. Hensinger, Brandon W. King Source Type: research

Management of the Rigid Cavus Foot in Children and Adolescents
This article reviews historical approaches to the various osteotomies in the treatment of rigid cavus feet in children, with an emphasis on the biplanar nature of historical osteotomies. The Akron dome midfoot osteotomy is performed at the apex of the rigid cavus deformity and allows for maximum correction in any plane, and for varus, valgus, dorsal, plantar, and rotational correction. In that regard, the Akron dome midfoot osteotomy provides the greatest amount of multiplanar correction. It does not, however, provide correction of hindfoot deformities or deformity distal to the neck of the metatarsal. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 30, 2013 Category: Orthopaedics Authors: Dennis S. Weiner, Kerwyn Jones, David Jonah, Martin S. Dicintio Source Type: research

What is the Role and Limit of Calcaneal Osteotomy in the Cavovarus Foot?
We present a comprehensive review of surgical calcaneal osteotomy techniques and the currently available state of literature for their indications and limitations. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 23, 2013 Category: Orthopaedics Authors: Jason T. Bariteau, Brad D. Blankenhorn, Josef N. Tofte, Christopher W. DiGiovanni Source Type: research

The Cavus Foot
Management of the cavovarus foot is challenging in determining which surgical procedures are required in addition to the complexity of the execution of the surgery itself. Surgical correction not only must address the bony abnormalities that are present but also requires attention to ligamentous stabilization and tendon rebalancing as well. In the setting of a severe deformity, surgical decision-making is facilitated; however, the decision to correct subtle deformity can be very challenging. We have formulated the articles to address the many controversial aspects in treating cavus foot deformity. The overall goal of the i...
Source: Foot and Ankle Clinics - September 23, 2013 Category: Orthopaedics Authors: Anish Raj Kadakia Source Type: research

Index
Note: Page numbers of article titles are in boldface type. Achilles allograft, in deltoid ligament reconstruction, 524 (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 1, 2013 Category: Orthopaedics Source Type: research

Joint Denervation and Neuroma Surgery as Joint-Preserving Therapy for Ankle Pain
Partial joint denervation or surgical neuroma therapy are alternative concepts to treat pain around the ankle joint that preserve joint function and relieve pain by interrupting neural pathways that transmit pain impulses from the joint to the brain. This review article summarizes the indication, anatomic background, operative techniques, and clinical results of joint denervation or neuroma surgery, which, although rarely reported and used, may provide a valuable alternative treatment in selected patients with neurogenous problems around the ankle. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 1, 2013 Category: Orthopaedics Authors: Andreas Gohritz, A. Lee Dellon, Daniel Kalbermatten, Ilario Fulco, Mathias Tremp, Dirk J. Schaefer Source Type: research

What Leads to Failure of Joint-preserving Surgery for Ankle Osteoarthritis? When This Surgery Fails, What Next?
This article discusses the lack of scientific evidence regarding the treatment of failed joint-preserving surgery. Most of the concepts of treatment derive from treatment modalities in trauma and orthopedic surgery. The main question for the foot and ankle specialist is whether the joint can be salvaged. The definition of failure is difficult. Therefore pain reported by the patient is the main symptom that dictates the course of treatment. Whenever possible the joint should be maintained. However, if pain is associated with global radiographic osteoarthritis, total ankle replacement or fusions are the only means to solve t...
Source: Foot and Ankle Clinics - September 1, 2013 Category: Orthopaedics Authors: Norman Espinosa Source Type: research