Managing Complications of Foot and Ankle Surgery
Hallux valgus deformity is nowadays one of the most common and symptomatic disorders affecting the foot. Surgical corrections of hallux valgus deformity are among the most common orthopedic procedures. Despite the general high success rate complications can occur. The treatment of complications start before the first incision has been performed by thorough preoperative planning and choice of the right procedure. Once the complication is evident, thorough planning is necessary to address the patient ’s individual needs. In this paper the treatment of recurrent hallux valgus, hallux varus, malunion, and avascular necrosis ...
Source: Foot and Ankle Clinics - May 11, 2022 Category: Orthopaedics Authors: Hans-J örg Trnka Source Type: research
Complications of Hallux Rigidus Surgery
Hallux rigidus can be treated with a variety of surgical procedures, including joint preserving techniques, arthrodesis, and arthroplasty. The most commonly reported complications for joint preserving techniques consist of progression of arthritis, continued pain, and transfer metatarsalgia. Although good outcomes have been reported for arthrodesis overall, careful attention must be paid to technique and positioning of the toe to avoid nonunion or malunion. Arthroplasty preserves motion but in the case of failure can present the additional challenge of bone loss. In these scenarios, the authors recommend distraction bone b...
Source: Foot and Ankle Clinics - May 11, 2022 Category: Orthopaedics Authors: MAJ Patrick D. Grimm, Todd A. Irwin Source Type: research
Salvage of Failed Lisfranc/Midfoot Injuries
Salvage of Lisfranc, or tarsometatarsal injuries, may be necessary because of a variety of clinical scenarios. Although rare, these injuries represent a broad spectrum of injury to the midfoot ranging from low-energy ligamentous injuries to high-energy injuries with significant displacement and associated fractures. Poor outcomes and complications may occur including posttraumatic arthritis, instability, pain, infection, and loss of function. Strategies and technical considerations for salvage of these complex injuries are provided. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 11, 2022 Category: Orthopaedics Authors: Michael Swords, Arthur Manoli, Arthur Manoli Source Type: research
Managing Complications of Foot and Ankle Surgery
Our understanding of the cause and principles of treatment of progressive collapsing foot deformity (PCFD) has significantly evolved in recent decades. The goals of treatment remain improvement in symptoms, correction of deformity, maintenance of joint motion, and return of function. Although notable advancements in understanding the deformity have been made, complications still occur and typically result from (1) poor decision making, (2) technical errors, and (3) patient-related conditions. In this article, we discuss common surgical modalities used in the treatment of PCFD and further highlight the common complications ...
Source: Foot and Ankle Clinics - May 11, 2022 Category: Orthopaedics Authors: Mitchel R. Obey, Jeffrey E. Johnson, Jonathon D. Backus Source Type: research
Persistent Pain After Hindfoot Fusion
One of the most challenging problems facing orthopedic surgeons is persistent pain after surgery and certainly is just as frustrating following hindfoot fusion. The hindfoot joints consist of the subtalar, talonavicular, and calcaneocuboid (CC) joints. These joints are commonly fused for degenerative changes, deformity correction, inflammatory or neuropathic arthropathy, tarsal coalition, or primarily after trauma. Goals of hindfoot fusion are a painless plantigrade foot capable of fitting in shoes without orthotics or a brace. Many believe that deformity correction is achievable without inclusion of the CC joint. Managing...
Source: Foot and Ankle Clinics - May 11, 2022 Category: Orthopaedics Authors: David Vier, John Kent Ellington Source Type: research
Complications of Lesser Toe Surgery
Complications following lesser toe surgery are challenging to manage. The keys to treatment of any of these conditions are, first, to try to avoid them through identification of patient- and surgeon-related variables that contribute to their development and, second, following the occurance of a complication, to understand what can and cannot be corrected with surgical and nonsurgical management. This review provides a comprehensive assessment of current literature, demonstrates best practices and approaches to lesser toe complications, and provides an illustration of clinical examples. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 11, 2022 Category: Orthopaedics Authors: Wesley J. Manz, Jason T. Bariteau Source Type: research
Revision Strategies for the Aseptic, Malaligned, Surgically Treated Ankle Fracture
This article describes our preferred systematic approach for diagnosis and treatment of the aseptic, malaligned, surgically treated ankle fracture. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 11, 2022 Category: Orthopaedics Authors: Eitan M. Ingall, John Zhao, John Y. Kwon Source Type: research
Ankle Instability
This article discusses various surgical procedures used to treat chronic lateral ankle instability, including direct ligament repair, anatomic reconstruction, and nonanatomic reconstruction. We focus our discussion on the most common and challenging complications of ankle stabilization, both in our experience and as supported by the existing literature, including recurrent instability, superficial peroneal nerve injury, and unaddressed pathology that continues to cause symptoms and limit function. We offer possible methods to manage these conditions as well as available outcome data. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 11, 2022 Category: Orthopaedics Authors: Mark Drakos, Oliver Hansen, Saanchi Kukadia Source Type: research
Achilles
Acute Achilles tendon ruptures are commonly managed with surgical repair. This particular surgery is prone to rerupture, wound complications, deep vein thrombosis, and sural nerve injuries. In this chapter the authors discuss complications, how to avoid them, and ultimately how to manage complications with your patients. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 11, 2022 Category: Orthopaedics Authors: Selene G. Parekh, Fernando S. Aran, Suhail Mithani, Aman Chopra Source Type: research
Surgical Management of the Undercorrected and Overcorrected Severe Club Foot Deformity
This article only focuses on severe complications caused by recurrence and overcorrection in both children and adult patients. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 11, 2022 Category: Orthopaedics Authors: Shuyuan Li, Mark S. Myerson Source Type: research
Management of Treatment Failures in Osteochondral Lesions of the Talus
We describe, in sequence, the surgical management options, including salvage procedures, for failed treatment of OLTs. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 11, 2022 Category: Orthopaedics Authors: Kenneth J. Hunt, Benjamin J. Ebben Source Type: research
Your Next Move
I was once told that there were three types of surgeons: “Those that don’t operate and don’t have complications. Those that do operate and have complications. And damn liars.” These were words from Dr William Hamilton, the founder of modern dance medicine, a pillar of the American Orthopaedic Foot and Ankle Society, and somebody who I could always count on for advice to get me out of trouble. I also recall constantly asking my friend, colleague, and mentor, Dave Levine, about complications when I was worried I did not have the answer in cases where things did not pan out as planned. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 5, 2022 Category: Orthopaedics Authors: Scott J. Ellis Tags: Preface Source Type: research
Navicular Fracture
The tarsal navicular is an essential component of the Chopart joint and crucial for most of hindfoot motion. Most fractures are low-energy dorsal avulsions that may be treated nonoperatively. Displaced comminuted fractures require open reduction and internal fixation, sometimes with external fixation, bridge plating, and bone grafting. Diagnosis of stress fractures is commonly delayed. Conservative treatment is associated with good results, but surgery allows for quicker return-to-play in athletes. Nonunion in acute and stress fractures needs open debridement, grafting, and stable fixation. M üller-Weiss disease may prese...
Source: Foot and Ankle Clinics - May 5, 2022 Category: Orthopaedics Authors: Manuel Monteagudo, Pilar Mart ínez-de-Albornoz Source Type: research
Failed Surgery for Achilles Tendinopathy
Treatments of Achilles tendinopathy continue to evolve. The body of literature is inadequate to provide a comprehensive guide to evaluation and treat failed surgeries. Issues related to failed surgical treatment may be divided into infection/wound issue, mechanical failure, and persistent pain. Awareness of the potential problems described in this article will allow surgeons to have a foundation in clinical assessment and making accurate diagnoses. Various surgical treatment options are available and should be executed carefully to treat individualized patient conditions. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 5, 2022 Category: Orthopaedics Authors: Phinit Phisitkul, Nacime Salomao Barbachan Mansur, Cesar de Cesar Netto Source Type: research
Failed Cavovarus Reconstruction
This article provides an overview of the techniques and strategies to address a failed cavovarus deformity correction. These problems pose significant challenges to the treating surgeons and should be accurately planned before embarking on surgery. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 5, 2022 Category: Orthopaedics Authors: Norman Espinosa, Georg Klammer Source Type: research
