Contents
Andrea Veljkovic (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - November 8, 2018 Category: Orthopaedics Source Type: research

Foot and Ankle Clinics
Avascular Necrosis of the Foot and Ankle (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - November 8, 2018 Category: Orthopaedics Source Type: research

Percutaneous Ankle Reconstruction of Lateral Ligaments
Chronic ankle instability following ankle sprains causes pain and functional problems such as recurrent giving way. Within the 3 ligaments of the lateral ligament complex, 80% of patients tear the anterior talofibular ligament (ATFL), whereas the other 20% of patients tear the ATFL and calcaneofibular ligament (CFL). Rarely, the posterior talofibular ligament is involved. An incidence of 10% to 30% of patients will fail conservative treatment and result in chronic ankle instability that may require surgical treatment. To date, numerous open surgical procedures for anatomic repair or reconstruction of ATFL and/or CFL provid...
Source: Foot and Ankle Clinics - September 28, 2018 Category: Orthopaedics Authors: Mark Glazebrook, Mohammad Eid, Meshal Alhadhoud, James Stone, Kentaro Matsui, Masato Takao Source Type: research

Acute Lateral Ankle Instability
Acute injuries to the lateral ankle complex remain common and account for 20% to 25% of musculoskeletal injuries. Initial assessment should use the Ottawa ankle rules, and grading should take into account degree of mechanical instability. Nonoperative measures are preferable for all grades of injury; however, mechanical instability is a predictor for resprains. Functional treatment after a short period of relative immobilization gives satisfactory results, and residual chronic ankle instability can be managed by repair or reconstruction. Delayed physical examination in elite athletes, along with 3T MRI, may be helpful in m...
Source: Foot and Ankle Clinics - September 26, 2018 Category: Orthopaedics Authors: Kim Slater Source Type: research

Chronic Lateral Ankle Instability
Open surgical reconstruction for chronic lateral ankle instability is a proven and effective means of providing renewed stability. Ankle arthroscopy is recommended before reconstruction to address intra-articular pathology. The open procedure discussed is well researched and proven to restore stability and the ability to return to sport and daily activity. Anatomic shortening with reattachment into a bony trough allows return to full motion, reliable stability, and return to an active lifestyle without sacrificing any tendons or requiring a tenodesis. The authors ’ aggressive rehabilitation protocol is provided; the ...
Source: Foot and Ankle Clinics - September 26, 2018 Category: Orthopaedics Authors: David A. Porter, Kreigh A. Kamman Source Type: research

Arthroscopic Treatment of Ankle Instability
Over the last 10  years, significant advances have been made and successful techniques have now been developed that effectively treat ankle instability via the arthroscope.Currently arthroscopic lateral ligament repair techniques can be grouped into “arthroscopic-assisted techniques,” “all-arthroscopic techni ques,” and “all-inside techniques.” Recent studies have proven these arthroscopic techniques to be a simple, safe, and biomechanically equivalent, stable alternative to open Brostrom Gould lateral ligament reconstruction. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 25, 2018 Category: Orthopaedics Authors: Jorge I. Acevedo, Robert C. Palmer, Peter G. Mangone Source Type: research

Medial Ankle Instability
Diagnosis and treatment of medial ankle instability (MAI) are still controversial and poorly discussed in literature. The purpose of this review is to highlight different clinical presentations of MAI and develop a guide for its management. The deltoid ligament complex is injured more commonly than expected, because deltoid ligament injuries may either be isolated or occur in combination with other lesions, such as lateral ankle ligament injury, posterior tibial tendon insufficiency, osteochondral lesion, and others. The presence of a pes planovalgus deformity in a patient without posterior tibial tendon insufficiency may ...
Source: Foot and Ankle Clinics - September 25, 2018 Category: Orthopaedics Authors: Saud Alshalawi, Ahmed E. Galhoum, Yousef Alrashidi, Martin Wiewiorski, Mario Herrera, Alexej Barg, Victor Valderrabano Source Type: research

Plantar Plate Injury and Angular Toe Deformity
Lesser toe plantar plate injuries at the metatarsophalangeal (MTP) joint are a common source of metatarsalgia. The second MTP joint is the most commonly affected digit. The fibrocartilaginous plantar plate is the most important static stabilizer of the MTP joint; high loading with weight bearing can lead to attritional plantar plate injuries. Chronic pain with weight bearing is the common presentation of lesser toe instability. Untreated plantar plate instability can lead to hammer toe and mallet toe deformities. Combined Weil osteotomy and plantar plate repair yields favorable pain relief and angular deformity correction ...
Source: Foot and Ankle Clinics - September 25, 2018 Category: Orthopaedics Authors: Craig C. Akoh, Phinit Phisitkul Source Type: research

Acute and Chronic Syndesmotic Injury
Ankle injuries are a common traumatic injury. Rupture to the syndesmosis may occur as a result of these injuries. Strategies for the treatment of both acute and chronic syndesmotic repair are reviewed in detail. Significance of Chaput, Wagstaffe, and posterior malleolus fractures on syndesmotic stability are reviewed. Treatment considerations for total ankle arthroplasty are discussed, and correction of coronal plane deformity as a result of late syndesmotic injury at the time of ankle arthroplasty is outlined. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 24, 2018 Category: Orthopaedics Authors: Michael Swords, Jean Brilhault, Andrew Sands Source Type: research

Turf Toe Injury - Current Concepts and an Updated Review of Literature
Turf toe injuries can be a disabling if not recognized and treated early. A high index of suspicion, based on the mechanism of injury and appropriate imaging, helps in the timely diagnosis. These injuries are frequently known to occur on artificial playing surfaces, because of the increased traction at the shoe-surface interface. Stress and instability testing are key components to assess the need for surgical intervention. Accurate timely diagnosis and treatment can allow full return to physical activities for most athletes, back to their pre-injury level. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 24, 2018 Category: Orthopaedics Authors: Tim M. Clough, Haroon Majeed Source Type: research

Low-Energy Lisfranc Injuries in an Athletic Population
Tarsometatarsal (TMT) joint complex injuries can be caused by either direct or indirect injuries. The Lisfranc joint represents approximately 0.2% of all fractures. Up to 20% of these injuries are misdiagnosed or missed on initial radiographic assessment; therefore, a high index of suspicion is needed to accurately diagnose TMT joint injuries and avoid the late sequelae of substantial midfoot arthrosis, pain, decreased function, and loss of quality of life. This review discusses the anatomy, diagnosis, and management of athletic Lisfranc injuries, including a description of the preferred minimally invasive surgical techniq...
Source: Foot and Ankle Clinics - September 24, 2018 Category: Orthopaedics Authors: Mario I. Escudero, Michael Symes, Andrea Veljkovic, Alastair S.E. Younger Source Type: research

Malalignment and Lateral Ankle Instability
A lower leg or hindfoot varus malalignment is a frequently encountered but underestimated cause of chronic ankle instability and ankle arthritis in the long term. When evaluating patients with ankle instability, a high index of clinical suspicion for tibia and hindfoot malalignment and subsequent biomechanics should be maintained. Management of lateral ankle instability in the presence of varus malalignment must comprise a generous indication for accurate hindfoot realignment. In young and active patients, realignment should be combined with formal lateral ligamentous repair. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 21, 2018 Category: Orthopaedics Authors: Fabian Krause, Angela Seidel Source Type: research

Revision of Surgical Lateral  Ankle Ligament Stabilization
Ankle sprains continue to be among the most common musculoskeletal injuries, most of which never require surgical treatment. Surgical treatment has traditionally been successful for those patients whose symptoms do not improve with nonoperative care. However, recurrent instability, although rare, can occur early or late after a stabilization procedure, as the result of an acute traumatic event or chronic repetitive minor injury. A complete workup of patients with recurrent ankle instability should be completed before revision surgery and should include evaluation for generalized joint hypermobility as well as anatomic vari...
Source: Foot and Ankle Clinics - September 21, 2018 Category: Orthopaedics Authors: Joseph T. O ’Neil, Gregory P. Guyton Source Type: research

Spring Ligament Instability
The crucial role of the spring ligament complex within the pathologic process that leads to flatfoot deformity has evolved recently. There has been improvement in the anatomic knowledge of the spring ligament and understanding of its complex relationship to the deltoid complex and outstanding advances in biomechanics concepts related to the spring ligament. Optimization of flatfoot treatment strategies are focused on a renewed interest in the spring ligament and medial soft tissue reconstruction in concert with bony correction to obtain an adequate reduction of the talonavicular deformity and restoration of the medial long...
Source: Foot and Ankle Clinics - September 21, 2018 Category: Orthopaedics Authors: Gonzalo F. Bastias, Miki Dalmau-Pastor, Claudia Astudillo, Manuel J. Pellegrini Source Type: research

Traumatic Injury to the Subtalar Joint
Traumatic injury to the subtalar joint occurs during subtalar dislocations, talar and calcaneal fractures, and fracture-dislocations. After closed reduction of subtalar dislocations, peripheral talar or calcaneal fractures need to be ruled out by computed tomography scanning. In fractures and fracture-dislocations of the talus and calcaneus involving the subtalar joint, anatomic reconstruction of joint congruity is essential for functional rehabilitation. Failure to anatomically reduce the subtalar joint potentially leads to chronic instability, subtalar arthritis and posttraumatic hindfoot deformity. Despite adequate mana...
Source: Foot and Ankle Clinics - August 8, 2018 Category: Orthopaedics Authors: Stefan Rammelt, Jan Barton íček, Kyeong-Hyeon Park Source Type: research

Update on Subtalar Joint Instability
Subtalar joint stability is ensured by the osseous geometry of the talocalcaneal joint and the complex array of the ligaments at the medial and lateral aspect of the ankle joint, the sinus and canalis tarsi, and the talocalcaneonavicular joint, respectively. There is still a substantial lack of knowledge about the interaction of the ankle and subtalar joint complex. Subtalar joint instability appears to be more frequent than is generally assumed. The diagnosis of chronic subtalar joint instability makes the application of a comprehensive algorithm necessary. There is ongoing debate about the preferable techniques for resto...
Source: Foot and Ankle Clinics - August 8, 2018 Category: Orthopaedics Authors: Thomas Mittlmeier, Stefan Rammelt Source Type: research

Medial Approach to the Subtalar Joint
Surgical access to the subtalar joint is required in a plethora of pathologic conditions of the hindfoot. The conventional lateral approach can give excellent access to subtalar joint; however, in hindfoot valgus deformities, there can be unacceptable risks of wound problems and incomplete deformity corrections. The medial approach offers good access to the subtalar joint with an increasing evidence base for its use, especially with double fusions in pes planus deformities. The authors review the current evidence in the use of the medial approach for the subtalar joint. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 8, 2018 Category: Orthopaedics Authors: James Widnall, Lyndon Mason, Andrew Molloy Source Type: research

Subtalar Arthroscopic Fusion
Arthroscopic subtalar fusion is an excellent approach to subtalar pathologic condition where conservative treatment has failed and a fusion has been indicated. Formal contraindications include excessive malalignment and bone loss. The posterior arthroscopic approach is analyzed in this article, including indications, surgical technique, surgical tips, and complications. Excellent results can be expected, including a shorter time to fusion, and faster rehabilitation, including activities of daily living and sports. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 8, 2018 Category: Orthopaedics Authors: Emilio A. Wagner, Rodrigo Melo Source Type: research

Subtalar Distraction Arthrodesis
The subtalar joint can be altered in its anatomy and biomechanical behavior. It is important to know how to assess the talar declination angle in order to assess the deformity at the subtalar joint. Consider a straight posterior approach to the subtalar joint and remain liberal in the use of z-shaped Achilles tendon lengthening. A structural bone graft should be used to elevate the talus. Positioning screws should be used to lock the construct. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 8, 2018 Category: Orthopaedics Authors: Norman Espinosa, Elena Vacas Source Type: research

Fractures of the Lateral Process of the Talus
This article proposes modifying the existing classification by differentiating the multifragmented type III into 3 subtypes: IIIa, articular multifragmented but metaphyseal simple; IIIb, articular and metaphyseal multifragmented but reconstructable; and type IIIc, comminuted and nonreconstructable. A treatment-algorithm is presented. Undisplaced fractures are usually treated conservatively and displaced are an indication for surgery. In general, the outcome is good to excellent, if timely diagnosed and adequately treated. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 8, 2018 Category: Orthopaedics Authors: Christian Tinner, Christoph Sommer Source Type: research

The Subtalar Joint
FOOT AND ANKLE CLINICS (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 8, 2018 Category: Orthopaedics Authors: Norman Espinosa Source Type: research

Copyright
ELSEVIER (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 8, 2018 Category: Orthopaedics Source Type: research

Contributors
MARK S. MYERSON, MD (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 8, 2018 Category: Orthopaedics Source Type: research

Editorial Advisory Board
J. Kent Ellington, MD, MS (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 8, 2018 Category: Orthopaedics Source Type: research

Contents
Norman Espinosa (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 8, 2018 Category: Orthopaedics Source Type: research

Forthcoming Issues
Managing Instabilities of the Foot and Ankle (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 8, 2018 Category: Orthopaedics Source Type: research

Anatomy of the Subtalar Joint
The subtalar joint is divided into the talocalcaneonavicular and the talocalcaneal joint, separated by a conical interosseous tunnel (canalis and sinus tarsi). The talocalcaneonavicular joint is a ball-and-socket articulation (coxa pedis). An important part of the coxa pedis is the spring ligament. The canalis and sinus tarsi are occupied by the roots of the inferior extensor retinaculum, cervical ligament, interosseous talocalcaneal ligament, and anterior talocalcaneal ligament. Three-dimensional motion in the subtalar joint complex (eversion/inversion) is guided by the axial alignment of the talus, calcaneus, and navicul...
Source: Foot and Ankle Clinics - July 3, 2018 Category: Orthopaedics Authors: Jan Barton íček, Stefan Rammelt, Ondřej Naňka Source Type: research

Subtalar Joint Biomechanics
Subtalar joint biomechanics are primarily driven by the shape of the articulations with contributions from the surrounding soft tissues. The joint motion occurs about a single axis oriented medially and superiorly. Joint contact forces change during different stages of gait and are affected by hindfoot alignment and traumatic alterations to their normal anatomy. A valgus subtalar joint axis is likely a contributing, and perhaps primary, risk factor for progression to adult acquired flat foot. The subtalar joint axis also contributes to the clinical picture of a cavus foot and a special subset of patients with dynamic varus...
Source: Foot and Ankle Clinics - July 3, 2018 Category: Orthopaedics Authors: Adam Sangeorzan, Bruce Sangeorzan Source Type: research

Open Technique for In Situ Subtalar Fusion
This article aims to describe a technique for in  situ arthrodesis of the subtalar joint, paying special attention to biomechanical aspects as well as preoperative clinical and radiological work-up. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - July 3, 2018 Category: Orthopaedics Authors: Stephan H. Wirth, Stefan M. Zimmermann, Arnd F. Vieh öfer Source Type: research

Arthroereisis
One of the most common orthopedic problems in the authors ’ practice is flatfoot and, although it is most commonly treated conservatively, there is still lack of consensus about the type of surgical treatment that is best recommended in a specific patient. Keeping in mind that medial soft tissue reconstruction alone has not proved enough as an isolated p rocedure and that osteotomies and arthrodesis are considered more invasive surgery, arthroereisis is a quick, easy, and reproducible technique that seems to have good results without major complications in the correct patient. Indications, biomechanical principles, a...
Source: Foot and Ankle Clinics - July 3, 2018 Category: Orthopaedics Authors: Cristian A. Ortiz, Emilio A. Wagner, Pablo A. Wagner Source Type: research

Coalitions of the Tarsal Bones
Tarsal coalitions are the result of impaired mesenchymal separation of the tarsal bones. The most common types include calcaneonavicular or talocalcaneal coalitions. Subtalar stiffness results in pathologic kinematics with increased risk of ankle sprains, planovalgus foot deformity, and progressive joint degeneration. Resection of the coalition yields good results. Tissue interposition may reduce the risk of reossification, and concomitant deformity should be addressed in the same surgical setting. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 27, 2018 Category: Orthopaedics Authors: Georg Klammer, Norman Espinosa, Lukas Daniel Iselin Source Type: research

The Subtalar Joint
The subtalar joint is a fascinating structure and, as Leonardo da Vinci would state, “a masterpiece of engineering.” The complex structure and its function are not yet completely understood. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 15, 2018 Category: Orthopaedics Authors: Norman Espinosa Tags: Preface Source Type: research

Sesamoid Position in Hallux Valgus in Relation to the Coronal Rotation of the First Metatarsal
Hallux valgus (HV) is not a simple two-dimensional deformity but is instead a three-dimensional deformity that is closely linked to sesamoid position and first metatarsal (MT) pronation. HV may or may not be accompanied by sesamoid subluxation and/or first MT head pronation. Each of these scenarios should be assessed using weighted computed tomography scan preoperatively, and the necessary corrections should be performed accordingly. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 3, 2018 Category: Orthopaedics Authors: Jin Su Kim, Ki Won Young Source Type: research

Comparison of Three-Dimensional Displacement Among Different Metatarsal Osteotomies
This article will review the 3-dimensional components of bony displacement in different surgical methods for hallux valgus correction. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 3, 2018 Category: Orthopaedics Authors: Young Yi, Woo-Chun Lee Source Type: research

Hallux Valgus Deformity and Treatment
The cause and effect between hallux valgus and first ray hypermobility continues to be debated. Understanding the anatomic and radiographic examination of the first metatarsocuneiform (MTC) joint is critical to choosing an appropriate treatment algorithm for the surgical management of hallux valgus deformity. Some studies suggest hypermobility can be corrected without fusing the first MTC joint. Some think hypermobility arises secondarily from malalignment of the soft tissue constraints as the hallux valgus deformity progresses. Others think hypermobility is a primary cause of the hallux valgus deformity and have reported ...
Source: Foot and Ankle Clinics - May 3, 2018 Category: Orthopaedics Authors: Jesse Forbes Doty, Wallace Taylor Harris Source Type: research

How Do I Use the Scarf Osteotomy to Rotate the Metatarsal and Correct the Deformity in Three Dimensions?
The scarf osteotomy has become the workhorse procedure for a large proportion of foot and ankle surgeons, especially in Europe, in the treatment of hallux valgus. Such a versatile procedure should not be underestimated, and planning and thought should precede any such procedure. The angle of bone cuts and magnitude of translation dictate the final position, and all movement axes should be given equal attention. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 3, 2018 Category: Orthopaedics Authors: Eric Swanton, Lyndon Mason, Andy Molloy Source Type: research

Hallux Valgus/Medial Column Instability and Their Relationship with Posterior Tibial Tendon Dysfunction
Historically, bunions have focused on the coronal plane; however, there is tension and compression failure in the sagittal plane of the midfoot during arch collapse. Correction of all 3 planes of deformity, coronal, sagittal, and rotational, can be achieved in several ways. Taking a big picture of global foot mechanics by recognizing the common types of conditions associated with arch collapse, including hallux valgus deformities, can serve as a useful roadmap for navigating more complicated deformities where hallux valgus exists. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 3, 2018 Category: Orthopaedics Authors: Steven Blackwood, Leland Gossett Source Type: research

Hallux Valgus: A Three-Dimensional Approach
Hallux valgus is a common deformity that often requires surgical correction. Therefore, every foot and ankle surgeon is familiar with several procedures for hallux valgus deformity. However, there are many recurrences and complications after hallux valgus surgery. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 3, 2018 Category: Orthopaedics Authors: Woo-Chun Lee Tags: Preface Source Type: research

Hallux Valgus Deformity and Treatment: A Three-Dimensional Approach
FOOT AND ANKLE CLINICS (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 3, 2018 Category: Orthopaedics Authors: Woo-Chun Lee Source Type: research

Copyright
ELSEVIER (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 3, 2018 Category: Orthopaedics Source Type: research

Contributors
MARK S. MYERSON, MD (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 3, 2018 Category: Orthopaedics Source Type: research

Editorial Advisory Board
J. Kent Ellington, MD, MS (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 3, 2018 Category: Orthopaedics Source Type: research

Contents
Woo-Chun Lee (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 3, 2018 Category: Orthopaedics Source Type: research

Forthcoming Issues
The Subtalar Joint (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 3, 2018 Category: Orthopaedics Source Type: research

Imaging of Hallux Valgus
This article describes the pathogenesis of hallux valgus (HV) and the traditional ways to image the deformities. It also discusses up-to-date advances and research in the field of imaging in HV. This includes weight-bearing computed tomography (CT) scanning, MRI, ultrasound and intraoperative imaging. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - March 22, 2018 Category: Orthopaedics Authors: Matthew James Welck, Naji Al-Khudairi Source Type: research

How I Use a Three-Dimensional Approach to Correct Hallux Valgus with a Distal Metatarsal Osteotomy
The role of uniplanar osteotomy in correction of multiplanar deformity in hallux valgus is a developing and promising concept. Careful consideration should be given to the literature when considering the concept of preexisting pronation of the metatarsal. Recent weight-bearing computed tomography studies contradict the existing literature and state that there is little or no rotation of the metatarsal; therefore, a multiplanar osteotomy should aim to correct the rotation caused by soft tissue imbalance at the tarsometatarsal and metatarsophalangeal joints rather than in the metatarsal itself. A minimally invasive technique...
Source: Foot and Ankle Clinics - March 22, 2018 Category: Orthopaedics Authors: Daniel M.G. Winson, Anthony Perera Source Type: research

Imaging of Hallux Valgus
This article describes the pathogenesis of hallux valgus (HV) and the traditional ways to image the deformities. It also discusses up-to-date advances and research in the field of imaging in HV. This includes weight-bearing computed tomography (CT) scanning, MRI, ultrasound and intraoperative imaging. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - March 22, 2018 Category: Orthopaedics Authors: Matthew James Welck, Naji Al-Khudairi Source Type: research

How I Use a 3-Dimensional Approach to Correct Hallux Valgus with a Distal Metatarsal Osteotomy
The role of uniplanar osteotomy in correction of multiplanar deformity in hallux valgus is a developing and promising concept. Careful consideration should be given to the literature when considering the concept of preexisting pronation of the metatarsal. Recent weight-bearing computed tomography studies contradict the existing literature and state that there is little or no rotation of the metatarsal; therefore, a multiplanar osteotomy should aim to correct the rotation caused by soft tissue imbalance at the tarsometatarsal and metatarsophalangeal joints rather than in the metatarsal itself. A minimally invasive technique...
Source: Foot and Ankle Clinics - March 22, 2018 Category: Orthopaedics Authors: Daniel M.G. Winson, Anthony Perera Source Type: research

Is the Rotational Deformity Important in Our Decision-Making Process for Correction of  Hallux Valgus Deformity?
Rotational deformity in hallux valgus is a recognized component and a demonstrated recurrence factor in patients who have undergone surgery. More than 20  years ago, publications started reporting metatarsal pronation as part of the hallux valgus pathology. Identifying metatarsal pronation should be part of the preoperative angular measurements. The proximal metatarsal rotational osteotomy and Lapidus fusion are some of the few techniques that relia bly correct metatarsal pronation. They have good results, with more nonunions reported for the Lapidus. The authors present their hallux valgus treatment algorithm that in...
Source: Foot and Ankle Clinics - March 9, 2018 Category: Orthopaedics Authors: Pablo Wagner, Emilio Wagner Source Type: research

Hallux Valgus Deformity and Treatment
In a hallux valgus deformity, the problem is deviation of the hallux at the metatarsophalangeal joint and of the first metatarsal at the tarsometatarsal joint. Although anterior-posterior radiograph findings have been prioritized, deviation in the other planes can substantially change visible cues. The modified technique for Lapidus procedure procedure, uses all 3 planes to evaluate and correct the deformity, making radiographic measurements less useful. Using a triplane framework and focusing on the apex of the deformity, all bunions become the same modified technique for Lapidus procedure can be performed regardless of t...
Source: Foot and Ankle Clinics - March 9, 2018 Category: Orthopaedics Authors: Robert D. Santrock, Bret Smith Source Type: research