The Role Of Minimally Invasive Osteotomies In Cavovarus Foot Reconstruction: Detailed Technique And Evidence For Procedures
This article presents the operative technique for percutaneous cavus foot correction including a lateralizing calcaneal osteotomy and proximal first ray osteotomy. However, methodologically robust evidence to support this procedure is lacking at present, and further research, particularly, focusing on long-term clinical outcomes and follow-up is required. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 26, 2023 Category: Orthopaedics Authors: Razi Zaidi, Thomas Lorchan Lewis, Robbie Ray Source Type: research
SPECT/CT of Total Ankle Arthroplasty
Use of SPECT/CT (Single Photon Emission Computed Tomography/Computed Tomography) is increasing providing additional information in patients with inconclusive clinical examination and unremarkable imaging findings presenting with chronic pain after total ankle arthroplasty. To differentiate the cause of pain after total ankle arthroplasty can be challenging. SPECT/CT combines structural and metabolic imaging as a hybrid tool leading to higher specificity and overall diagnostic accuracy presumably in cases of gutter impingement, prosthetic loosening, and osteoarthritis of adjacent joints. Moreover, SPECT/CT can complement di...
Source: Foot and Ankle Clinics - June 26, 2023 Category: Orthopaedics Authors: Alena Richter, Christian Plaass, Christina Stukenborg-Colsman Source Type: research
Cavovarus Deformity
Cavovarus foot is a complex three-dimensional deformity, which includes a wide range of clinical conditions from subtle deformities to disabling feet. In this article, the authors discuss the role of weight-bearing computed tomography, which might enable to avoid double imaging (radiographs + tomography) in patients for which a detailed osteoarticular assessment is required, with the advantage to obtain tomographic images in standing position and a reduction of radiation exposure. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 26, 2023 Category: Orthopaedics Authors: Fran çois Lintz, Alessio Bernasconi Source Type: research
Innovative Approaches on Cavovarus Deformity
This article presents the operative technique for percutaneous cavus foot correction including a lateralizing calcaneal osteotomy and proximal first ray osteotomy. However, methodologically robust evidence to support this procedure is lacking at present, and further research, particularly, focusing on long-term clinical outcomes and follow-up is required. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 26, 2023 Category: Orthopaedics Authors: Razi Zaidi, Thomas Lorchan Lewis, Robbie Ray Source Type: research
Innovative Approaches on Cavovarus Deformity
The cavovarus foot is a complex deformity that can be treated using multiple surgical procedures, ranging from soft tissue surgery to triple arthrodesis. Among these options, anterior midfoot tarsectomy is a three-dimensional closed-wedge osteotomy, traditionally performed slowly and progressively in a blind fashion, and remaining a challenge for unexperimented surgeons with variable outcomes. As such, we investigated and discussed the use of patient-specific cutting guides (PSCGs) in computer-assisted anterior midfoot tarsectomy in terms of accuracy, reproducibility, and safety. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 26, 2023 Category: Orthopaedics Authors: Julie Mathieu, Louis Dagneaux, CAOS France Source Type: research
Charcot-Marie-Tooth Disease
In Charcot-Marie-Tooth (CMT) cavovarus surgery, a regimented approach is critical to create a plantigrade foot, restore hindfoot stability, and generate active ankle dorsiflexion. The preoperative motor examination is fundamental to the algorithm, as it is not only guides the initial surgical planning but is key in the decision making that occurs throughout the operation. Surgeons need to be comfortable with multiple techniques to achieve each surgical goal. There is no one operation that works for all patients with CMT. A plantigrade foot is the most important of the surgical goals as hindfoot stability and ankle dorsifle...
Source: Foot and Ankle Clinics - June 26, 2023 Category: Orthopaedics Authors: Glenn B. Pfeffer, Max P. Michalski Source Type: research
Osteomyelitis and Septic Arthritis of the Foot and Ankle
Radiography is considered the first-line screening exam for clinically suspected osteomyelitis. However, additional evaluation is generally needed. MRI is the definitive diagnostic exam with high sensitivity and specificity combined with excellent anatomic definition. Gadolinium contrast can be useful to detect areas of devitalization before surgery. Bone marrow edema on fluid-sensitive images and low signal intensity on T1-weighted images in the presence of secondary MRI findings, including ulcer, sinus tract, and cellulitis with or without abscess are typical findings of osteomyelitis. If MRI is contraindicated, three ph...
Source: Foot and Ankle Clinics - June 26, 2023 Category: Orthopaedics Authors: Islam Zaki, William B. Morrison Source Type: research
Is Subtle Cavovarus a Problem for Athletes?
Cavovarus or high-arched foot is a common foot deformity that occurs due to the disruption of the foot-driven equilibrium between the first metatarsal, fifth metatarsal, and the heel. This imbalance leads to an increase in the foot ’s normal plantar concavity. Cavovarus deformity ranges from a mild and flexible malalignment to a fixed, complex, and severe deformation. Subtle cavovarus foot, the mild form of the cavus foot, was first described by Manoli and colleagues. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 26, 2023 Category: Orthopaedics Authors: Ashraf T. Hantouly, Ahmed Khalil Attia, Khalid Hasan, Pieter D ’Hooghe Source Type: research
Total Ankle Replacement in Cavovarus Deformity
Because of the good functional results and satisfactory implant survival achieved with modern models, total ankle replacement (TAR) has become a legitimate alternative to ankle fusion. However, alignment and balance are mandatory for implant survival. Satisfactory results can be achieved in patients with significant preoperative deformity if alignment and balance were obtained. If not, a staged procedure involving deformity correction and secondary TAR is possible. The authors describe the principal aspects of this concept and illustrate their current approach to TAR in cavovarus deformity. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 26, 2023 Category: Orthopaedics Authors: Jean M. Brilhault, Gaspard Auboyneau, Louis Rony Source Type: research
Presurgical and Postsurgical MRI Evaluation of Osteochondral Lesions of the Foot and Ankle
The gold standard diagnostic imaging tool for ankle OCLs is magnetic resonance imaging, which allows precise evaluation of the articular cartilage and assessment of the surrounding soft tissue structures. Post-operative morphologic MRI assessment via MOCART scores provide semi-quantitative analysis of the repair tissue, but mixed evidence exists regarding its association with post-operative outcomes. Post-operative biochemical MRIs allow assessment of the collagen network of the articular cartilage via T2-mapping and T2 ∗ mapping, and assessment of the articular glycosaminoglycan content via delayed gadolinium-enhanced M...
Source: Foot and Ankle Clinics - June 23, 2023 Category: Orthopaedics Authors: James J. Butler, Taylor Wingo, John G. Kennedy Source Type: research
Multiaxial 3D MRI of the Ankle
This article provides an overview of the clinical application of 3D MRI of the ankle, compares diagnostic performances of 2D and 3D MRI for diagnosing ankle abnormalities, and illustrates clinical 3D ank le MRI applications. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 20, 2023 Category: Orthopaedics Authors: Benjamin Fritz, Cesar de Cesar Netto, Jan Fritz Source Type: research
Hindfoot Fusions in the Cavovarus Foot
The aim of hindfoot fusions in the cavovarus foot is to establish a painless, plantigrade, balanced and stable foot. A comprehensive clinical and radiographic assessment enables the surgeon to fully understand the patient ’s deformity and plan a reliable surgical strategy for deformity correction. Pre-operative planning and intraoperative techniques are discussed. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 17, 2023 Category: Orthopaedics Authors: Matthew James Welck, Anil Haldar Source Type: research
Managing Cavovarus Feet in Diabetic Patients
A cavovarus foot is characterized by exacerbated medial longitudinal arch (cavus), hindfoot varus, plantar flexed first ray, forefoot pronation (apparent supination), forefoot adduction, and claw toe deformities. It can be broadly divided as flexible and rigid and further classified based on the neurological and non-neurological causes. Diabetes associated peripheral neuropathy complicates individual bony deformities associated with cavovarus foot with early callus which can breakdown to ulceration rapidly. Based on the disease progression in neurological and non-neurological causes of cavovarus feet in patients with diabe...
Source: Foot and Ankle Clinics - June 17, 2023 Category: Orthopaedics Authors: Madhu Tiruveedhula, Venu Kavarthapu Source Type: research
Nonneurologic Cavovarus Feet in Skeletally Immature Patients
The foot resembles a tripod. The 3 legs consist of (1) the tip of the heel, (2) the first metatarsal, and (3) the fifth metatarsal. This concept is useful to explain cavus or flat feet. When the tips of the tripod move closer, the arch becomes higher. The leg of the tripod that moves the most will determine the type of cavus feet, which can be hindfoot cavus, forefoot cavus, or first metatarsal cavus. Cavovarus foot denotes the presence of a three-dimensional deformity of the foot, but it is much more a descriptive feature than a diagnosis. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 17, 2023 Category: Orthopaedics Authors: Jordanna Maria Pereira Bergamasco, No é De Marchi Neto, Marco Túlio Costa Source Type: research
Advanced Foot and Ankle Imaging: Breaching New Frontiers for More Accurate Diagnosis and Post-Operative Care
Imaging is a critical component in diagnosing ankle conditions and postoperative care. While radiography remains the bedrock of first-line imaging, MRI, computed tomography, and ultrasonography permit the noninvasive diagnosis of a broad spectrum of injuries, conditions, and abnormalities of bones, joints, ligaments, muscle-tendon units, nerves, and vessels. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 17, 2023 Category: Orthopaedics Authors: Jan Fritz Tags: Preface Source Type: research
