A Proposed Staging Classification for Minimally Invasive Management of Haglund's Syndrome with Percutaneous and Endoscopic Surgery
Haglund ’s syndrome encompasses several different pathologies, including Haglund’s deformity, insertional Achilles tendonopathy, retrocalcaneal bursitis, and superficial bursitis. Traditionally treated with open surgery, there is increasing interest in a more minimally invasive approach to this difficul t region to reduce complications and improve the rate and ease of recovery. We review the evidence available for 2 of these techniques: the endoscopic calcaneoplasty and percutaneous Zadek’s calcaneal osteotomy (also known as Keck and Kelly’s osteotomy). The senior author’s classification for m...
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Authors: Turab Arshad Syed, Anthony Perera Source Type: research

Minimally Invasive Osteotomies of the Calcaneus
Osteotomies of the calcaneus are powerful surgical tools, representing a critical component of the surgical reconstruction of pes planus and pes cavus deformity. Modern minimally invasive calcaneal osteotomies can be performed safely with a burr through a lateral incision. Although greater kerf is generated with the burr, the effect is modest, can be minimized, and is compatible with many fixation techniques. A hinged jig renders the procedure more reproducible and accessible. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Authors: Gregory P. Guyton Source Type: research

Percutaneous Hindfoot and Midfoot Fusion
Hindfoot and midfoot fusions can be performed with percutaneous techniques. Preliminary results of these procedures are encouraging because they provide similar results than those obtained with open techniques with less morbidity and quick recovery. The best indications are probably fusions for mild-to-moderate reducible hindfoot and midfoot deformities in fragile patients with general or local bad conditions. The main limit is linked to the surgeon ’s experience in percutaneous foot surgery because a learning curve with the specific tools is necessary before doing these procedures. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Authors: Thomas Bauer Source Type: research

Endoscopic Ankle Lateral Ligament Graft Anatomic Reconstruction
This article describes an endoscopic technique, using a step-by-step approach, to reconstruct the ATFL and CFL with a gracilis graft. The endoscopic technique is reproducible and safe with regard to the surrounding anatomic structures. Short and midterm results confirm the benefits of this technique. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Authors: Frederick Michels, Guillaume Cordier, St éphane Guillo, Filip Stockmans, ESKKA-AFAS Ankle Instability Group Source Type: research

Managing Complications of Percutaneous Surgery of the First Metatarsal
The percutaneous osteotomy based on a Hohmanntype first metatarsal subcapital linear osteotomy was introduced into Mainland China in the late 1980s. No internal fixation is used for stabilization of the osteotomy, leading unfortunately to unpredictable results. Despite its high acceptance by patients and enthusiasm by surgeons at present, the clinical outcomes of percutaneous surgery have not been promising. The authors have no experience of performing this osteotomy and report only on their management of the complications of this technique and their recommended treatment algorithm. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Authors: Shu-Yuan Li, Jian-Zhong Zhang, Yong-Tao Zhang Source Type: research

Neuropathic Minimally Invasive Surgeries (NEMESIS):
Patients with peripheral neuropathy associated with ulceration are the nemesis of the orthopedic foot and ankle surgeon. Diabetic foot syndrome is the leading cause of peripheral neuropathy, and its prevalence continues to increase at an alarming rate. Poor wound healing, nonunion, infection, and risk of amputation contribute to the understandable caution toward this patient group. Significant metalwork is required to hold these technically challenging deformities. Neuropathic Minimally Invasive Surgeries is an addition to the toolbox of management of the diabetic foot. It may potentially reduce the risk associated with la...
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Authors: Roslyn J. Miller Source Type: research

Arthroscopic Subtalar, Double, and Triple Fusion
Arthroscopic approaches to subtalar, double, and triple arthrodesis allow relative preservation of the soft tissue envelope compared with traditional open approaches. The surgical technique involving the use of a 4.5-mm 30 ° arthroscope via sinus tarsi portals is described. All 3 joints of the triple joint can be prepared for fusion with motorized burrs. Rigid fixation is achieved with cannulated screws. High union rates and low complication rates have been reported. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Authors: Richard Walter, Stephen Parsons, Ian Winson Source Type: research

Advances in Minimally Invasive Surgery of the Foot and Ankle —Percutaneous, Arthroscopic, and Endoscopic Operative Techniques
The development in our understanding of the foot and ankle over the last 20 years has given us a very good idea of what needs to be changed in order to correct most conditions. In addition, over the last 10 years, there has been a major focus on advances in implant technology and options to the extent that the reliability of achieving and maintaining that correction has also greatly improved. However, in contrast to other fields, for instance, trauma surgery where minimizing the approach is an important driver of change, little has changed with regard to the surgical approach in the foot and ankle. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Authors: Anthony Perera Tags: Preface Source Type: research

Minimally Invasive Surgery in the Foot and Ankle
FOOT AND ANKLE CLINICS (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Authors: Anthony Perera Source Type: research

Copyright
ELSEVIER (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Source Type: research

Contributors
MARK S. MYERSON, MD (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Source Type: research

Contents
Anthony Perera (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Source Type: research

Forthcoming Issues
Bone Grafts, Bone Graft Substitutes, and Biologics in Foot and Ankle Surgery (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Source Type: research

Index
Note: Page numbers of article titles are in boldface type. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 13, 2016 Category: Orthopaedics Source Type: research

Percutaneous Pediatric Foot and Ankle Surgery
The techniques for performing percutaneous osteotomies in treating deformities of the foot in children are presented along with a detailed description of the operative details. The author ’s use of minimal-access surgery for tibial, os calcis, and midfoot osteotomies is described using a cooled side-cutting burr that has not previously been described for use in the child’s foot. The cancellous nature of the bones in the child are easily cut with the burr and the adjacent soft tis sues are not damaged. The early experience of the healing times are not impaired and the complications associated with percutaneous s...
Source: Foot and Ankle Clinics - June 29, 2016 Category: Orthopaedics Authors: Michael G. Uglow Source Type: research

Percutaneous Pediatric Foot and Ankle Surgery
The techniques for performing percutaneous osteotomies in treating deformities of the foot in children are presented along with a detailed description of the operative details. The author’s use of minimal-access surgery for tibial, os calcis, and midfoot osteotomies is described using a cooled side-cutting burr that has not previously been described for use in the child’s foot. The cancellous nature of the bones in the child are easily cut with the burr and the adjacent soft tissues are not damaged. The early experience of the healing times are not impaired and the complications associated with percutaneous sca...
Source: Foot and Ankle Clinics - June 29, 2016 Category: Orthopaedics Authors: Michael G. Uglow Source Type: research

Total Toe Replacement in the United States
This article reviews the literature for implants currently available and describes the surgical techniques. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 1, 2016 Category: Orthopaedics Authors: Michael D. Johnson, Michael E. Brage Source Type: research

Minimally Invasive Forefoot Surgery in France
The objective of this article was to advance the awareness of the current trends in minimally invasive surgery for common diseases of the forefoot. The percutaneous surgery at the forefoot is less developed at this time, but also will be discussed. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 1, 2016 Category: Orthopaedics Authors: Tristan Meusnier, Prikesht Mukish Source Type: research

State-of-the-Art in Ankle Fracture Management in Chile
The ankle represents the most commonly injured weightbearing joint in the human body. They are typically the result of low-energy, rotational injury mechanisms. However, ankle fractures represent a spectrum of injury patterns from simple to very complex, with varying incidence of posttraumatic arthritis. Stable injury patterns can be treated nonoperatively; unstable injury patterns are typically treated operatively given that they could lead to severe arthritis if not properly addressed. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 1, 2016 Category: Orthopaedics Authors: Cristián A. Ortiz, Pablo Wagner, Emilio Wagner Source Type: research

Recent Advances in Egypt for Treatment of Talar Osteochondral Lesions
This article highlights current state-of-the-art techniques and reviews recent advances in the literature about articular cartilage repair using various novel tissue engineering approaches, including various scaffolds, growth factors, and cell niches; which include chondrocytes and culture-expanded bone marrow-derived mesenchymal stem cells. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 1, 2016 Category: Orthopaedics Authors: Amgad M. Haleem, Mostafa M. AbouSayed, Mohammed Gomaa Source Type: research

Total Ankle Arthroplasty
Total ankle arthroplasty use has increased across Canada over the last two decades. Multiple implant designs are readily available and implanted across Canada. Although arthrodesis is a reliable procedure for treating end-stage ankle arthritis, ankle replacement is often the preferred surgical treatment by patients. A recent prospective study evaluated intermediate-term outcomes of ankle replacement and arthrodesis at multiple centers across Canada, with variability in prosthesis type, surgeon, and surgical technique. Intermediate-term clinical outcomes of total ankle replacement and ankle arthrodesis were comparable ...
Source: Foot and Ankle Clinics - June 1, 2016 Category: Orthopaedics Authors: Warren C.W. Latham, Johnny T.C. Lau Source Type: research

My Experience as a Foot and Ankle Trauma Surgeon in Montreal, Canada
This article outlines numerous techniques and tricks that are not always mentioned in classic textbooks. It focuses on ankle, talus, calcaneus, and midfoot fractures, and discusses numerous techniques and aids to avoid potential problems that may be encountered intraoperatively. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 1, 2016 Category: Orthopaedics Authors: Stéphane Leduc, Marie-Lyne Nault, Dominique M. Rouleau, Jonah Hebert-Davies Source Type: research

Preface
Today’s world disseminates information at a rapid rate, with the Internet and social media bringing current events, in real time, into our homes. Progress occurs at a much faster pace than many of us are accustomed to. Innovation in health care is not only driven by technology, it is also driven by ideas. In this information age, the rapid spread of data allows all of us access to the same ideas and technology, regardless of nationality or location. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 1, 2016 Category: Orthopaedics Authors: John G. Anderson, Donald R. Bohay Source Type: research

New Ideas and Techniques in Foot and Ankle Surgery: A Global Perspective
FOOT AND ANKLE CLINICS (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 1, 2016 Category: Orthopaedics Authors: John G. Anderson, Donald R. Bohay Source Type: research

Copyright
ELSEVIER (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 1, 2016 Category: Orthopaedics Source Type: research

Contributors
MARK S. MYERSON, MD (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 1, 2016 Category: Orthopaedics Source Type: research

Contents
John G. Anderson and Donald R. Bohay (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 1, 2016 Category: Orthopaedics Source Type: research

Forthcoming Issues
Minimally Invasive Surgery in the Foot and Ankle (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 1, 2016 Category: Orthopaedics Source Type: research

Index
Note: Page numbers of article titles are in boldface type. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - June 1, 2016 Category: Orthopaedics Source Type: research

Cheilectomy for Hallux Rigidus
Hallux rigidus is a degenerative condition leading to arthritis of the first metatarsophalangeal joint. Cheilectomy is a surgical procedure that is used in the treatment of hallux rigidus. It removes dorsal and dorsomedial or dorsolateral osteophytes, primarily relieving the impingement at the first metatarsophalangeal joint, which causes patients pain. The minimally invasive technique has proven to be an excellent technique to remove bony spurs to relieve symptoms with minimal surgical complications and fast recovery time. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 24, 2016 Category: Orthopaedics Authors: Aisha Razik, A.H. Sott Source Type: research

Minimally Invasive Arthrodesis of 1st Metatarsophalangeal Joint for Hallux Rigidus
This article describes and discusses a percutaneous technique that has been successfully used to achieve a pain-free stable and functional 1st metatarsophalangeal joint. All aspects of surgical indication and operative technique and details of patient-reported outcomes are presented with a referenced discussion. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 24, 2016 Category: Orthopaedics Authors: A.H. Sott Source Type: research

Cheilectomy for Hallux Rigidus
Hallux rigidus is a degenerative condition leading to arthritis of the first metatarsophalangeal joint. Cheilectomy is a surgical procedure that is used in the treatment of hallux rigidus. It removes dorsal and dorsomedial or dorsolateral osteophytes, primarily relieving the impingement at the first metatarsophalangeal joint, which causes patients pain. The minimally invasive technique has proven to be an excellent technique to remove bony spurs to relieve symptoms with minimal surgical complications and fast recovery time. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 24, 2016 Category: Orthopaedics Authors: Aisha Razik, A.H. Sott Source Type: research

Minimally Invasive Arthrodesis of 1st Metatarsophalangeal Joint for Hallux Rigidus
This article describes and discusses a percutaneous technique that has been successfully used to achieve a pain-free stable and functional 1st metatarsophalangeal joint. All aspects of surgical indication and operative technique and details of patient-reported outcomes are presented with a referenced discussion. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - May 24, 2016 Category: Orthopaedics Authors: A.H. Sott Source Type: research

Controversies and Trends in United Kingdom Bunion Surgery
Current practice and controversies in UK bunion surgery are discussed. Patients tend to be offered a distally based metatarsal osteotomy, such as a chevron or scarf osteotomy, for mild to moderate symptomatic bunions. Greater deformities are managed with a more extreme scarf, supplemented with a proximal phalangeal osteotomy. A proximal fusion in the form of the Lapidus-type procedure is still reserved for the most severe, hypermobile, or arthritic cases. Minimally invasive techniques for bunions have failed to disseminate into common UK practice. The trends in the United Kingdom regarding litigation, venous thromboembolis...
Source: Foot and Ankle Clinics - April 6, 2016 Category: Orthopaedics Authors: William D. Harrison, Christopher R. Walker Source Type: research

Sports Medicine and Arthroscopic Treatment of the Foot and Ankle
Foot and ankle abnormalities are common in Singapore because of the compulsory conscription, the slipper-wearing culture, and the promotion of healthy living through exercise. The rapidly aging population, lack of elite sportsmen, and social and cultural norms pose unique challenges to foot and ankle surgery. Orthopedic surgery in Singapore has progressed because of the good infrastructure and modern practices executed by fellowship-trained surgeons. Evolving local practices are polarized by practice trends emulated from North America and Europe. The small community of foot and ankle surgeons currently practicing in Singap...
Source: Foot and Ankle Clinics - April 5, 2016 Category: Orthopaedics Authors: Sean Wei Loong HO, Gowreeson Thevendran Source Type: research

Current Swiss Techniques in Management of Lisfranc Injuries of the Foot
This article outlines current techniques in the management of Lisfranc injuries and resultant postoperative outcomes in a level I trauma center. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - April 5, 2016 Category: Orthopaedics Authors: Fabian Krause, Timo Schmid, Martin Weber Source Type: research

Foot and Ankle Injuries in Professional Soccer Players
Soccer is one of the most popular sports in the world. It has undergone many changes in recent years, mainly because of increased physical demands, and this has led to an increased injury risk. Direct contact accounts for half of all injuries in both indoor and outdoor soccer and ankle sprains are the most common foot and ankle injury. There is a spectrum of foot and ankle injuries and their treatment should be individualized in these high-demand patients. An injury prevention program is also important and should the players, the trainer, responsible physician, and physical therapists. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - April 2, 2016 Category: Orthopaedics Authors: Caio Nery, Fernando Raduan, Daniel Baumfeld Source Type: research

What ’s New in Severe Deformity Correction
This article presents some basic principles for evaluating the deformity and a toolkit of procedures to deal with these complex cases. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - March 31, 2016 Category: Orthopaedics Authors: Sebastian Schmitt, Anna C. Peak, Gregor Berrsche, Wolfram Wenz Source Type: research

What’s New in Severe Deformity Correction
This article presents some basic principles for evaluating the deformity and a toolkit of procedures to deal with these complex cases. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - March 31, 2016 Category: Orthopaedics Authors: Sebastian Schmitt, Anna C. Peak, Gregor Berrsche, Wolfram Wenz Source Type: research

Recent Advances in Foot and Ankle Surgery in Mainland China
Foot and ankle physicians in China encounter quite a large amount of severe and complex deformities. The main cause of severe ankle and foot deformity is trauma, while the other causes may be neuromuscular diseases, improper reduction and fixation and so on. Staged procedure may sometimes be a safer way to correct deformities in the presence of severe soft tissue contracture. Periarticular osteotomy combined with soft tissue balancing can be used in treating severe varus ankle arthritis, including stage IIIb cases and patients with talar tilt of more than 10 degrees. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - March 31, 2016 Category: Orthopaedics Authors: Yuan Zhu, Xiang-yang Xu, Bi-bo Wang Source Type: research

Supramalleolar Osteotomies for Posttraumatic Malalignment of the Distal Tibia
Supramalleolar osteotomies of the tibia (SMOT) for posttraumatic distal tibial malalignment has shown to reduce pain, improve function and radiographic signs of osteoarthritis, and delay ankle arthrodesis or total joint replacement. The procedure also protects the articular cartilage from further degenerative processes by shifting and redistributing loads in the ankle joint. It is technically demanding and requires extensive preoperative planning. The type of osteotomy (opening vs closing wedge) does not influence the final outcome. However, based on the limited evidence, a grade I treatment recommendation has been given f...
Source: Foot and Ankle Clinics - February 24, 2016 Category: Orthopaedics Authors: Fabian Krause, Andrea Veljkovic, Timo Schmid Source Type: research

Corrective Osteotomies for Malunited Malleolar Fractures
Ankle fractures are common and may be treated nonoperatively or by reduction and internal fixation. Both treatments may lead to nonanatomic healing, called malunions. Malunions lead to joint instability and pathologic load transfer. Arthritic joint destruction may be the consequence. Corrective osteotomies for malunited malleolar fractures have to restore anatomic conditions. Osteotomies of the medial malleolus, lateral malleolus, posterior malleolus (Volkmann’s triangle), and the posteromedial corner or combinations thereof described. Corrective osteotomies for malleolar malunions show good results in the majority o...
Source: Foot and Ankle Clinics - February 24, 2016 Category: Orthopaedics Authors: Daniel Weber, Martin Weber Source Type: research

Treatment of Nonunions After Malleolar Fractures
Ankle fracture nonunion is a rare occurrence following closed or operative intervention. When it does occur, patients can experience debilitating symptoms that limit daily function. Malleolar nonunion can be caused by patient factors, such as smoking, malnutrition, or vascular insufficiency. Surgeon factors, such as insufficient or inappropriate operative fixation, also play a role. Several adjuncts, such as bone grafting, bone morphogenic protein, and bone stimulation, are useful in treating nonunions. Through a multimodal approach, malleolar nonunions are reliably treated with operative fixation leading to good patient o...
Source: Foot and Ankle Clinics - February 24, 2016 Category: Orthopaedics Authors: Brian M. Capogna, Kenneth A. Egol Source Type: research

Corrective Osteotomies for Malunited Extra-Articular Calcaneal Fractures
The most effective way to treat calcaneal malunions is avoidance. With any articular fracture, progressive arthrosis and dysfunction are common. By restoring the anatomy initially through reduction, late reconstructive options become less complicated. Numerous studies have shown that restoration of the anatomic alignment either through percutaneous or open techniques is effective. In patients with no or minimal articular degeneration, extrarticular joint-sparing procedures can be performed. This represents a small select group who may benefit from simple osteotomy procedures with associated soft tissue reconstruction, if n...
Source: Foot and Ankle Clinics - February 24, 2016 Category: Orthopaedics Authors: John Ketz, Michael Clare, Roy Sanders Source Type: research

Joint-sparing Corrections in Malunited Lisfranc Joint Injuries
Lisfranc fracture–dislocations are very serious and potentially disabling injuries. Unfortunately, they are often misdiagnosed. Multiplanar midfoot deformities that result from these fracture–dislocations are precursors of joint degeneration and significant functional disabilities. Anatomic reduction with different types of internal fixation is an efficient method to reconstruct midfoot alignment and stability. Joint-preserving reconstruction techniques emerge as a viable alternative to corrective fusion as they achieve stable joint realignment with preserved motion. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 24, 2016 Category: Orthopaedics Authors: Caio Nery, Fernando Raduan, Daniel Baumfeld Source Type: research

Intra-articular Osteotomy for Correction of Malunions and Nonunions of the Tibial Pilon
Malunions of the tibial pilon lead to painful posttraumatic ankle arthritis and malposition of the hindfoot with severe functional disability. Most will need corrective ankle fusion as a salvage procedure. Joint-preserving correction with secondary anatomic reconstruction for intra-articular malunions is possible only in carefully selected patients with intact cartilage, sufficient bone quality, residual function, and good compliance. Osteotomies of solid malunions are planned according to preoperative computed tomography scans. Bone grafting is needed after resection of a fibrous nonunion or sclerotic or necrotic bone. Es...
Source: Foot and Ankle Clinics - February 24, 2016 Category: Orthopaedics Authors: Stefan Rammelt, Hans Zwipp Source Type: research

The Use of Tibial Osteotomy (Ankle Plafondplasty) for Joint Preservation of Ankle Deformity and Early Arthritis
Asymmetric ankle osteoarthritis (OA) is an increasingly recognized condition. It is imperative to differentiate between extraarticular and intraarticular deformity and to address these appropriately. Any associated instability and multilevel deformity must be recognized and addressed. Patients with intraarticular varus or valgus asymmetric OA have poorer outcomes and higher rates of recurrence when treated with standard techniques targeted at correction with traditional supramalleolar or inframalleolar techniques. Plafondplasty aims to correct the deformity at its center of rotation and angulation and is associated with lo...
Source: Foot and Ankle Clinics - February 24, 2016 Category: Orthopaedics Authors: Shafic Said Al-Nammari, Mark S. Myerson Source Type: research

Secondary Reconstruction for Malunions and Nonunions of the Talar Body
Malunions and nonunions after central or peripheral fractures of the talar body frequently lead to pain and disability. In properly selected, compliant patients without symptomatic arthritis or total avascular necrosis leading to collapse of the talar dome, and sufficient bone stock, secondary anatomic reconstruction with osteotomy along the former fracture plane and preservation of the essential peritalar joints may lead to considerable functional improvement. Bone grafting is needed after resection of a fibrous pseudarthrosis, sclerotic, or necrotic bone. Malunions and nonunions of the lateral or posterior process are tr...
Source: Foot and Ankle Clinics - February 24, 2016 Category: Orthopaedics Authors: Hans Zwipp, Stefan Rammelt Source Type: research

Joint-Sparing Corrections of Malunited Chopart Joint Injuries
Treatment of malunion and nonunion at the Chopart joint aims at axial realignment of the midfoot to the hindfoot and restoration of the normal relationship of the lateral and medial columns of the foot. In carefully selected patients with intact cartilage, joint-preserving osteotomies are feasible at all 4 bony components of the Chopart joint to restore near-normal function. Priority should be given to the anatomic reconstruction of the talonavicular joint because it is essential for global foot function. Patients must be counseled about the risk of progressive arthritis or osteonecrosis necessitating late fusion. (Source:...
Source: Foot and Ankle Clinics - February 24, 2016 Category: Orthopaedics Authors: Wolfgang Schneiders, Stefan Rammelt Source Type: research

Joint-Preserving Osteotomies for Malaligned Intraarticular Calcaneal Fractures
Intraarticular calcaneal fracture treatments that result in malalignment often require reconstructive surgery. Seven cases are used to demonstrate the intricacies of reconstructive case management. Reestablishment of calcaneal height, length, orientation, and position relative to the other tarsals is necessary to reestablish appropriate foot function. Inherent or acquired gastrocnemius equinus should be treated with recession to reduce destructive forces on the reconstruction. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 24, 2016 Category: Orthopaedics Authors: Stephen K. Benirschke, Patricia A. Kramer Source Type: research