Stepcut Calcaneal Lengthening Osteotomy in the Management of Stage IIB Adult-acquired Flatfoot Deformity: Surgical Technique and Review of Literature
We describe stepcut calcaneal lengthening osteotomy with a “Z” design, which is essentially a combination of the above techniques with an additional full-thickness transverse cut made along the long axis of calcaneus that has the ability to obtain deformity correction of forefoot and hindfoot through a single incision. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - May 19, 2020 Category: Orthopaedics Tags: CME Article Source Type: research

Continuous Loop Double Cortical Button Technique for Distal Tibiofibular Syndesmosis Stabilization: A Technical Note and Case Series
Injury to the distal tibiofibular syndesmosis is common and failure to correct instability may lead to inferior outcomes. Recently, suture-button devices have garnered increasing attention for dynamic syndesmotic fixation. However, current constructs and techniques have been consistently associated with complications such as lateral knot irritation and wound breakdown. In addition, knot slippage, loosening, and osteolysis have been described leading to recurrent syndesmotic diastasis. To address these shortcomings, a continuous loop double cortical button technique has been developed for dynamic syndesmotic stabilization. ...
Source: Techniques in Foot and Ankle Surgery - May 19, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

Syndesmotic Injuries Treated With an Aperture Fixation Device
Syndesmotic injuries commonly occur in rotation injuries to the ankle. Suspensory suture button devices have become commonplace but are known to have several drawbacks. The aperture fixation device composed of a threaded tibia anchor, fixed length suture bridge, and telescoping fibular anchor. It preserves the concept of retaining physiological motion of the syndesmosis but provides several potential advantages over suspensory suture button devices. The most important and unique is it provides aperture fixation. This concept is significant in that it provides more strength and stiffness and less stretch and creep compared ...
Source: Techniques in Foot and Ankle Surgery - May 19, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

Lapidus Arthrodesis by an Anatomic Dorsomedial Plate
Background: Arthrodesis of the first tarsometatarsal joint (Lapidus arthrodesis) is a powerful modality for correction of a bunion deformity because it both addresses the instability of the first tarsometatarsal joint and fuses the base of first and second metatarsal. The Lapidus arthrodesis can be modified to fuse only the first tarsometatarsal joint. A comprehensive clinical evaluation and appropriate imaging modalities are essential to ensure the right indications for Lapidus arthrodesis and to provide an excellent surgical outcome. Objectives: The purpose of our study was to present an anatomic dorsomedial low-pro...
Source: Techniques in Foot and Ankle Surgery - May 19, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

Flexor to Extensor Tendon Transfer and Weil Osteotomy to Treat Grade IV Plantar Plate Tears
Conclusions: The GTP technique associated with the Weil osteotomy is a reliable option for treating grade IV PP tears. The limitations of our study were the small number of patients analyzed, the absence of a control group, and the minimum follow-up period of 12 months. Level of Evidence: Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - May 19, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

Percutaneous Surgery for Mild to Severe Hallux Valgus
Percutaneous surgery for hallux valgus correction is increasing in popularity. Third generation techniques under image intensifier control, with rigid internal fixation have improved the reproducibility and reliability of this technique. Percutaneous hallux valgus surgery has been shown to decrease immediate and early postoperative pain compared with open distal osteotomies, with comparable patient reported outcome scores. The transverse osteotomy, under image intensifier guidance gives complete control of metatarsal head correction in all planes of movement. The stability relies on rigid fixation of the first screw in bot...
Source: Techniques in Foot and Ankle Surgery - May 19, 2020 Category: Orthopaedics Tags: Special Focus Source Type: research

Lesser Toes Deformities: A Percutaneous Approach
Not all toe deformities are identical, and yet our classic procedures offer very few options. The typical open bone procedures result in the creation of a stiff joint where it was previously mobile. The main advantage of percutaneous surgical techniques is to afford the surgeon an expanded variety of treatment options to correct both rigid and flexible deformities. Percutaneous techniques increase our armamentarium for better adaption to the individual deformity of each patient. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - May 19, 2020 Category: Orthopaedics Tags: Special Focus Source Type: research

Minimally Invasive Revision Forefoot Surgery
This article examines forefoot minimally invasive surgery principles and techniques in the revision situation. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - May 19, 2020 Category: Orthopaedics Tags: Special Focus Source Type: research

Minimally Invasive Foot Surgery
No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - May 19, 2020 Category: Orthopaedics Tags: Guest Editorial Source Type: research

Osteoid Osteoma in Talus: Our Experience in Radioguided Surgery
We present a retrospective cohort study of 4 patients with clinical and radiologic findings suspicious OO with at least 1 year of follow-up. We used radioguided surgery for surgical resection after the injection of a dose of 99mTc-hydroxydiphosphonate. The nidus was located with the help of a portable gamma camera and gamma detection probe, concluding the surgical resection when its activity decreased to the levels present in healthy tissues. Samples were sent for pathologic anatomy for further examination. Lesions were localized in all patients. The cure rate, based on the absence of relapse of symptoms, was 100%. On the ...
Source: Techniques in Foot and Ankle Surgery - February 20, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

Revision of Synthetic Cartilage Implant Hemiarthroplasty of the Great Toe to Metatarsophalangeal Joint Arthrodesis: Technique and Indications
This study describes the surgical technique used to convert synthetic cartilage implant hemiarthroplasty of the first metatarsophalangeal joint to arthrodesis and the 3 cases that underwent revision at a single center in the United Kingdom. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - February 20, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

INBONE Revision Total Ankle Arthroplasty
The INBONE total ankle replacement is both a primary and a revision total ankle replacement. It is a modular tibial ankle with the ability to increase the length of the stem as necessary for stability. It also has available an enlarged baseplate for the tibia and a modular talar extension component for use when the talar bone is insufficient for the standard prosthesis. Its flexibility in use makes it an ideal ankle replacement for revision ankle replacement surgery. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - February 20, 2020 Category: Orthopaedics Tags: Special Focus Source Type: research

Arthroscopic Tibiotalocalcaneal Arthrodesis
Introduction: Arthrodesis is still the gold standard for severe ankle and hindfoot osteoarthritis. The arthroscopic tibiotalocalcaneal arthrodesis technique has been described and developed in the past decade. Tibiotalocalcaneal arthrodesis (TTCA) is the election procedure for combined severe ankle and subtalar osteoarthritis after failure of conservative treatment. The arthroscopic technique is more respectful to the surrounding soft tissues and the vascular supply; hence, it provides a theoretical benefit in terms of consolidation, and it is suitable for cases in which the open surgery is not desirable. We perform the ...
Source: Techniques in Foot and Ankle Surgery - February 20, 2020 Category: Orthopaedics Tags: Special Focus Source Type: research

Open Ankle Arthrodesis: Transfibular Approach
Ankle arthrodesis is a well-established surgical treatment for patients suffering from end-stage ankle osteoarthritis. This procedure can be executed by surgeons through various techniques. Among these methods is the open transfibular approach, which is utilized by the senior author as a routine procedure to treat the degenerative articulation. Outcomes of primary open ankle arthrodesis operations and cases necessitating a revision following a primary procedure were assessed through retrospective data and collective experience and were found to be similar to comparable postoperative complication rates. (Source: Techniques ...
Source: Techniques in Foot and Ankle Surgery - February 20, 2020 Category: Orthopaedics Tags: Special Focus Source Type: research

Arthroscopic Ankle Arthrodesis: A Review of Current Concepts and Technique
Background: Open ankle arthrodesis (OAA) has traditionally been the gold standard for improving pain and function in ankle osteoarthritis patients. With advances in arthroscopic technology and improved instrumentation, arthroscopic ankle arthrodesis (AAA) has become more popular among orthopedic surgeons with equivalent or better outcomes compared with OAA. Recent studies have shown that, with increasing experience, AAA can even be suitable for large deformities, which has been traditional viewed as a relative contraindication. A review of literature and concepts with expert opinion. AAA has been shown in the literature ...
Source: Techniques in Foot and Ankle Surgery - February 20, 2020 Category: Orthopaedics Tags: Special Focus Source Type: research

Hinged Motion Distraction Surgery for Ankle Osteoarthritis
We describe, in this article, the hinged joint distraction technique. A total of 50 patients with posttraumatic ankle osteoarthritis with a mean age of 40.0±8.5 years were included in a prospective randomized study: 25 patients in ankle debridement alone group and 25 patients in debridement and hinged ankle distraction group. The mean follow-up was 46±12 months (range: 36 to 78 mo). The clinical and radiographic outcomes were evaluated at the 6-month and 3-year follow-up using the Visual Analog Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, SF-36 quality of life score,...
Source: Techniques in Foot and Ankle Surgery - February 20, 2020 Category: Orthopaedics Tags: Special Focus Source Type: research

Arthroscopic Treatment of Ankle Impingement
The current article briefly discusses the impingement pathologies around the ankle joint and provides a short overview of the surgical technique. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - February 20, 2020 Category: Orthopaedics Tags: Special Focus Source Type: research

Surgical Technique of the VANTAGE Total Ankle Arthroplasty
The VANTAGE total ankle arthroplasty is a novel anatomic mobile or fixed-bearing total ankle arthroplasty with a good and simple instrumentation giving to surgeons a safe implantation ventral approach technique. Our first cases report a successful functional outcome for patients, with or without additional surgeries, and without very early complications. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - February 20, 2020 Category: Orthopaedics Tags: Special Focus Source Type: research

Surgical Techniques for Ankle Osteoarthritis
No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - February 20, 2020 Category: Orthopaedics Tags: Guest Editorial Source Type: research

Keep the Change
No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - February 20, 2020 Category: Orthopaedics Tags: Editorial Source Type: research

It All Fell Apart … Now How Do I Reconstruct My End-stage Flatfoot?
We present our diagnostic algorithm, surgical techniques, and pearls for the treatment of the failed extra-articular flatfoot reconstruction. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - November 22, 2019 Category: Orthopaedics Tags: Special Focus Source Type: research

Deltoid Insufficiency and Flatfoot—Oh Gosh, I’m Losing the Ankle! What Now?
Adult acquired flatfoot deformity is a severe condition in which the ankle is markedly affected by medial instability and valgus deformity. Unbalanced forces pose high stress on the tibiotalar joint, and different levels of arthritis may develop. Correcting valgus tilt in the ankle, at the time of flatfoot reconstruction, is imperative to prevent future collapse and the need for ankle arthrodesis or arthroplasty. Unfortunately, there has been no universal procedure adapted by foot and ankle surgeons for repair or augmentation of the deltoid ligament. We recommend a technique of reconstruction of the superficial and deep de...
Source: Techniques in Foot and Ankle Surgery - November 22, 2019 Category: Orthopaedics Tags: Special Focus Source Type: research

The Flatfoot in Collapse Needs Stability and That is Why I Fuse It
The pathophysiology and treatment of the adult-acquired flatfoot is still quite controversial. Soft tissue reconstruction and tendon transfer surgery combined with corrective osteotomy for flexible deformities are well established in the literature. However, patients with signs of hindfoot osteoarthritis, rheumatological or neurological diseases, and obesity can benefit from surgical correction with arthrodesis because of greater outcome predictability. Various types of arthrodesis, including isolated, triple, double, or segmental procedures, have been described to treat this deformity. We will discuss the events leading t...
Source: Techniques in Foot and Ankle Surgery - November 22, 2019 Category: Orthopaedics Tags: Special Focus Source Type: research

The Collapsing Flatfoot: Bone Alignment, Bone Alignment, Bone Alignment!
Stage II adult acquired flatfoot deformity involves a loss of the medial longitudinal arch and an increase in hindfoot valgus due to both soft tissue dysfunction and attenuation with subsequent collapse of the foot’s inherent bony architecture. Although there is an important role for soft tissue reconstruction in the majority of cases of adult acquired flatfoot deformity, any soft tissue procedure in the absence of correction of the underlying bony alignment will be prone to failure so these soft tissue procedures should only be performed after maximal bony realignment has been obtained. In this article, we discuss o...
Source: Techniques in Foot and Ankle Surgery - November 22, 2019 Category: Orthopaedics Tags: Special Focus Source Type: research

The Collapsing Foot: It’s All About the Ligaments!
There are many surgical techniques described for the deltoid ligament and spring ligament reconstruction in the treatment of a collapsing flatfoot. In some cases, addressing these ligaments may offer a way to treat a collapsing flatfoot that preserves the talonavicular and subtalar joints. Preservation of these joints may lead to better outcomes for patients, as their functionality is not limited by hindfoot fusions. Preliminary evidence suggests that patients, when properly selected for, show good long-term outcomes after undergoing surgical reconstruction of those ligaments. The technique for spring ligament and deltoid ...
Source: Techniques in Foot and Ankle Surgery - November 22, 2019 Category: Orthopaedics Tags: CME Article Source Type: research

Should it Stay or Should it Go? Thinking Critically About Posterior Tibial Tendon Excision in Flatfoot Correction
Stage II adult acquired flatfoot deformity is characterized by painful, progressive collapse long thought to be driven by posterior tibialis tendon (PTT) deficiency or insufficiency. In this article, we discuss the history of our understanding the role of the PTT in the development of adult acquired flatfoot deformity, and considerations in tendon excision in flatfoot correction. We argue that routine excision of the PTT should be rethought and instead the tendon should be critically assessed in each case and debridement with repair should be attempted when appropriate. Technique for flexor digitorum longus transfer is det...
Source: Techniques in Foot and Ankle Surgery - November 22, 2019 Category: Orthopaedics Tags: Special Focus: Adult Acquired Flatfoot Deformity (AAFD): To the Infinity and Beyond! Source Type: research

The Role of Biologics in the Treatment of Flatfoot
Symptomatic adult-acquired flatfoot deformity (AAFD) is traditionally treated by realignment osteotomy and a tendon transfer. Despite high success rates for this procedure, prolonged recovery time and associated morbidities may lead many patients to shy away from having this type of surgery performed on them. Over the past decade, the use of biologics such as platelet-rich plasma and concentrated bone marrow aspirate concentrate has been gaining much popularity. The efficacy of these biologics to treat tendon pathologies is currently well supported in the literature. Therefore, when treating early AAFD with a functioning p...
Source: Techniques in Foot and Ankle Surgery - November 22, 2019 Category: Orthopaedics Tags: Special Focus: Adult Acquired Flatfoot Deformity (AAFD): To the Infinity and Beyond! Source Type: research

The Flatfoot Through a Pinhole: Do It Percutaneously!
Surgical treatment of adult-acquired flatfoot deformity typically requires multiple soft tissue and bony procedures, many of which can be effectively performed with minimally invasive surgery techniques. Use of minimal skin incisions helps limit the morbidity of surgery, reducing postoperative pain and the incidence of wound complications. This chapter will focus primarily on the bony procedures which can be accomplished through minimally invasive surgery, including the medializing calcaneal osteotomy and the first tarsometatarsal fusion. Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete d...
Source: Techniques in Foot and Ankle Surgery - November 22, 2019 Category: Orthopaedics Tags: Special Focus: Adult Acquired Flatfoot Deformity (AAFD): To the Infinity and Beyond! Source Type: research

Using the Scope in the Treatment of Flatfoot? Are You Kidding?
Flatfoot surgery is evolving. As in other areas, less invasive techniques result in fewer wound complications, less postoperative pain, less bleeding, shorter hospital stays, and potentially shorter recovery times. In this article, we outline how the arthroscope can be used in flatfoot surgery to reduce the invasiveness of surgery. The article outlines how to perform a percutaneous gastrocnemius slide for the associated tight heel cord, and how to perform tibialis posterior tendoscopy. A percutaneous medializing calcaneal osteotomy can be performed as an arthroscopic guided procedure to confirm the placement of the saw, an...
Source: Techniques in Foot and Ankle Surgery - November 22, 2019 Category: Orthopaedics Tags: Special Focus: Adult Acquired Flatfoot Deformity (AAFD): To the Infinity and Beyond! Source Type: research

Guest Editorial: Adult Acquired Flatfoot Deformity (AAFD): To the Infinity and Beyond!
No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - November 22, 2019 Category: Orthopaedics Tags: Special Focus: Adult Acquired Flatfoot Deformity (AAFD): To the Infinity and Beyond! Source Type: research

Surgical Technique and Algorithm for Treatment of Displaced Intra-articular Calcaneal Fractures Using a Sinus Tarsi Approach and Plate Fixation
This article describes the surgical technique used in the treatment of closed and displaced intra-articular calcaneal fracture, sinus tarsi approach and fixation with a locking plate including a therapeutic algorithm. Level of Evidence: Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - August 21, 2019 Category: Orthopaedics Tags: CME Article Source Type: research

Forefoot Supination and Medial Column Instability in the Setting of AAFD: The Role of the Medial Column
Several variables may contribute to adult-acquired flatfoot deformity, one such variable is the medial column of the foot, which commonly manifest as forefoot varus or supination. The medial column is subjected to considerable loads during gait, and under normal conditions provides dynamic stability during the stance phase of gait. Pathology occurring along the medial column and forefoot can disrupt normal foot mechanics and lead to flatfoot deformity. A careful history and examination can diagnose dysfunction relating to the medial column and forefoot. Specifically, first tarsometatarsal dysfunction can result in malalign...
Source: Techniques in Foot and Ankle Surgery - August 21, 2019 Category: Orthopaedics Tags: Special Focus: Adult Acquired Flatfoot Deformity: The Pandora’s Box of Foot and Ankle Surgery Source Type: research

AAFD: Is the Gastroc Just Pulling Some Strings?
Whether ankle equinus predominantly contributes to or ensues from an adult-acquired flatfoot deformity (AAFD) remains unknown. Regardless of the exact nature of this relationship, current evidence supports a distinct role for concomitant gastrocnemius recession or Achilles tendon lengthening during surgical correction of significant AAFD deformity. Achieving the appropriate degree of surgical correction for components of ankle equinus, hindfoot valgus, and/or Chopart collapse that may contribute to AAFD requires proper clinical evaluation and an appreciation of contributory pathophysiology. Review of recent literature desc...
Source: Techniques in Foot and Ankle Surgery - August 21, 2019 Category: Orthopaedics Tags: Special Focus: Adult Acquired Flatfoot Deformity: The Pandora’s Box of Foot and Ankle Surgery Source Type: research

Subtle Dynamic Flatfoot Deformity: Is It More Than Stage I PTTD?
We present our preferred treatment strategy. Nonoperatively, patients are managed with a stretching program focused on the hamstrings and gastrocsoleus as well as the use of orthotics and night splint. Operative treatment consists of treatment of any areas of impingement and correcting the biomechanics of the foot and ankle with a Strayer, Cotton Osteotomy, and lateral column lengthening. Resection of the accessory facet of the talus is optional depending on preoperative symptoms. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - August 21, 2019 Category: Orthopaedics Tags: Special Focus: Adult Acquired Flatfoot Deformity: The Pandora’s Box of Foot and Ankle Surgery Source Type: research

AAFD: Conventional Radiographs are not Enough! I Need the Third Dimension
In this study, we reviewed the recent literature about the use of WBCT in AAFD, starting from a critical analysis about the biases related to conventional radiography and to non-standing CT. Then, we focused on the effects of load on the 3D architecture of the foot and ankle in AAFD. Finally, we discussed the benefits and future perspectives for the use of WBCT in the management of this condition and as a surgical planning tool as well. Level of Evidence: Diagnostic Level V, expert opinion. See Instructions for Authors for a complete description of levels of evidence. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - August 21, 2019 Category: Orthopaedics Tags: Special Focus: Adult Acquired Flatfoot Deformity: The Pandora’s Box of Foot and Ankle Surgery Source Type: research

AAFD Staging System: Did We Get It Right?
We describe clinical as well as patient parameters which do not fit in with the current classification scheme, and make recommendations for future study. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - August 21, 2019 Category: Orthopaedics Tags: Special Focus: Adult Acquired Flatfoot Deformity: The Pandora’s Box of Foot and Ankle Surgery Source Type: research

Guest Editorial: Adult Acquired Flatfoot Deformity: The Pandora’s Box of Foot and Ankle Surgery
No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - August 21, 2019 Category: Orthopaedics Tags: Special Focus: Adult Acquired Flatfoot Deformity: The Pandora’s Box of Foot and Ankle Surgery Source Type: research

Technique or Technician
No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - August 21, 2019 Category: Orthopaedics Tags: Editorial Source Type: research

Total Talus Replacement for Traumatic Bone Loss or Idiopathic Avascular Necrosis of the Talus
More than a dozen surgical techniques have been described for management of avascular necrosis or traumatic loss of large portions of the talus. The smaller the area of necrosis, the better the outcomes. Procedures to induce revascularization (core decompression/drilling, vascularized bone grafts) have been reported with variable success. Patients with avascular necrosis of large portions of the talus present unique treatment difficulties. These techniques largely focus on pantalar or tibiotalar-calcaneal arthrodesis with large bone blocks. These surgeries eliminate motion, lead to high levels of patient dissatisfaction, a...
Source: Techniques in Foot and Ankle Surgery - May 23, 2019 Category: Orthopaedics Tags: Technique Source Type: research

Peroneal Tendon Tears: When to Use an Allograft
Allograft reconstruction of chronic peroneal tendon tears is a safe and effective option to help restore patient function and limit pain. Both the author’s experience, along with cadaveric and clinical studies, have shown that this technique can restore function and stability. The authors provide step-by-step instruction of their preferred allograft reconstruction technique for chronic peroneal attritional injuries, while limiting the comorbidities that may be seen with autograft reconstruction. Level of Evidence: Level IV—review article, expert opinion, operative technique. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - May 23, 2019 Category: Orthopaedics Tags: Special Focus: Innovations in Foot and Ankle Sports Injury Treatment Source Type: research

Ankle Microinstability
Ankle sprains are one of the most common injuries in foot and ankle, and the superior fascicle of the anterior talofibular ligament (ATFL) frequently is injured as a consequence. Patients with isolated rupture of ATFL’s superior fascicle can sustain a subtle ankle instability or ankle microinstability. Patients with symptomatic ankle microinstability may describe a subjective feeling of ankle instability, recurrent symptomatic ankle sprains, chronic anterolateral pain or a combination of any of them. When conservative management fails, anatomic all-inside ATFL’s superior fascicle repair under direct arthroscopi...
Source: Techniques in Foot and Ankle Surgery - May 23, 2019 Category: Orthopaedics Tags: Special Focus: Innovations in Foot and Ankle Sports Injury Treatment Source Type: research

Ankle Ligament Reconstruction: The Role of Augmentation
The most reliable reconstruction for chronic ankle ligament instability continues to be debated. The conventional Broström is widely used, but there are limitations to the technique. By virtue of the tissue repair a conservative rehabilitation approach is advocated, and there is an increasing concern that the repair does not match the strength of the native ligament. That begs the question of whether an augmentation is needed and if it is done, how does it affect the native ligament repair and how does it stand up over time? This chapter will discuss these questions as well as our current approach to lateral ligament ...
Source: Techniques in Foot and Ankle Surgery - May 23, 2019 Category: Orthopaedics Tags: Special Focus: Innovations in Foot and Ankle Sports Injury Treatment Source Type: research

Treatment of Osteochondral Lesions of Talus With Extracellular Matrix Cartilage Allografts
The treatment of osteochondral lesions of the talus (OLTs) can be challenging. Currently, there exists a wide variety of treatment options to address OLTs, and the development of new, innovative surgical techniques has continued to evolve. The use of extracellular matrix cartilage allografts, or BioCartilage, is a biological agent that can be utilized as an adjunct to bone marrow stimulation. There are early promising clinical, radiographic, and histologic results. Therefore, it is prudent to understand the application of extracellular matrix cartilage allograft in the treatment of OLTs. We will provide a detailed review o...
Source: Techniques in Foot and Ankle Surgery - May 23, 2019 Category: Orthopaedics Tags: Special Focus: Innovations in Foot and Ankle Sports Injury Treatment Source Type: research

New Flexible Fixation for Subtle Lisfranc Injury
Lisfranc ligament injuries are not so common and often overlooked. If missed, they can cause long-term disability and pain. The treatment of these injuries are still controversial and very little is known about which types of injury can be treated without surgery. Successful surgical management of these injuries is predicated on anatomic reduction and stable fixation. Open reduction and internal fixation remains the standard treatment, although ligament reconstruction has emerged as a viable option for certain types of tarsometatarsal joint injuries. This paper describes the authors’ approach to treat Lisfranc’...
Source: Techniques in Foot and Ankle Surgery - May 23, 2019 Category: Orthopaedics Tags: Special Focus: Innovations in Foot and Ankle Sports Injury Treatment Source Type: research

New Option for Achilles Tendon Ruptures, Combining the Best of All: The PARS-Dresden
Surgical treatment remains the standard of care for active patients with acute midsubstance Achilles tendon ruptures. Minimal invasive surgery, rupture’s site hematoma preservation, strong fixation, avoidance of sural nerve entrapment, and early rehabilitation are essential concepts desirable for any Achilles tendon repair. Hereby, we present a technique modification that incorporates all these advantages in one single procedure. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - May 23, 2019 Category: Orthopaedics Tags: Special Focus: Innovations in Foot and Ankle Sports Injury Treatment Source Type: research

Guest Editorial: Innovations in Foot and Ankle Sports Injury Treatment
No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - May 23, 2019 Category: Orthopaedics Tags: Special Focus: Innovations in Foot and Ankle Sports Injury Treatment Source Type: research

Asymmetric Z-Tendon Shortening to Maximize Excision of Abnormal Tendon Tissue: A Technique Tip to Treat Elongated Tendons With Pathology
Operative treatment for a diseased or elongated Achilles tendon often involves resection of diseased tissue and Achilles tendon shortening. If the amount of diseased tissue is minimal, a traditional Z-shortening technique can be used to achieve appropriate tendon repair and function, which involves making an incision along the longitudinal axis mid-substance of the Achilles tendon. This technique is limited in its ability to resect abnormal tissue due to the placement of the incision traditionally along the midline of the tendon. In this chapter we describe an original modification of the Z-shortening technique to allow fo...
Source: Techniques in Foot and Ankle Surgery - February 21, 2019 Category: Orthopaedics Tags: CME Article Source Type: research

Sliding Distal Metatarsal Minimally Invasive Osteotomy (S-DMMO) for the Treatment of Tailor’s Bunion
We present a surgical technique consisting in a distal osteotomy of the fifth metatarsal, which resembles DMMO, but requires a lateral displacement. We retrospectively investigated 38 feet from 32 patients with symptomatic bunionette deformity and showed good to excellent functional and clinical results. The S-DMMO proved to be a safe (low complication rate) and effective (adequate clinical results and powerful radiologic correction) procedure for the treatment of bunionette deformity. Level of Evidence: Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence. (Source: Techniques ...
Source: Techniques in Foot and Ankle Surgery - February 21, 2019 Category: Orthopaedics Tags: Technique Source Type: research

Appropriate MRI Evaluation of Lisfranc Ligaments: How to Avoid Missing Ligamentous Lisfranc Injuries
Knowledge of injuries at the tarsal metatarsal joints continues to evolve. Fractures and ligamentous injuries at the tarsal metatarsal joints, also known as the Lisfranc joint complex, are uncommon yet can be of great clinical significance. The initial radiographic findings, suspected mechanism of injury, and physical examination findings can result in varying diagnoses and recommendations. Subtle or ligamentous injuries can be missed and result in the potential of midfoot instability and rapid progression to posttraumatic osteoarthritis. The imaging features of injury at the Lisfranc joint are reviewed, and guidance is pr...
Source: Techniques in Foot and Ankle Surgery - February 21, 2019 Category: Orthopaedics Tags: Special Focus: Acute Lisfranc Injuries Source Type: research

Flexible Fixation Treatment Strategies for Low-energy Lisfranc Injuries
This article will focus on the technique of using a suture button device, and also introduce the technique of Lisfranc InternalBrace fixation. The internal brace technique allows for less bone loss from drilling, allows for collagen ingrowth, and can be used in conjunction with bridge plating techniques. Level of Evidence: Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - February 21, 2019 Category: Orthopaedics Tags: Special Focus: Acute Lisfranc Injuries Source Type: research