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Joint Salvage Procedures for Failed First Metatarsal Phalangeal Joint Cheilectomy
Hallux rigidus is a painful arthritic condition of the first metatarsal phalangeal joint. For over 40 years, cheilectomy has been considered a first-line surgical treatment for mild and moderate cases of hallux rigidus. Despite successful results in the majority of cases, cheilectomy sometimes fails. Therefore, a number of revision surgical treatment options are available including joint-salvaging procedures such as repeat cheilectomy, dorsal osteotomy of the proximal phalangeal base, or interposition arthroplasty with allograft tissue. These revision surgical procedures will be discussed along with factors such as patient...
Source: Techniques in Foot and Ankle Surgery - August 19, 2016 Category: Orthopaedics Tags: Special Focus: Revision Forefoot Surgery Source Type: research

Guest Editorial: Revision Forefoot Surgery
No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - August 19, 2016 Category: Orthopaedics Tags: Special Focus: Revision Forefoot Surgery Source Type: research

Crystal Ball
No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - August 19, 2016 Category: Orthopaedics Tags: Editorial Source Type: research

First MTP Joint Distraction Arthrodesis With Cancellous Autograft and Bridge Plating: A Novel Surgical Technique to Restore Maximum Length
A novel technique used in a small series of patients is presented that describes a management option for the difficult situation of hallux metatarsophalangeal pathology with associated first-ray shortening and transfer lesions. Distraction arthrodesis was performed using proximal tibial cancellous autograft and locked plating to achieve an average of 10.6 mm length restoration with all patients showing radiographic signs of union by the eighth postoperative week and resolution of transfer metatarsalgia. This novel technique shows promise for reliable outcomes in a variety of historically difficult clinical situations such ...
Source: Techniques in Foot and Ankle Surgery - May 25, 2016 Category: Orthopaedics Tags: CME Article Source Type: research

Anchoring of the 1-2 Interspace and Medial Capsule in Hallux Valgus Surgery
The goal in the surgical treatment of hallux valgus deformities is to correct the alignment of the first metatarsophalangeal joint and the 1-2 intermetatarsal angle (IMA). Anchoring techniques between the first and second metatarsals have been used to facilitate the correction of the IMA. These techniques have been modified to provide support to the IMA correction (that can be done by whatever technique the surgeon prefers to use) and also facilitate anchoring of the repaired medial capsule to the bone. This technique is used with a distal soft tissue realignment procedure. Sutures are passed using the existing incisions a...
Source: Techniques in Foot and Ankle Surgery - May 25, 2016 Category: Orthopaedics Tags: Techniques Source Type: research

Tension-Band Ankle Arthrodesis: An Update
Ankle arthrodesis remains the gold standard for the treatment of end-stage ankle arthritis, despite the significant improvement in the clinical outcomes of total ankle arthroplasty because of newer designs. Posttraumatic degeneration is the most common cause of ankle arthritis. Other causes include infection, systemic arthritides, and avascular necrosis. Many tibiotalar arthrodesis techniques have been described with varying fusion and complication rates. This paper describes a reliable and reproducible technique of ankle arthrodesis based on the tension-band technique and modern internal fixation principles. This techniqu...
Source: Techniques in Foot and Ankle Surgery - May 25, 2016 Category: Orthopaedics Tags: Techniques Source Type: research

Surgical Approaches to Arthritis and Deformity of the Midfoot
Midfoot arthritis with concomitant deformity can present a daunting reconstructive dilemma. Midfoot arthritis without other deformity can usually be treated with minor realignment at the tarsometatarsal joints. Some patients however, have concomitant hindfoot deformity and other problems which must be noted and addressed at the time of reconstruction. These more severe deformities can require midfoot osteotomy and inclusion of other adjunct procedures to appropriately correct the alignment of the midfoot and hindfoot. Level of Evidence: Diagnostic Level 5. See Instructions for Authors for a complete description of levels ...
Source: Techniques in Foot and Ankle Surgery - May 25, 2016 Category: Orthopaedics Tags: Special Focus: Treatment of Disorders of the Midfoot Source Type: research

Surgical Management of Posttraumatic Midfoot Deformity and Arthritis
Posttraumatic joint disruption and deformity remains one of the most common etiologies for midfoot degenerative joint disease. Patients presenting with midfoot arthritis commonly complain of increased pain with weight-bearing activity, and tenderness over the dorsum of the foot with constrictive shoe wear secondary to dorsal osteophyte formation. Nonoperative measures assist with symptom control, focusing on limiting both pain and deformity. Operative intervention is generally considered after an adequate trial of nonoperative measures. Arthrodesis procedures remain the “gold standard” for operative treatment of midfoo...
Source: Techniques in Foot and Ankle Surgery - May 25, 2016 Category: Orthopaedics Tags: Special Focus: Treatment of Disorders of the Midfoot Source Type: research

Selective Fusions for Primary Midfoot Osteoarthritis
Midfoot arthritis is a common condition presenting to foot and ankle specialists. Primary osteoarthritis of the midfoot demonstrates a unique combination of symptoms and radiographic changes, most commonly involving the second tarsometatarsal, the third tarsometatarsal, and the medial facet of the naviculocuneiform joints. Operative intervention typically involves fusing the arthritic joints. This paper reviews the important steps for a successful outcome, discusses the common complications, and delineates a typical postoperative protocol. Level of Evidence: Diagnostic Level 5. See Instructions for Authors for a complete ...
Source: Techniques in Foot and Ankle Surgery - May 25, 2016 Category: Orthopaedics Tags: Special Focus: Treatment of Disorders of the Midfoot Source Type: research

The Treatment of Mueller-Weiss Disease: A Systematic Approach
Mueller-Weiss disease (MWD), which involves dorsolateral fragmentation and collapse of the navicular, leads to functional misalignment and painful deformities. The successful treatment of MWD hinges on a detailed and through assessment of the patient to establish the modality of treatment that best suits the patient. In cases where operative management is indicated, proceeding to recreate a relatively pain-manageable (or where possible pain free), well-aligned, plantegrade foot is the goal. This can be performed technically by (1) determining as to which joints are involved/arthritic, and ensuring to address them; (2) esta...
Source: Techniques in Foot and Ankle Surgery - May 25, 2016 Category: Orthopaedics Tags: Special Focus: Treatment of Disorders of the Midfoot Source Type: research

Guest Editorial: Treatment of Disorders of the Midfoot
No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - May 25, 2016 Category: Orthopaedics Tags: Special Focus: Treatment of Disorders of the Midfoot Source Type: research

Trials to Trust
No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - May 25, 2016 Category: Orthopaedics Tags: Editorial Source Type: research

The Addition of an “Internal Brace” to Augment the Broström Technique for Lateral Ankle Ligament Instability
This article describes the augmentation of a Broström anatomic repair for ankle lateral ligament instability by the use of the internal brace. The paper describes the role of the internal brace in allowing the natural tissues to progressively strengthen while encouraging early rehabilitation. The surgical technique is outlined and the early clinical outcomes both by the inventor surgeon (G.M.M.) and an independent surgeon (W.J.R.) described. 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, 2016 Category: Orthopaedics Tags: Technique Source Type: research

Reconstruction of the Deltoid-Spring Ligament: Tibiocalcaneonavicular Ligament Complex
We describe a novel anatomic reconstruction of the tibiocalcaneonavicular ligament with peroneus longus allograft. This is the first surgical technique to reconstruct both the deltoid and spring ligament complex. Level of Evidence: Diagnostic Level 5, 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 - February 21, 2016 Category: Orthopaedics Tags: CME Article Source Type: research

Arthroscopic FHL Harvest and Transfer for Neglected TA Rupture
Conclusions: This combined technique may offer a safer surgical pathway for low-demand patients with a potential for wound problems if treated with open surgery. 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, 2016 Category: Orthopaedics Tags: Special Focus: Minimally Invasive Techniques: European Perspective Source Type: research