Techniques in Foot and Ankle Surgery 
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No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - November 19, 2015 Category: Orthopaedics Tags: Editorial Source Type: research
Retrograde Intramedullary Tibiotalocalcaneal (Hindfoot) Arthrodesis With Concomitant Midfoot and Forefoot Corrections
We report on the operative technique, the importance of addressing concomitant ankle and foot deformities when present and the outcomes (radiologic fusion rate, limb salvage rate, and global patient satisfaction) with a hindfoot arthrodesis nail. It was used for tibiotalocalcaneal arthrodesis on 63 consecutive patients (6 bilateral procedures). The minimum follow-up was 12 months; the mean age was 59 (range, 24 to 87) years, with 69% male. At 3 months, the fusion rate was 77.7% (49/63); 6-month fusion rate was 95% (60/63). The overall complication rate was 12.6% (8/63). There was a 100% limb salvage rate. Fifty-seven conco...
Source: Techniques in Foot and Ankle Surgery - August 22, 2015 Category: Orthopaedics Tags: CME Article Source Type: research
Minimally Invasive Plate Osteosynthesis (MIPO) of Distal Tibial Fracture Using a Posterolateral Approach
This study presents a novel technique for dealing with this situation, minimally invasive plate osteosynthesis of a distal tibial fracture using a posterolateral approach. The postoperative care and potential complications of the two patients who underwent this surgical technique are also described. The study shows that this minimally invasive plate osteosynthesis technique is an alternative option for the treatment of distal tibial fractures especially when the anterior soft tissue is compromised.
Level of Evidence: Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence. (Source:...
Source: Techniques in Foot and Ankle Surgery - August 22, 2015 Category: Orthopaedics Tags: Techniques Source Type: research
Center-Center Syndesmosis Fixation Technique
This article describes the center-center technique for syndesmosis screw insertion. The technique defines the neutral anatomic axis of the distal tibiofibular joint, and improves the surgeon’s ability to determine the ideal start point, clamp position, and screw trajectory. The technique avoids potential malreduction caused by suboptimal clamp and screw placement.
Level of Evidence: Diagnostic Level 5. 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 22, 2015 Category: Orthopaedics Tags: Techniques Source Type: research
Arthroscopic Flexor Hallucis Longus Transfer for Chronic Achilles Tendon Rupture
We report our experience in the arthroscopic FHL transfer technique, which is less invasive, avoids possible risks of wound complications associated with open technique, and potentially allows for earlier rehabilitation. We recommend this technique in all chronic TA ruptures, particularly in patients with comorbidities, which could result in postoperative wound infection.
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 - August 22, 2015 Category: Orthopaedics Tags: Special Focus: Innovative Techniques in Foot and Ankle Surgery, Part II Source Type: research
Osteochondral Grafting of the Distal Tibia Without a Malleolar Osteotomy: An All-Arthroscopic Antegrade Approach
Osteochondral (OCD) lesions of the tibia are rare and can be treated with microfracture and debridement in the first instance. However, a major issue arises if bulk-grafting is required as access to the joint surface for perpendicular packing/insertion is not possible. Tibial osteotomy for access to the talus has morbidity associated with it, but moreover it does not significantly improve access to the tibia for standard retrograde (ie, from the joint surface into the bone) drilling and insertion of a graft into an OCD lesion. In order to obviate the need for malleolar osteotomy an antegrade approach through the bone rathe...
Source: Techniques in Foot and Ankle Surgery - August 22, 2015 Category: Orthopaedics Tags: Special Focus: Innovative Techniques in Foot and Ankle Surgery, Part II Source Type: research
Management of Posterior Tibial Tendon Rupture With Allograft Reconstruction, Osteotomy, and Peroneus Brevis to Longus Transfer
Traditional treatment for stage II posterior tibial tendon (PTT) dysfunction includes flexor digitorum longus (FDL) transfer combined with various osteotomies. However, the FDL has been shown to be much weaker than the PTT and thus may not be the ideal tendon for transfer. Furthermore, the peroneus brevis continues to be a deforming force following reconstructive surgery and may contribute to recurrent deformity. This paper presents a novel technique consisting of posterior tibial tendon reconstruction with allograft and peroneus brevis to longus transfer combined with various osteotomies necessary for correction.
Level of...
Source: Techniques in Foot and Ankle Surgery - August 22, 2015 Category: Orthopaedics Tags: Special Focus: Innovative Techniques in Foot and Ankle Surgery, Part II Source Type: research
Open Mind
No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - August 22, 2015 Category: Orthopaedics Tags: Editorial Source Type: research
Technique Tip: Use of Incisional Negative-pressure Wound Therapy After Complex Foot and Ankle Reconstruction
Operative correction of complex foot and ankle deformities and surgical reconstruction through limited or compromised skin exposures can potentially lead to increased skin tension or tenuous incisional sites that result in costly wound healing problems. In these higher risk situations, carefully layered soft tissue closure can be augmented by a negative-pressure incisional dressing to enhance rapid epithelialization, control tissue tension, and mitigate fluid volume build-up beneath the incision line as a means of lowering the chances of dehiscence or subsequent wound infection while adding little further risk to the patie...
Source: Techniques in Foot and Ankle Surgery - May 21, 2015 Category: Orthopaedics Tags: CME Article Source Type: research
Reconstruction of the Tibialis Anterior Tendon With Allograft: A Novel Technique
Rupture of the tibialis anterior tendon is often not clinically recognized. It typically occurs in the atraumatic setting and leads to a steppage gait. For sedentary individuals, nonoperative management may be considered. In more active individuals with stable soft-tissue envelope and a stable neurovascular status, reconstruction of the tendon is a viable option. This technique paper introduces a novel technique that bypasses the need to open the extensor retinaculum and avoids potential wound complications.
Levels of Evidence: Diagnostic Level 5. See Instructions for Authors for a complete description of levels of evidenc...
Source: Techniques in Foot and Ankle Surgery - May 21, 2015 Category: Orthopaedics Tags: Techniques Source Type: research
The Wire-form Fixation Device: A New Device for the Fixation of Medial Malleolar Fractures
Conclusions: The wire-form fixation device provides reliable fixation for ORIF of transverse, oblique, and vertical, medial malleolar fractures. Nonunion, reoperation rates, and other complication rates are similar to other medial malleolar fixation methods.
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 21, 2015 Category: Orthopaedics Tags: Techniques Source Type: research
Particulated Juvenile Articular Cartilage Allograft Transplantation With Bone Marrow Aspirate Concentrate for Treatment of Talus Osteochondral Defects
Osteochondral defects (OCDs) of the talus are potential sequelae of traumatic ankle injury and chronic ankle instability. Conservative treatment may fail thus requiring surgical intervention. Primary surgical intervention has classically entailed bone marrow stimulation, which may include drilling, microfracture, and/or abrasion arthroplasty, filling in the defect with fibrocartilage. Clinical data has revealed good short-term success but the long-term effects and follow-up have been questioned. Newer techniques, such as osteochondral autograft transfer, fresh osteochondral allograft transfer, and autologous chondrocyte im...
Source: Techniques in Foot and Ankle Surgery - May 21, 2015 Category: Orthopaedics Tags: Special Focus: Innovative Techniques in Foot and Ankle Surgery, Part I Source Type: research
Perinavicular Arthrodesis as Treatment of Advanced Navicular Osteonecrosis
Osteonecrosis of the navicular is known as Muller-Weiss disease (MWD). In its advanced stages, MWD renders patients with severe perinavicular (PN) arthritis, pain, and dysfunction. Current surgical treatment options are limited by scant literature about this condition. This text describes a novel means of treating advanced MWD with a PN arthrodesis. This procedure involves a combined dorsal approach to the talonavicular (TN) and naviculocuneiform (NC) and lateral approach to the calcaneocuboid (CC) joints. As cartilage is removed from the TN, NC, and CC joints to achieve fusion, all necrotic portions of the navicular are e...
Source: Techniques in Foot and Ankle Surgery - May 21, 2015 Category: Orthopaedics Tags: Special Focus: Innovative Techniques in Foot and Ankle Surgery, Part I Source Type: research
Total Ankle Replacement Through a Lateral Approach
Since the first clinical series of total ankle replacements in 1973, implants design has evolved tremendously. Early catastrophic failures associated with first-generation total ankle replacement are now less common with modern prostheses. However, registry data suggest that the 10-year survivorship is still lower than total knee and hip arthroplasty. The anterior surgical approach used in the vast majority of implants lies between 2 angiosomes and can lead to complications including wound breakdown and damage to the peroneal nerves and anterior tibial artery. Furthermore, current anterior approach implants do not allow bo...
Source: Techniques in Foot and Ankle Surgery - May 21, 2015 Category: Orthopaedics Tags: Special Focus: Innovative Techniques in Foot and Ankle Surgery, Part I Source Type: research
Interpositional Arthroplasty of the Great Toe Metatarsophalangeal Joint Using Autogenous Fascia Lata for Advanced Hallux Rigidus
A technique using interpositional autogenous fascia lata graft after complete resection of the joint for primarily advanced hallux rigidus has provided pain relief, flexibility, allowed the use of various dress shoe heel heights, maintained joint alignment, and been durable. Toe flexion power is decreased and some degree of transfer metatarsal callusing has occurred, but patient satisfaction has been high. It appears to be an alternative to fusion in selected patients. Between 2005 and 2010, 13 patients, 15 feet, (11 females, 2 males), aged 36 to 81 years (mean age, 65 y) underwent interpositional arthroplasty with fascia ...
Source: Techniques in Foot and Ankle Surgery - May 21, 2015 Category: Orthopaedics Tags: Special Focus: Innovative Techniques in Foot and Ankle Surgery, Part I Source Type: research
