Prospective Randomized Controlled Study on an Innovative Mini-open Technique Versus Standard Percutaneous Technique to Avoid Sural Nerve Injury During Acute Achilles Tendon Repair
Percutaneous and mini-open repair of the tendo-Achilles have proved good results according to several authors. However, sural nerve injury is one of the most important complications that may be associated with this technique because of either entangling the nerve inside the suture laterally or piercing the nerve with the needle. The authors present a simple and reproducible technique to avoid injury of the sural nerve with the mini-open repair of the Achilles tendon. The patients were split into 2 groups, each consisted of 20 patients. They were randomly allocated using identical envelopes to either treatment by the new mo...
Source: Techniques in Foot and Ankle Surgery - February 24, 2021 Category: Orthopaedics Tags: Techniques Source Type: research

Outcomes of Liquifying PLDLLA Suture Anchor for Lateral Ligament Reconstruction of the Ankle
Liquifying poly-DL lactic acid (PLDLLA) suture anchors represent a novel fixation technique in lateral ligament reconstruction. Biomechanical testing has demonstrated that these bone-welding anchors have significant resistance to pullout in cancellous bone. To determine if this superior strength translates to improved clinical outcomes, an initial evaluation of complications and patient-reported outcomes of ultrasound-activated anchor fixation was conducted. A chart review of prospectively collected data were conducted on 8 patients who underwent a modified Broström technique using bone-welding technology for lateral lig...
Source: Techniques in Foot and Ankle Surgery - February 24, 2021 Category: Orthopaedics Tags: Techniques Source Type: research

Multidirectional Y-V Flap Capsulorrhaphy in Hallux Valgus Surgery
We describe a new technique of multidirectional medial capsulorrhaphy that allows the surgeon to balance the soft tissue reliably in the coronal, sagittal, and axial planes. This described technique utilizes a Y-V flap configuration with multiple anchor points that can be tailored to the optimal tension and rotation to suit the individual deformity. Proper tensioning of the flap produces soft tissue balance and reduction of the sesamoids that is readily apparent with fluoroscopy. The technique is simple to perform and reproduce, and can be easily adopted and applied to any open hallux valgus procedure. (Source: Techniques ...
Source: Techniques in Foot and Ankle Surgery - February 24, 2021 Category: Orthopaedics Tags: Techniques Source Type: research

Percutaneous, Intra-articular, Chevron Osteotomy (PeICO) for the Treatment of Hallux Valgus
Percutaneous (also called minimally invasive surgery) surgery has advanced and, nowadays, is a valid option for the treatment of hallux valgus deformities. This fact is strongly supported by different studies. Early results of the third-generation procedures seem very promising with at least comparable deformity correction and less postoperative stiffness and pain compared with some open osteotomies. Percutaneous, intra-articular, chevron osteotomy is one of this type of procedures and presents some advantages when comparing with other third-generation surgeries. Percutaneous, intra-articular, chevron osteotomy accurately ...
Source: Techniques in Foot and Ankle Surgery - February 24, 2021 Category: Orthopaedics Tags: Techniques Source Type: research

Recurrent Syndesmotic Diastasis Treated With Revision Tightrope Fixation
This article reviews the background of syndesmotic injuries, as well as recent aspects of management that have generated controversy. Particular emphasis is placed on syndesmotic stability, assessment of reduction, and various methods of fixation. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - February 24, 2021 Category: Orthopaedics Tags: Special Focus Source Type: research

Diagnosis and Treatment of Persistent Problems After Ankle Sprains: Surgical Management of Osteochondral Lesions of the Talus
Ankle sprains are common injuries that can lead to persistent disability and pain for many patients. Such symptoms are often a result of damage to the articular cartilage of the talar dome and the subchondral bone, an injury broadly classified as an osteochondral lesion of the talus. Lesions indicated for surgery can be treated with a range of methods. These generally fall into the categories of reparative treatment, which is suitable for smaller lesions and can typically be performed arthroscopically, or replacement strategies, which can provide superior outcomes for large lesions but often require an open approach. In re...
Source: Techniques in Foot and Ankle Surgery - February 24, 2021 Category: Orthopaedics Tags: Special Focus Source Type: research

Posterior Ankle Pain After Ankle Sprain: Bony and Soft Tissue Impingement and Flexor Hallucis Longus (FHL) Tenosynovitis
Level of Evidence Level V—expert opinion. See Instructions for Authors for a complete description of levels of evidence. The proper diagnosis of posterior ankle pain after ankle sprains is often missed. This can occur as an overuse injury or as a result of acute trauma in patients performing repetitive forced plantar flexion sports. An understanding of various causes of posterior ankle impingement, both bony and soft tissue, is critical to make the proper diagnosis and provide appropriate treatment. Nonoperative treatment should be considered as the initial treatment for the posterior ankle pathology. Surgical int...
Source: Techniques in Foot and Ankle Surgery - February 24, 2021 Category: Orthopaedics Tags: Special Focus Source Type: research

Deltoid Ligament Insufficiency
Deltoid ligament insufficiency can be present after an ankle sprain or fracture and in the setting of adult acquired flatfoot. If symptoms of medial ankle instability persist after nonoperative treatment for an ankle sprain, deltoid ligament repair or reconstruction may be indicated. More commonly, deltoid ligament injuries occur at the time of rotational ankle fractures. The indications for acute deltoid ligament repair in the setting of fracture are of great interest and debate. This chapter will review the conditions of deltoid ligament insufficiency in the setting of sprains and fractures including the current state of...
Source: Techniques in Foot and Ankle Surgery - February 24, 2021 Category: Orthopaedics Tags: Special Focus Source Type: research

Persistent Nerve Injury and CRPS After Ankle Sprains
A number of patients continue to experience prolonged pain, swelling, instability, and disability after a lateral ankle sprain, which is sufficient to limit their activity. There are several conditions that are misdiagnosed as chronic lateral ligament injury. In this review, we highlight common nerve conditions, with specific attention to the peroneal nerve, and chronic regional pain syndrome that can mimic chronic lateral ligament injury and can cause persistent ankle pain after lateral ankle sprain. We also offer advice for effective diagnosis and treatment of these associated pathologies. Sprained ankle syndrome, as it ...
Source: Techniques in Foot and Ankle Surgery - February 24, 2021 Category: Orthopaedics Tags: Special Focus Source Type: research

Guest Editorial: Comments on Monograph Pertaining to Persistent Problems After Ankle Sprains
No abstract available (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - February 24, 2021 Category: Orthopaedics Tags: Special Focus Source Type: research

Particulate Juvenile Articular Cartilage Transfer for Talar Osteochondral Lesions
Osteochondral lesions of the talus present a challenge to the foot and ankle surgeon with regards to treatment. Although most bone marrow stimulation (BMS) procedures have relatively good outcomes, those patients who do not improve or present with large lesions (>1.5 cm2) are candidates for a range of more involved procedures. All of these treatments focus on improving pain and function by restoring cartilage at the lesion site. Treatment options are generally classified as either BMS or restorative. Histologic studies have found that BMS leads to infill by fibrocartilage that has physical properties inferior to that of ...
Source: Techniques in Foot and Ankle Surgery - December 1, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

Tendoscopy for Early-Stages (I and II) Posterior Tibial Tendon Dysfunction
Tendoscopy of tibialis posterior tendon has been proposed>20 years ago for the treatment of posterior tibial tendon dysfunction. A few studies have reported satisfactory results in stages I and II posterior tibial tendon dysfunction (Johnson and Strom classification). This approach allows us to assess the posterior tibial tendon and the spring ligament status, and if needed to perform a synovectomy with soft-tissue debridement. Longitudinal split tendon tears can also be repaired. In case of failure, a traditional corrective open surgery can normally be performed. In this manuscript, we summarize the history of this techni...
Source: Techniques in Foot and Ankle Surgery - December 1, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

Surgical Strategies: Cement Spacer for Staged First Metatarsophalangeal Arthrodesis After Failed Arthroplasty
We describe a 2-stage technique for first metatarsophalangeal arthrodesis in the setting of osteolysis, infection, or bone loss. This staged technique allows for the restoration of appropriate soft tissue tension through the use of a temporary cement spacer before structural grafting. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - December 1, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

Minimally Invasive Approach for the Reconstruction of the Peroneal Brevis Tendon Using Semitendinosus Autograft: An Alternative Technique to Avoid Soft Tissue Complications
We present a less invasive approach through 2 short incisions, preserving the lateral soft tissues of the hindfoot. It represents an effective and safe alternative to the long lateral curved approach. Besides that, it can be useful to treat patients at risk of wound healing complications such as smokers, vasculopaths and diabetics. (Source: Techniques in Foot and Ankle Surgery)
Source: Techniques in Foot and Ankle Surgery - December 1, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

Neuromuscular Electrostimulation Device Reduces Preoperative Edema and Accelerates Readiness for Theater in Patients Requiring Open Reduction Internal Fixation for Acute Ankle Fracture
Significant edema manifests as soft tissue swelling that can delay surgery in patients with ankle fractures. Interventions that expedite swelling reduction may yield clinical and economic benefits. This case-control pilot study aimed to assess the ability to recruit ankle fracture patients to a prospective study using a neuromuscular electrostimulation (NMES) device. Device effectiveness, safety, and patient acceptability were also assessed. Prospective evaluation of 20 patients admitted for ankle fracture fixation with the application of NMES device to the skin just below the knee (intervention arm). Participants were mat...
Source: Techniques in Foot and Ankle Surgery - December 1, 2020 Category: Orthopaedics Tags: Techniques Source Type: research