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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 21, 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 arthroscopic visual...
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 reco...
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’s pure l...
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