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How Mini-Rail Fixators Can Be Beneficial For Jones Fractures

10829 reads | 3 comments

A Jones fracture is a fracture of the metaphyseal-diaphyseal junction of the fifth metatarsal base. Fractures in this area are known to have difficulty healing due to the tenuous blood supply to this area.

To that end, one may treat these fractures with strict non-weightbearing for a minimum of six weeks or explore surgical options.



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Pertinent Pearls On Treating Insertional Tibialis Posterior Tendinitis

6563 reads | 2 comments

Insertional tibialis posterior tendinitis is a common cause of medial arch pain in adults. We tend to think about this condition in pediatric patients with a large navicular tuberosity and/or an os tibiale externum associated with a flat foot (Kidner foot type). When you have an adult with navicular tuberosity pain who has a normal X-ray and no os tibiale externum, you probably ask yourself, “Now what I am going to do with that?”



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Key Considerations In Treating Lister’s Corn

25166 reads | 2 comments

I want to dedicate this blog to Perry Horton, DPM, who recently passed away. He was one of my attendings in residency. I have fond memories of Dr. Horton. He had the utmost confidence his Northlake Medical Center residents. Dr. Horton would tell us what he wanted done in surgery and to ask for help if we had any questions or problems. He would generally sit on a stool and tell stories while we performed surgery. He would take an occasional peek in on what we were doing and always knew we would do a great job.



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A Closer Look At Surgical Options For Neglected Tendon Ruptures

11768 reads | 0 comments

Neglected tendon ruptures present challenges for reconstruction. The most common neglected ruptures that you will encounter include the Achilles, tibialis anterior, tibialis posterior and the peroneal tendons.



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How To Solve The Dilemma Of The Jumbo Bunion

10275 reads | 8 comments

When it comes to surgical treatment of very large bunion deformities, I think we all scratch our heads a little and have to ponder what to do. For the average run-of-the-mill deformity, it is pretty much a slam dunk. You do whatever you are comfortable with such as an Austin bunionectomy, Scarf bunionectomy, distal-L osteotomy, etc.



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Secrets To Navigating Hammertoe Surgery On The Fifth Toe

11980 reads | 3 comments

This blog is dedicated to the ultimate podiatry oxymoron: a simple hammertoe surgery of the fifth toe.

When it comes to foot surgery, we all got our start working on toes. In school, we all learned the three etiologies of hammertoes: extensor substitution, flexor substitution and flexor stabilization. Based on those theories, we learned a surgical algorithm. Once we got into residency, we learned that nobody really used the "textbook" for making a decision on what to do surgically.



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Evolution Of A Jones Fracture

7717 reads | 5 comments

In an earlier blog (http://tinyurl.com/285eurj ), I discussed the common lateral foot and ankle pain syndromes in the foot. I recently stumbled on a great case, which is applicable to that theme.

Stress fractures are common in the foot and they most often affect the metatarsal bones. The distal second metatarsal neck is the most common site of a stress fracture in the foot. Stress fractures of the third or fourth metatarsals are less frequent. I think we can all agree that stress fractures of the first and fifth metatarsal bones are relatively rare.



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Key Considerations When Recommending Elective Foot Surgery

3614 reads | 3 comments

The decision to recommend foot and ankle surgery is not always straightforward. Unless the clinical condition is a serious fracture, abscess or dislocation, we have to rely on other criteria. Unfortunately, the criteria that we rely on are mostly anecdotal.

For example, we all learn somewhere in our training that we should consider surgery for plantar fasciitis after six months of active treatment, which usually includes a series of cortisone injections, physical therapy, orthotics and possibly an immobilization period. Do you always adhere to this treatment protocol dogma?



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When A Patient Pursues Surgery With Another Surgeon

2908 reads | 1 comments

I received a phone call from a colleague, who was upset because a patient whom he worked up for surgery went somewhere else to have the surgery done. He happened to be in the hospital where he saw his patient’s name on the surgery scheduling board having surgery with another surgeon.



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How A Solid Routine Can Help You Tackle Any Surgical Situation

2920 reads | 3 comments

Some people may call me boring. Some may think I am predictable. I call myself disciplined and regimented.

To illustrate, my closet is lined with identical pants and dress shirts so I wear the same clothes to work each day. If I have surgery, I wear surgical scrubs. If I am in the office all day, I wear khaki pants and a blue dress shirt. That way, I do not have to make any decisions in the morning as I know exactly what to wear.