Surgical Pearls

John F. Grady, DPM, FASPS
| 14,326 reads | 1 comments
Hallux limitus is generally responsive to conservative care consisting of anything from changing foot gear, changing activity and exercises to orthoses, injections, anti-inflammatory medication and physical therapy.1 When these things fail, surgery is necessary.    It has long been believed that arthrodesis is the optimum procedure of choice to resolve any painful arthritic... Read More.
Nicholas J. Bevilacqua, DPM, FACFAS
| 7,703 reads | 0 comments
Ankle fractures are seemingly uncomplicated injuries. However, in the elderly and people with diabetes, this seemingly straightforward injury can have catastrophic outcomes.    Systemic illnesses such as diabetes with end-organ damage clearly affect the overall outcome of ankle fractures and complications may occur due to a failure to recognize the unique treatments necessary for... Read More.
Samantha Bark, DPM, Meagan M. Jennings, DPM, FACFAS, and Shannon M. Rush, DPM, FACFAS
| 6,965 reads | 0 comments
There has been a variety of research looking at treatments for acute Achilles tendon ruptures including non-operative repair with different rehabilitation protocols, extensile open repairs, percutaneous repairs, percutaneous repair with ultrasound guidance, percutaneous repair with endoscopic guidance and mini-open repairs.1-3 Some physicians advocate for surgical repair whereas others insist... Read More.
Michael M. Cohen, DPM, FACFAS
| 10,738 reads | 0 comments
Imagine that you were running late on your way to the hospital to attend to an urgent patient. You have a choice of two routes. One route is longer because it uses two streets, each with a traffic light, and no place to make a U-turn and change direction if the traffic is heavy. The shorter route is a straight shot but has no traffic lights with options for U-turns if necessary.   ... Read More.
Shelby Swanson, BA, Andrea Dyack, BS, BA, and Michael S. Lee, DPM, FACFAS
| 14,673 reads | 1 comments
Arthrodesis of the first metatarsophalangeal joint (MPJ) was first advocated in 1894 by Clutton for severe, painful hallux valgus.1 McKeever refined the technique in 1952 using intramedullary screw fixation, which is currently the gold standard for treatment of advanced arthritis and/or significant deformities of the hallux.2 Common indications for arthrodesis include stage 3 hallux rigidus (... Read More.
By Bradly W. Bussewitz, DPM, and Christopher F. Hyer, DPM, FACFAS
| 8,562 reads | 0 comments
Operating room (OR) efficiency does not happen by accident. The ability to synchronize anesthesia, the OR staff and junior physicians can take the attending surgeon great time, effort and diplomacy within the hospital or surgery center. At the center of the efficient model is the surgery itself. The surgeon must have a procedural template to help maneuver and facilitate the ease of each given... Read More.
Jerome A. Slavitt, DPM, FACFAS
| 12,920 reads | 0 comments
Hammertoe correction, one of the mainstays of podiatric surgery, is not as simple and straightforward as one would think. A surgeon may schedule a hammertoe surgery and assume an arthroplasty will correct the deformity. The surgeon is thinking this procedure is quick, easy to perform and he or she will be in and out of the operating room in no time.    Perhaps there is some... Read More.
Jodi Schoenhaus, DPM
| 8,920 reads | 0 comments
The complexity of venous ulcerations leads to prolonged healing and doubt. Clinicians have traditionally treated venous wounds with debridement, multi-layer compression dressings and skin grafts.    Most of the literature focuses on various topical ointments, the use of allogenic grafting, compression therapies, etc. Unfortunately, there is little research on addressing the... Read More.
Sean Grambart, DPM
| 27,663 reads | 1 comments
Fifteen to 25 percent of all injuries involving the human musculoskeletal system are reportedly sprains of the lateral ankle ligaments.1 The majority of patients with ankle sprains have excellent results following surgical treatment but 20 to 40 percent of patients with severe ankle sprains will have continued pain and instability.2    Primary repair typically consists of a... Read More.
Stephen L. Barrett, DPM, Joseph M. Vella, and A. Lee Dellon, MD
| 15,489 reads | 0 comments
As with other types of extremity surgery, podiatric surgery is very specialized and very diverse in the different types of procedures performed routinely by surgical specialists. Procedures can range from simple or complex osseous surgery to delicate peripheral nerve surgery — all of which require some type of hemostasis to be performed optimally.    It is universally accepted... Read More.
Nga T. Ho, DPM, Branden R. Rhodes, DPM, and Stephen Kominsky, DPM, FACFAS
| 14,499 reads | 0 comments
The original Akin osteotomy for the correction of hallux abducto valgus (HAV) included resection of the medial prominence of the first metatarsal head in combination with a medial based wedge osteotomy of the proximal phalanx of the hallux.1 Subsequently, there have been several modifications to the original procedure in order to address factors such as location, rotation, shortening,... Read More.
Michael E. Graham, DPM, FACFAS
| 37,084 reads | 0 comments
Subtalar arthroereisis has a long evolutionary history since its first conception in the 1940s. Since then, researchers have created and abandoned many different methods, materials and devices. The promise of the next great device to stabilize the subtalar joint complex without osteotomy or arthrodesis usually diminished with long-term usage.    The need to stabilize the talus on... Read More.