Surgical Pearls

Kerry Zang, DPM
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Over the years, hallux valgus repair has evolved from simple bunionectomies to complex and multiple osteotomies. The keys to a successful outcome are the realignment of the structural abnormalities and a stable postoperative environment.The former is important for proper function and the latter facilitates the healing process. With this in mind, let us take a closer look at the potential... Read More.
By Luke D. Cicchinelli, DPM, FACFAS
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Learning and performing effective surgery is akin to studying and speaking a foreign language. Not every one does so with the same fluency. The patient often does not speak a single word. Anatomy is the vocabulary, surgical procedure selection is the syntax and some aspects like verb conjugation and internal fixation sequences simply have to be committed to memory.    There are... Read More.
By J. Michael Miller, DPM
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Minimizing postoperative discomfort for patients is a common goal of all surgeons. Techniques for achieving this goal seem to vary significantly among surgical specialties. Unfortunately, patients often have preconceived expectations that they will experience considerable discomfort after foot surgery. This is usually based on their experience with other surgical procedures or from discussions... Read More.
By Jason S. Harrod, DPM
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There are many methods you can use to prepare the first metatarsophalangeal joint (MPJ) for arthrodesis. One of those techniques involves using a cup and cone reamer system. Using this system can be helpful, especially when there has been some trauma to the joint surface, when you’re dealing with an extremely arthritic joint with hypertrophy or when the patient has a square metatarsal head. These... Read More.
By Gerald W. Paul, DPM
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The advantages of lesser proximal interphalangeal joint arthrodesis in hammertoe surgery are numerous and well known. Arthrodesis is indicated in patients who have compromised intrinsic muscle function and are lacking both digital and metatarsophalangeal joint stability. Indeed, digital arthrodesis has always been an excellent procedure to consider if you fear reoccurrence of the hammertoe... Read More.
By Jesse B. Burks, DPM
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Surgery in general seems to gravitate toward smaller and less invasive procedures. Obviously, the less tissue disruption that occurs during surgery, the less risk one has of postoperative complications such as scarring, infections, delayed healing, etc. Although this may not be true with every surgical advance, arthroscopy has revolutionized the treatment of joint disorders and allowed many of... Read More.
By Thomas Cusumano, DPM
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Hallux limitus/rigidus is defined as a degenerative arthrosis of the first metatarsophalangeal joint (MTPJ) which is characterized by a decrease in the MTPJ range of motion and an eventual lack of motion.1 Treatment for this condition is a frequently discussed topic at podiatric conferences. When it comes to the stages of osteoarthritis in the MTPJ, one may consider performing joint preservation... Read More.
By Stephen L. Barrett, DPM
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Keck first described tarsal tunnel syndrome in the literature back in 1962 and it remains a controversial topic today.1 While tarsal tunnel syndrome is a prevalent and common condition, lower extremity peripheral nerve entrapments and other nerve pathology can be clinically difficult to appreciate and understand. Needless to say, making a decision to proceed with surgical intervention for this... Read More.
By Harold Schoenhaus, DPM, Jodi Schoenhaus, DPM, and Dawn Pfeiffer, DPM
| 4,103 reads | 0 comments
One of the most commonly performed procedures in the foot is an implant arthroplasty of the first metatarsophalangeal (MPJ) joint. However, we have occasionally noted a hollow medullary canal after resecting the base of the proximal phalanx. This can cause problems with incorporation of the implant. Yet there is an intraoperative option one can use to address this problem. Adequate bone stock of... Read More.
By Lynnelle R. Gabriel, DPM
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Treating a Morton’s neuroma can be a delicate operation. There is currently much discussion and controversy over whether to remove an intermetatarsal neuroma or leave the nerve intact and release the deep transverse intermetatarsal ligament via a minimally invasive nerve decompression (MIND). There have not been enough studies to sway the majority of surgeons to leave the intermetatarsal neuroma... Read More.
By Jesse B. Burks, DPM
| 9,189 reads | 0 comments
Isolated fusions of the rearfoot have long been a choice of many podiatric foot and ankle surgeons for conditions such as coalitions, arthrosis and symptomatic flatfoot deformities. Persuasive arguments can be made for fusion of the calcaneocuboid, subtalar or talonavicular joints, especially when it comes to deformities such as the symptomatic flatfoot. While each of these procedures provide... Read More.
By Graham A. Hamilton, DPM
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   A challenging problem for any podiatric surgeon is surgically managing cases in which a silicone elastomer implant in the first metatarsophalangeal joint (MPJ) has failed. When patients initially present with this problem, they will complain of pain, deformity or both at either the first or lesser metatarsophalangeal joints.    The cause of the pain or deformity... Read More.