Surgical Pearls

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
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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.
By Richard O. Lundeen, DPM
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   Back when I left the didactic world of podiatry school and entered my residency, I was ready for a transition that would blend the books with practice. Of course, the first two surgeries I performed did not fit the mold. The first one was a cartilage articulation preservation procedure (CAPP) and the other was a Keller procedure.    The CAPP procedure was... Read More.
By Michael Baker, DPM, CWS
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As foot and ankle surgeons, we are constantly reminded that we are the ultimate champions of diabetic foot care. However, another emerging problem is chronic venous insufficiency (CVI) ulcerations. While it does not have nearly the potential impact of limb loss one may see with complications from the diabetic foot, there is an increasing incidence of CVI with the continued aging of the population... Read More.
By Jesse Burks, DPM
| 7,416 reads | 0 comments
   Severe, acute or repetitive chronic inversion ankle sprains can often result in lateral instability of the lateral ankle complex. Although one can treat the vast majority of these conditions conservatively, a significant and unresponsive case may require surgical intervention. Over the course of the past two decades, improved soft tissue anchors and arthroscopic procedures have... Read More.
By Peter M. Wilusz, DPM, and Guy R. Pupp, DPM
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   Multiple etiologies exist for painful conditions that involve the first metatarsophalangeal joint (MPJ). Hallux abducto valgus and hallux limitus are the most common pathologies of the first MPJ podiatrists see in most foot and ankle clinics. Other causes may include rheumatoid arthritis, trauma, connective tissue disorders, infection, iatrogenic and metabolic disorders.... Read More.
By Erwin Juda, DPM, R.Ph.
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   Pain management in the elderly remains one of the most challenging issues for the podiatric surgeon. As life expectancy continues to advance, more geriatric patients will undergo surgery. While these patients may undergo these procedures to help facilitate independence and a better quality of life, one must carefully weigh the risks and benefits of surgical intervention in this... Read More.
By Daniel K. Lee, DPM, and Gregory E. Tilley, DPM
| 15,752 reads | 0 comments
   There have been many surgical treatment modalities described in the podiatric and orthopedic literature for the correction of hallux limitus.1-5 Since the Regnauld procedure was introduced in 1968, surgeons have used it in the treatment of a pathologically long proximal phalanx and hallux limitus.6 However, since its development, this procedure has been characterized as a... Read More.
By Don Green, DPM and Peter S. Kim, DPM
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The etiology of heel pain is quite varied. First described by Wood in 1812, the most common cause is thought to be plantar fasciitis. This is typically marked by focal tenderness to any component of the aponeurosis but most frequently at the proximal medial insertion of the plantar aponeurosis.1 Many symptomatic patients with plantar fasciitis demonstrate plantar heel spurs (traction... Read More.
By John A. DeBello, DPM, Kordai I. DeCoteau, DPM, and Eric Beatty, DPM
| 19,692 reads | 0 comments
   Hammertoes may have an etiology that is either congenital or acquired. Pain and cosmetic appearance are the leading factors for patients wanting surgical intervention for hammertoe deformities. While there are a variety of approaches for hammertoe correction, we have found success with a novel approach that emphasizes the use of medial and lateral incisions.    ... Read More.
By Kerry Zang, DPM, Shahram Askari, DPM, A’Nedra Fuller, DPM, and Chris Seuferling, DPM
| 40,204 reads | 2 comments
Addressing the biomechanics of the first metatarsophalangeal joint (MPJ) as well as the first ray are the keys to any surgical correction of first metatarsal pathology. According to Rootian theory, the principal etiologies of hallux limitus are as follows.1 • A long first metatarsal or when the position of the first metatarsal head is relative to the second. When the first metatarsal is long,... Read More.