Surgical Pearls
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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.
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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.
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12,126 reads
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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.
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25,824 reads
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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.
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11,930 reads
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One of the most documented postoperative complications of distal metatarsal osteotomies is adhesive capsulodesis that limits dorsiflexion of the first metatarsophalangeal joint (MPJ). When faced with such a post-op complication, one may be able to use a proven cartilage preservation procedure that maintains, if not improves, the first MPJ range of motion.
... Read More.
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7,300 reads
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While the concept of infections has been studied for many years, our current understanding of infections is based upon studies and observations of planktonic bacteria. This is free floating bacteria that cause diseases such as pneumonia, sepsis, urinary tract infections, gas gangrene and many other examples. These types of infections often respond well to antibiotics and... Read More.
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Foot and ankle surgeons have no shortage of choices when it comes to selecting instruments for surgical procedures. Our surgical team has found success in using the Koby line of instruments (OsteoMed) for the treatment of various conditions.
For the last four years, surgeons have found success using Koby instruments for three procedures commonly performed in... Read More.
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20,482 reads
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When it becomes apparent that the current treatment is not proving effective for a debilitating disease or a trauma induced by accident or warfare, amputation is generally considered the medical intervention of last resort. Indeed, one would exhaustively consider any and all other medical alternatives to save a limb before deeming it necessary to amputate.
However, once the... Read More.
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Nonunions can be difficult to address with any patient. Accordingly, the surgeon may benefit from any additional modalities that can prevent a recurrent nonunion after a revision. When evaluating a nonunion for surgical revision, one should critically evaluate the primary fixation. If a fixation technique has failed with the use of screws and both sides of the failed fusion have been penetrated,... Read More.
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Practitioners have described various osteotomies for the proximal hallux. However, the Akin closing wedge osteotomy is currently the most common procedure. Podiatric surgeons commonly employ the transverse plane closing wedge osteotomy for the correction of hallux abductus interphalangous deformity. One may also use this as an additional procedure for the correction of hallux... Read More.
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One of the most common conditions that the foot and ankle surgeon will encounter is the hammertoe deformity. Surgeons have used multiple procedures for more than 60 years to deal with this condition. These have included amputation of the digit, arthrodesis of the interphalangeal joints, soft tissue releases, arthroplasty (removal of bone, partial or complete), tendon... Read More.
We are an aging population. One can ascertain that with aging comes an increased incidence of comorbid conditions. With the vast majority of podiatric surgical cases being elective, documentation supporting the vascular system prior to surgery will protect the surgeon from postoperative complications associated with circulatory issues, or may help surgeons recognize an asymptomatic issue for... Read More.
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