Surgical Pearls

By Gordon Zernich, CP, Tomas Dowell, CPO/LPO, Gary M. Rothenberg, DPM, FACFAS, and Michael M. Cohen, DPM, FACFAS
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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.
By Devon Glazer, DPM
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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.
By Anthony Weinert, DPM, Ali Elkhalil, DPM, and Ahmad Farah, DPM
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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.
By Kerry Zang, DPM
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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.
Benjamin Sefcik, DPM, and Peter M. Wilusz, DPM
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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.
Dina Stock, DPM, Cory Baxter, DPM, James Sferra, MD, Christopher Herbert, DPM, and Elizabeth Baracz, BS
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Tarsal tunnel syndrome is an entrapment of the posterior tibial nerve or its branches within the tarsal tunnel.1 This syndrome is most frequently unilateral as opposed to carpal tunnel syndrome in the upper extremity, which is typically bilateral.2 Keck and Lam first described the term “tarsal tunnel syndrome” in 1962.3,4 Malaisé first described the clinical signs and... Read More.
By Graham A. Hamilton, DPM
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     Nonunion is a well-documented potential complication of the Lapidus arthrodesis. It reportedly occurs anywhere from 3.3 percent to 12 percent of the time, and is a very challenging problem to fix.1-7      Granted, a strict definition of nonunion and timeline for classifying a nonunion varies from one surgeon to another. However, for the purpose of this... Read More.
By Luis Leal, DPM
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Vacuum Assisted Closure (VAC) is one of our greatest tools in managing large as well as deep wounds. It crosses multiple surgical disciplines and is applicable to virtually all anatomical sites. This technology has revolutionized limb salvage surgery and has prevented untold numbers of amputations. There is an exciting growth curve with the use of this technology. Surgeons can modify the... Read More.
By Andreas Boker, MD; Clinical Editor: Jesse Burks, DPM
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The fully keratinized, thick multilayered structure of the nail plate presents a formidable barrier to nail bed access. This limits the options for treatment of nail diseases such as onychomycosis and subungual hematoma from nail trauma. Until recently, clinicians considered nail removal as an option for formal repair of the nail bed for subungual hematomas involving large regions of the nail bed... Read More.
By Richard T. Braver, DPM
| 122,141 reads | 1 comments
In my experience, the Modified Kidner procedure is one of the most reliable operations for reducing arch pain associated with an accessory navicular bone (a.k.a. os tibial externum). You can also use this procedure to treat a prominence at the inner aspect of the arch, which has been caused by an enlarged navicular bone. The most common patients to visit our office with these problems are between... Read More.
By Richard Braver, DPM
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Distal posterior heel pain is a deformity we see quite often. It masquerades as chronic Achilles tendinitis, when in fact a calcaneal step (aka retrocalcaneal exostoses) is present at the Achilles insertion. You must also clinically differentiate it from adjacent problems, such as Haglund’s deformity, retrocalcaneal bursitis and intra-Achilles tendon tear. Often, these problems may be concurrent... Read More.