Surgical Pearls
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.
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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.
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.
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.
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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.
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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.
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