Surgical Pearls

Michael Tritto, DPM
9,894 reads | 0 comments | 06/25/2013
The correction of a significantly subluxed or dislocated hammertoe in an elderly patient can be a challenge to any surgeon. Over the last 22 years, I have tried numerous ways to correct the problem, all with varying degrees of success. The use of the Weil osteotomy along with other procedures, including proximal interphalangeal joint fusion, flexor transfer and now plantar plate repair from a dorsal approach, has not given me consistent results with patients who are over 65 years of age. | Continue reading
Keith D. Cook, DPM, FACFAS, and Irene Labib, DPM, MS
39,383 reads | 0 comments | 04/19/2013
Both pediatric and adult-acquired flatfoot deformities, particularly posterior tibial tendon dysfunction (PTTD) stage II, remain difficult to treat and there is much controversy in regard to the optimal form of treatment. Patients usually present with increased pain and swelling along the medial aspect of the ankle or rearfoot. The foot generally maintains an abducted forefoot position and a decrease in the height of the medial longitudinal arch. Sometimes patients can perform a double heel raise but cannot perform a single heel raise. This signifies posterior tibial tendon pathology. | Continue reading
Jason R. Miller, DPM, FACFAS, and Stanley Chen, DPM, AACFAS
13,414 reads | 0 comments | 02/26/2013
Tendon and ligament pathologies are extremely common in the adult population. Eleven percent of runners experience Achilles tendinopathy with seven out of 100,000 people sustaining a rupture. There are 1 million ankle injuries per year, 85 percent of which are ankle sprains. The total cost of tendon and ligament treatment is approximately $30 billion per year in the United States alone.1 The medical community has actively sought the augmentation of these repairs and the response by orthobiologic companies has been great. | Continue reading
By Bradly Bussewitz, DPM
13,446 reads | 0 comments | 12/19/2012
The European approach to the bunion commonly involves the scarf bunionectomy, much more so than here in the United States. Of the many bunion approaches, why should we bother adding another to the list? Those who utilize the scarf approach understand the stability, power of correction and utilitarian nature of this bunionectomy choice. I use the scarf as one of my go-to procedures for correcting mild to severe hallux abducto valgus. | Continue reading
Jodi Schoenhaus Gold, DPM, FACFAS
18,414 reads | 0 comments | 10/26/2012
Fat pad augmentation or the use of grafting in the ball of the foot and the heel has gained popularity over the past decade. The goal is simply to add cushioning or padding to areas that demonstrate a loss or displacement of natural fat due to an increased peak pressure. | Continue reading
Lawrence Fallat, DPM, FACFAS, and Ruby Chahal, DPM
82,408 reads | 0 comments | 08/28/2012
Fifth metatarsal fractures are the most common of all metatarsal fractures.1 Avulsion fractures, Jones fractures and proximal diaphyseal fractures occur most frequently, but diaphyseal, neck and head fractures also occur.2 Clinicians can treat most of these fractures conservatively if the fractures are not significantly displaced. | Continue reading
Damien Dauphinée, DPM, FACFAS, CWS-P
31,831 reads | 1 comments | 06/27/2012

The interdigital neuroma is a common source of forefoot pain that podiatric foot and ankle surgeons see in their practices every day. The characteristic symptoms have been well known since Morton first described them in 1876.1 Even though Morton believed the problem was located at the fourth metatarsophalangeal articulation, his name has been associated with the pathology for over a century. Peripheral nerve surgeons have chosen to avoid the term “neuroma,” opting instead for “interdigital neuritis,” which better describes the problem.

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Kelley Wallin, DPM, and Donald Green, DPM, FACFAS
12,055 reads | 0 comments | 04/23/2012
Subtalar joint arthrodesis and subtalar joint arthroereisis are widely used surgical procedures for eliminating motion or limiting excessive pronation at the subtalar joint.1-3 | Continue reading
John F. Grady, DPM, FASPS
30,544 reads | 1 comments | 02/22/2012
Hallux limitus is generally responsive to conservative care consisting of anything from changing foot gear, changing activity and exercises to orthoses, injections, anti-inflammatory medication and physical therapy.1 When these things fail, surgery is necessary. | Continue reading
Nicholas J. Bevilacqua, DPM, FACFAS
12,442 reads | 0 comments | 12/21/2011
Ankle fractures are seemingly uncomplicated injuries. However, in the elderly and people with diabetes, this seemingly straightforward injury can have catastrophic outcomes. | Continue reading