Surgical Pearls

Kenneth Seiter, DPM
21,164 reads | 0 comments | 02/23/2010
   Surgical revision of a failed silicone prosthesis in the first metatarsophalangeal joint (MPJ) is a difficult dilemma that many foot and ankle surgeons increasingly encounter. While advocates of silicone and similar implants have alluded to their preliminary benefits, there is a scarcity of literature on how to salvage these failures, especially when they occur in younger, active patients. | Continue reading
Lawrence Fallat, DPM, FACFAS
54,134 reads | 0 comments | 12/30/2009
   There are numerous surgical procedures designed to correct the variations of bunion deformities. Often, the final step of the operation is to correct the valgus and abduction component of the great toe. This has been the subject of a popular and technically simple procedure that was introduced approximately 85 years ago. | Continue reading
Michael S. Downey, DPM, FACFAS­­
67,910 reads | 0 comments | 10/26/2009
   The management of posterior heel pain can be a perplexing diagnostic and therapeutic problem. The differential diagnosis is extensive and even the skilled clinician can experience difficulty establishing an accurate diagnosis. Of the challenging conditions affecting the back of the heel, the retrocalcaneal exostosis may be the most onerous to treat. | Continue reading
Graham A. Hamilton, DPM, and Travis L. Sautter, DPM
27,094 reads | 0 comments | 08/24/2009
   Arthroscopy is an expedient tool in the management of intra-articular fractures of the ankle and post-fracture articular defects. It provides the surgeon the ability to anatomically reduce a fracture under direct visualization with minimal intervention. It also enables the surgeon to address any articular injury primarily. | Continue reading
Jodi Schoenhaus, DPM, and Jason Gold, DPM
235,131 reads | 0 comments | 06/26/2009
   Entrapment neuropathy of the tarsal tunnel and its terminal branches is a painful condition, which can be challenging to diagnose given the possibility of concurrent conditions with overlapping symptoms. Heel spur syndrome/plantar fasciitis and entrapment neuropathy often present at the same time. However, it is important to differentiate clearly between the two pathologies as entrapment neuropathy has a distinct history and clinical presentation. | Continue reading
Adam R. Johnson, DPM
23,407 reads | 0 comments | 04/23/2009
   While total joint replacement has been successful in the shoulder, the hip and the knee, we have not seen similar success with total ankle replacement in the past.    Initial reports on total ankle replacements were promising in 1979.1 However, long-term follow-up studies painted a different picture as many failures and poor survivorship of the implants led many authors to abandon the procedure in favor of arthrodesis as it had more predictable results and fewer complications.2-4    Yet there has been a recent resurg | Continue reading
Gary Peter Jolly, DPM, FACFAS
26,140 reads | 0 comments | 02/26/2009
   Compression neuropathies of the posterior tibial nerve and its branches are a fairly common group of disorders, which are often misdiagnosed.1,2 In order to diagnose lesions of these nerves accurately, one must maintain a fairly high index of suspicion of their presentation. Relying on abnormal findings via electromyography and nerve conduction velocity testing is risky because the incidence of false negatives is quite high.2,3    In contrast, pressure specific sensory testing may produce false positive results. Although the classical | Continue reading
By Sean Grambart, DPM
16,733 reads | 0 comments | 12/30/2008
   Joint sparing procedures include total ankle arthroplasty, distraction arthrodiastasis and allograft total ankle replacement. However, the gold standard is still ankle arthrodesis.    Traditional exposure for ankle arthrodesis has been through the open transfibular approach. This approach usually involves a fibular takedown osteotomy but researchers have described a medial malleolar approach.1 Unfortunately, this technique has the disadvantages of a larger skin incision that can lead to wound dehiscence and increased risk of postoperative infecti | Continue reading
Jerome Slavitt, DPM
24,965 reads | 0 comments | 10/29/2008
   While warts are among the most common pathological problems that podiatrists treat, they are also among the most frustrating conditions. While there are multiple forms of therapy available, the success rate is not what we would like to see. In my clinical experience, I have found that these modalities only have an average cure rate of 75 percent.    There is no individual approach that can be construed as the single most effective form of wart therapy. It is also a good idea to inform the patient about the possibility of recurrence both during and after th | Continue reading
Using a blunt needle, the surgeon may place the calcium phosphate bone cement directly into the surgical void as shown above. In this procedure, surgeons are utilizing OsteoVation calcium phosphate bone cement with a total non-constrained great joint impl
Kerry Zang, DPM
24,045 reads | 0 comments | 09/03/2008


Over the years, hallux valgus repair has evolved from simple bunionectomies to complex and multiple osteotomies. The keys to a successful outcome are the realignment of the structural abnormalities and a stable postoperative environment.The former is important for proper function and the latter facilitates the healing process.
With this in mind, let us take a closer look at the potential benefits of utilizing calcium phosphate bone cement (OsteoVation™, OsteoMed Corp.) for filling voids in metatarsal osteotomy-type bunionectomies to achieve a favorable surgica | Continue reading