ABSTRACT
The authors introduce the long plantar wing distal metaphyseal osteotomy of the first metatarsal through a medial plantar approach. This procedure for mild-to-moderate hallux valgus is capable of correcting an increased proximal articular set angle and first intermetatarsal angle concomitantly. The biomechanical, surgical, and clinical rationale for this procedure are discussed.
Subject(s)
Hallux Valgus/surgery , Hallux/surgery , Osteotomy/methods , Biomechanical Phenomena , Follow-Up Studies , Hallux/physiology , Hallux Valgus/physiopathology , Humans , Treatment OutcomeABSTRACT
The Scarf bunionectomy offers the surgeon the ability to correct a mild to moderate intermetatarsal angle with the stability inherent to this procedure. When an increased proximal articular set angle is encountered, this procedure could previously only address either the increased intermetatarsal angle or the increased proximal articular set angle. The authors' modifications will incorporate the best attributes of the Scarf, Reverdin, and McBride bunionectomies to allow for concomitant correction of the osseous and soft tissue components of the hallux abducto valgus deformity. The authors' experience with 27 of these procedures performed on 15 different patients from 1987 to 1991 is presented.
Subject(s)
Hallux Valgus/surgery , Osteotomy , Adult , Aged , Aged, 80 and over , Bone Nails , Female , Hallux Valgus/diagnostic imaging , Humans , Middle Aged , Models, Anatomic , Osteotomy/instrumentation , Radiography , Reoperation , Treatment OutcomeABSTRACT
Narcotic analgesics may be used safely in most patients. Common adverse effects may be managed successfully with naloxone. PCA is a newer approach to the management of postoperative pain. The authors' survey results indicate that most podiatric physicians would benefit from the understanding of the considerations in the patient subgroups with renal or hepatic dysfunction that required postoperative pain control.
Subject(s)
Analgesics/therapeutic use , Narcotics/therapeutic use , Pain, Postoperative/drug therapy , Age Factors , Drug Administration Schedule , Humans , Kidney Diseases/physiopathology , Liver Diseases/physiopathology , Pain, Postoperative/physiopathologyABSTRACT
The authors' present a plantar surgical approach for the patient with painful heel syndrome that is refractory to conservative care. Patient selection, methods, and results are discussed and analyzed. Twenty-two patients with 25 painful heels underwent the procedure. Retrospective analysis of these patients clearly shows this procedure is a viable alternative for heel surgery.
Subject(s)
Calcaneus/surgery , Heel/surgery , Adult , Aged , Bone Diseases/complications , Bone Diseases/surgery , Female , Humans , Male , Middle Aged , Pain/etiology , Retrospective Studies , SyndromeABSTRACT
Charcot-Marie-Tooth disease is a hereditary motor and sensory neuropathy with well documented manifestations in the extremities. Recent literature suggests systemic involvement in this neuropathy. The authors present a review of the literature, anesthetic considerations, and practical recommendations for the assessment of involved systems.
