Approach to the Ankle in Adult Acquired Flatfoot Deformity.

Adult acquired flatfoot is a progressive deformity of the foot and ankle, which frequently becomes increasingly symptomatic. The posterior tibial tendon is most commonly associated with the deformity. A targeted physical examination with plain film radiographs is the recommended initial assessment, which will further guide a physician toward procuring more advanced imaging or toward surgical intervention. In this chapter the authors review the current literature of their approach to the treatment of the ankle in end stage of adult acquired flatfoot deformity.

Lesser toe deformity classification: A simplified approach with treatment influence.

Deformities of the lesser toes are one of the most commonly treated conditions by foot and ankle surgeons. Despite their frequency, a standardized classification has yet to take hold among providers. Generic nomenclature with the addition of multiple adjunctive descriptors continues to be the standard leading to international confusion. A literature review was conducted to analyze any literature and/or textbooks pertaining to lesser toe deformity classification systems. Seven sources met the inclusion criteria and were analyzed consisting of novel, modified, and previously published systems. A simplified and treatment driven lesser toe deformity classification utilized at the University of Louisville is introduced, which categorizes these deformities into one of two groups. Type 1 deformities are those isolated to the toe only and Type 2 deformities are toe deformities that include metatarsal phalangeal joint involvement. The intent of the University of Louisville Lesser Toe Deformity Classification (LTDC) is to improve communication and documentation, as well as assist surgical planning. LEVEL OF CLINICAL EVIDENCE: 5.

Novel Technique for the Treatment of a Tongue-Type Calcaneal Fracture in the Setting of Chronic Osteomyelitis.

Osteomyelitis of the calcaneus combined with a pathologic fracture is a rare and difficult presentation for any practicing foot and ankle surgeon. Treatment for achieving an aseptic nonunion involves a variety of steps, including surgical debridement, antibiotic administration, and fracture stabilization. In this case series, we report a novel technique for the treatment of a tongue-type calcaneal fracture in the setting of chronic osteomyelitis using the Biomet JuggerLoc bone-to-bone system for fixation.