ABSTRACT
The authors review the ankle and pantalar fusion literature. The authors performed a retrospective review on 42 ankle and pantalar fusions, emphasizing the role of internal fixation. The Podiatry Institute technique for internal fixation of ankle fusions is described and experience with the technique is reviewed. Complications included delayed union and nonunion at the fusion site or the repaired fibular osteotomy site and tibial fractures at screw stress riser sites. Modifications to reduce these complications are discussed. Experience with internal fixation in ankle and pantalar fusions, both in this study and in current literature, has been positive.
Subject(s)
Ankle Joint/surgery , Arthrodesis/methods , Talus/surgery , Adult , Aged , Female , Humans , Internal Fixators , Male , Middle Aged , Patient Selection , Postoperative Complications , Retrospective StudiesABSTRACT
The authors present a brief history of the development of the Ilizarov external fixator, and the classic uses associated with it. A preliminary study of 3 patients using 56 frames is presented. The Ilizarov external fixator is successfully used in these cases in place of traditional fixation.
Subject(s)
Ilizarov Technique , Leg/surgery , Adolescent , Adult , Bone Diseases/surgery , Child , External Fixators , Female , Foot Deformities/surgery , History, 20th Century , Humans , Ilizarov Technique/history , Leg/abnormalities , Leg Injuries/surgery , MaleABSTRACT
One hundred seventy-two patients (265 feet) were reviewed following correction of hallux abducto valgus surgery, using the Kalish modification of the Austin bunionectomy. Fifty-three cases were followed up on an average of 2.5 years from 1986 through 1992. The statistical results support the use of this osteotomy with rigid internal fixation for the reduction of the intermetatarsal angle, hallux abductus angle, and tibial sesamoid position. Patients are weightbearing immediately and are usually back in soft shoes or sneakers 2 weeks after surgery. Surgical techniques and complications of this procedure are discussed to help surgeons use this procedure in correcting hallux abducto valgus deformities.
Subject(s)
Hallux Valgus/surgery , Osteotomy/methods , Humans , Metatarsal Bones/surgery , Retrospective StudiesABSTRACT
Although most practitioners are familiar with brachymetatarsia, it is a relatively uncommon clinical entity presenting for surgical correction. Traditional methods of surgical correction have been successful for the most part; however, a number of potentially devastating complications exist with these procedures. The authors present a review of the deformity, including the historical surgical techniques, and introduce a new surgical approach that minimizes the risk of complication.
Subject(s)
Foot Deformities, Congenital/surgery , Metatarsal Bones/abnormalities , Foot Deformities, Congenital/etiology , Humans , Metatarsal Bones/surgery , Postoperative ComplicationsABSTRACT
Diabetic lower extremity infections, frequently polymicrobial, are at times fascinating though frustrating for the practitioner to treat. The classical triad of neuropathy, infection, and angiopathy is the hallmark of diabetic foot pathology. One of the main forms demonstrating the severe long-term neuropathic disease is called osteoarthropathy or Charcot joint. This is usually relatively painless, always progressive, and frequently destructive. It generally attacks the midtarsal joint and eventually changes the entire architecture of the foot, causing the so-called "rocker bottom" foot type. We present a case of a severely destructive Charcot foot that caused a large synovial cyst because of its vast underlying osseous pathology. The morbidity and mortality of these infections can be minimized by understanding the unique challenges these individuals offer the practitioner.
Subject(s)
Arthropathy, Neurogenic/surgery , Diabetic Neuropathies , Foot Diseases/surgery , Synovial Cyst/surgery , Tarsal Joints/surgery , Humans , Male , Middle AgedSubject(s)
Braces , Casts, Surgical , Air , Glass , Humans , Immobilization , Physical Therapy ModalitiesABSTRACT
The authors review the literature on Achilles tendon ruptures and discuss the conservative and surgical approaches to treatment of acute ruptures. A case history of acute Achilles tendon rupture is presented, including clinical signs not previously described. The primary complication of Achilles tendon rupture is the high incidence of rerupture after conservative therapy. The authors note that complications after surgical repair of an Achilles tendon rupture may be avoided by a surgeon skilled in the performance of this procedure and by the use of an appropriate surgical drain. The authors conclude that primary surgical repair is the treatment of choice for acute Achilles tendon ruptures.
Subject(s)
Achilles Tendon/injuries , Tendon Injuries/therapy , Tendons/transplantation , Achilles Tendon/surgery , Adult , Humans , Immobilization , Male , Radiography , Rupture , Tendon Injuries/diagnostic imagingSubject(s)
Foot Diseases/etiology , Scleroderma, Systemic/complications , Female , Humans , Male , Scleroderma, Systemic/diagnosisABSTRACT
A review of the literature and two case reports of subungual exostosis are presented herein. This benign bony overgrowth, usually caused by trauma, is often misdiagnosed and sometimes mistaken for a malignancy. It is our intention to stimulate interest in and alert the practitioner to this entity so that he can include subungual exostosis in his differential diagnosis of digital lesions.
