Double calcaneal osteotomy in the treatment of posterior tibial tendon dysfunction.

This article presents an alternative treatment for tibialis posterior tendon rupture in a select group of patients with recent rupture and planovalgus foot structure. Double calcaneal osteotomy is used to realign weightbearing forces in situations where soft-tissue repair alone is not sufficient, and arthrodesis is premature. A single case is presented followed by a discussion, with encouraging results.

Complications of calcaneal osteotomies.

This article describes the associated complications encountered with calcaneal osteotomies. The paper stresses the importance of preoperative evaluation, surgical technique, and postoperative care. We also emphasize the triplanar nature of calcaneal deformities that calcaneal osteotomies correct.

Complications of the Grice-Green operation.

A case presentation involving complications resulting from errors in surgical technique with the Grice-Green procedure is discussed in this report. The patient was treated 18 years after bilateral tendo achillis lengthenings and Grice-Green extra-articular subtalar arthrodeses with autogenous tibial bone grafts. The complications encountered were severe adductovarus deformity of the feet with multiple painful plantar callosities, in-toed gait with weightbearing on the lateral aspect of the feet, inversion ankle instability, and tripping over the feet. Deformity and symptoms were worse on the right foot. The patient required further surgery, consisting of bilateral calcaneal osteotomy, metatarsal neck osteotomies, excision of callosities and ostectomies for painful plantar metatarsal base lesions, tenotomy of the abductor hallucis and digital fusions. The original surgery was performed for idiopathic flatfeet. Despite the many different causes of flatfoot for which the Grice-Green procedure has been employed, most authors believe it should not be used for idiopathic flatfeet, and restrict its use to the original indication, that of paralytic pes valgus secondary to poliomyelitis. The reader should also realize that there are very long-term consequences to surgery on the pediatric patient.

Tailor's bunion: clinical evaluation and correction by distal metaphyseal osteotomy with cortical screw fixation.

Fifth metatarsal distal metaphyseal osteotomy represents a very common surgical procedure performed for tailor's bunion deformity. The authors advocate using a cortical bone screw for fixation device offers many advantages over conventional devices (i.e., Kirschner wire). The purpose of this paper is to offer a means to thoroughly evaluate tailor's bunion deformity clinically, biomechanically, and radiographically. This will allow the podiatric surgeon to choose a procedure of choice to correct the deformity. The technique of fifth metatarsal distal metaphyseal osteotomy with cortical bone screw fixation using AO4 principles is fully described.

Causalgia: clarifications in terminology and a case presentation.

By way of literature review, clarifications are made in the terminology employed in discussing the atypical post-traumatic pain syndromes, particularly reflex sympathetic dystrophy (RSD). Causalgia is a form of RSD and is the focus of a case report presented from the files at St. Anne's Hospital-West, Northlake, Illinois.