Podiatry Institute ankle fusion technique.

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.

Bilateral osteochondritis dissecans of the first metatarsophalangeal joint.

The authors present a review of the literature concerning the pathogenesis, diagnosis, and treatment of osteochondral defects of the lower extremity. A case of bilateral osteochondritis dissecans of the first metatarsophalangeal joint in a 43-year-old female is presented, including surgical treatment with 1- and 3-year follow-up examinations. The correlation between articular damage to the first metatarsal head and concomitant hallux limitus and hallux rigidus is discussed. The authors also propose that osteochondritis dissecans lesions almost always occur on the convex surface of a joint because of a convergence of impaction forces.

Vascular decompression. The critical element in forefoot crush injury.

The authors present an overview of post-traumatic foot compartment syndrome with an emphasis on the importance of relieving vascular compromise immediately. The incisional approach selected should not only effectively decompress the foot, but also allow for repair of concomitant osseous and soft tissue injury as well. Vascular considerations may dictate the course of simultaneous fracture management.

1993 William J. Stickel Bronze Award. Imaging of the infected foot. Fact or fancy?

Advancements in methods of imaging infection have surpassed their worth. Although scientifically substantiated, their clinical pertinence is frequently disappointing. Diabetic infections, postoperative or traumatic sequelae, rheumatologic conditions, and Charcot disease are difficult to differentiate from osseous infection because they all manifest as inflammation. As this country struggles to contain health care costs, a critical investigation regarding the practical benefits of imaging osteomyelitis in the foot is overdue.

Penicillins, cephalosporins, quinolones.

This article details the mechanisms of action, antimicrobial spectrum, pharmacokinetics, and adverse reactions of these three antibiotics.

Fixation devices in rearfoot surgery.

Numerous advances in biomaterials and fixation devices have improved the caliber of rearfoot surgical procedures. An understanding of the underlying physical properties of fixation devices along with the improvement in surgical technique have elevated complex foot surgery to a higher level of quality with improved results. Since the addition and continued improvement of rigid fixation to tarsal arthrodesis, more consistent osseus fusion with a decrease in nonunion has been found.