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Foot and Ankle Clinics

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https://www.readbyqxmd.com/read/30097088/the-subtalar-joint
#1
EDITORIAL
Norman Espinosa
No abstract text is available yet for this article.
September 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/30097087/subtalar-distraction-arthrodesis
#2
REVIEW
Norman Espinosa, Elena Vacas
The subtalar joint can be altered in its anatomy and biomechanical behavior. It is important to know how to assess the talar declination angle in order to assess the deformity at the subtalar joint. Consider a straight posterior approach to the subtalar joint and remain liberal in the use of z-shaped Achilles tendon lengthening. A structural bone graft should be used to elevate the talus. Positioning screws should be used to lock the construct.
September 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/30097086/subtalar-arthroscopic-fusion
#3
REVIEW
Emilio Wagner, Rodrigo Melo
Arthroscopic subtalar fusion is an excellent approach to subtalar pathologic condition where conservative treatment has failed and a fusion has been indicated. Formal contraindications include excessive malalignment and bone loss. The posterior arthroscopic approach is analyzed in this article, including indications, surgical technique, surgical tips, and complications. Excellent results can be expected, including a shorter time to fusion, and faster rehabilitation, including activities of daily living and sports...
September 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/30097085/open-technique-for-in-situ-subtalar-fusion
#4
REVIEW
Stephan H Wirth, Stefan M Zimmermann, Arnd F Viehöfer
The subtalar joint plays an important role for the hindfoot when accommodating during gait. Joint degeneration may be caused by posttraumatic, inflammatory, and pathologic biomechanical changes. Once conservative treatment has failed, subtalar fusion should be considered. The indication for surgery is based on thorough clinical and radiographic evaluation. Several techniques for subtalar fusion are published in literature. This article aims to describe a technique for in situ arthrodesis of the subtalar joint, paying special attention to biomechanical aspects as well as preoperative clinical and radiological work-up...
September 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/30097084/medial-approach-to-the-subtalar-joint
#5
REVIEW
James Widnall, Lyndon Mason, Andrew Molloy
Surgical access to the subtalar joint is required in a plethora of pathologic conditions of the hindfoot. The conventional lateral approach can give excellent access to subtalar joint; however, in hindfoot valgus deformities, there can be unacceptable risks of wound problems and incomplete deformity corrections. The medial approach offers good access to the subtalar joint with an increasing evidence base for its use, especially with double fusions in pes planus deformities. The authors review the current evidence in the use of the medial approach for the subtalar joint...
September 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/30097083/coalitions-of-the-tarsal-bones
#6
REVIEW
Georg Klammer, Norman Espinosa, Lukas Daniel Iselin
Tarsal coalitions are the result of impaired mesenchymal separation of the tarsal bones. The most common types include calcaneonavicular or talocalcaneal coalitions. Subtalar stiffness results in pathologic kinematics with increased risk of ankle sprains, planovalgus foot deformity, and progressive joint degeneration. Resection of the coalition yields good results. Tissue interposition may reduce the risk of reossification, and concomitant deformity should be addressed in the same surgical setting.
September 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/30097082/arthroereisis-what-have-we-learned
#7
REVIEW
Cristian A Ortiz, Emilio Wagner, Pablo Wagner
One of the most common orthopedic problems in the authors' practice is flatfoot and, although it is most commonly treated conservatively, there is still lack of consensus about the type of surgical treatment that is best recommended in a specific patient. Keeping in mind that medial soft tissue reconstruction alone has not proved enough as an isolated procedure and that osteotomies and arthrodesis are considered more invasive surgery, arthroereisis is a quick, easy, and reproducible technique that seems to have good results without major complications in the correct patient...
September 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/30097081/update-on-subtalar-joint-instability
#8
REVIEW
Thomas Mittlmeier, Stefan Rammelt
Subtalar joint stability is ensured by the osseous geometry of the talocalcaneal joint and the complex array of the ligaments at the medial and lateral aspect of the ankle joint, the sinus and canalis tarsi, and the talocalcaneonavicular joint, respectively. There is still a substantial lack of knowledge about the interaction of the ankle and subtalar joint complex. Subtalar joint instability appears to be more frequent than is generally assumed. The diagnosis of chronic subtalar joint instability makes the application of a comprehensive algorithm necessary...
September 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/30097080/fractures-of-the-lateral-process-of-the-talus
#9
REVIEW
Christian Tinner, Christoph Sommer
Lateral talar process fractures (LTPF) are uncommon injuries but have become more relevant with snowboarding. Currently the fractures are classified according to McCrory-Bladin into 3 types, with advice for treatment that is not ideal anymore. This article proposes modifying the existing classification by differentiating the multifragmented type III into 3 subtypes: IIIa, articular multifragmented but metaphyseal simple; IIIb, articular and metaphyseal multifragmented but reconstructable; and type IIIc, comminuted and nonreconstructable...
September 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/30097079/traumatic-injury-to-the-subtalar-joint
#10
REVIEW
Stefan Rammelt, Jan Bartoníček, Kyeong-Hyeon Park
Traumatic injury to the subtalar joint occurs during subtalar dislocations, talar and calcaneal fractures, and fracture-dislocations. After closed reduction of subtalar dislocations, peripheral talar or calcaneal fractures need to be ruled out by computed tomography scanning. In fractures and fracture-dislocations of the talus and calcaneus involving the subtalar joint, anatomic reconstruction of joint congruity is essential for functional rehabilitation. Failure to anatomically reduce the subtalar joint potentially leads to chronic instability, subtalar arthritis and posttraumatic hindfoot deformity...
September 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/30097078/subtalar-joint-biomechanics-from-normal-to-pathologic
#11
REVIEW
Adam Sangeorzan, Bruce Sangeorzan
Subtalar joint biomechanics are primarily driven by the shape of the articulations with contributions from the surrounding soft tissues. The joint motion occurs about a single axis oriented medially and superiorly. Joint contact forces change during different stages of gait and are affected by hindfoot alignment and traumatic alterations to their normal anatomy. A valgus subtalar joint axis is likely a contributing, and perhaps primary, risk factor for progression to adult acquired flat foot. The subtalar joint axis also contributes to the clinical picture of a cavus foot and a special subset of patients with dynamic varus...
September 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/30097077/anatomy-of-the-subtalar-joint
#12
REVIEW
Jan Bartoníček, Stefan Rammelt, Ondřej Naňka
The subtalar joint is divided into the talocalcaneonavicular and the talocalcaneal joint, separated by a conical interosseous tunnel (canalis and sinus tarsi). The talocalcaneonavicular joint is a ball-and-socket articulation (coxa pedis). An important part of the coxa pedis is the spring ligament. The canalis and sinus tarsi are occupied by the roots of the inferior extensor retinaculum, cervical ligament, interosseous talocalcaneal ligament, and anterior talocalcaneal ligament. Three-dimensional motion in the subtalar joint complex (eversion/inversion) is guided by the axial alignment of the talus, calcaneus, and navicular; the ligaments; and the shape of the articular surfaces...
September 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729804/hallux-valgus-a-three-dimensional-approach
#13
EDITORIAL
Woo-Chun Lee
No abstract text is available yet for this article.
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729803/hallux-valgus-medial-column-instability-and-their-relationship-with-posterior-tibial-tendon-dysfunction
#14
REVIEW
Steven Blackwood, Leland Gossett
Historically, bunions have focused on the coronal plane; however, there is tension and compression failure in the sagittal plane of the midfoot during arch collapse. Correction of all 3 planes of deformity, coronal, sagittal, and rotational, can be achieved in several ways. Taking a big picture of global foot mechanics by recognizing the common types of conditions associated with arch collapse, including hallux valgus deformities, can serve as a useful roadmap for navigating more complicated deformities where hallux valgus exists...
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729802/hallux-valgus-deformity-and-treatment-a-three-dimensional-approach-modified-technique-for-lapidus-procedure
#15
REVIEW
Robert D Santrock, Bret Smith
In a hallux valgus deformity, the problem is deviation of the hallux at the metatarsophalangeal joint and of the first metatarsal at the tarsometatarsal joint. Although anterior-posterior radiograph findings have been prioritized, deviation in the other planes can substantially change visible cues. The modified technique for Lapidus procedure procedure, uses all 3 planes to evaluate and correct the deformity, making radiographic measurements less useful. Using a triplane framework and focusing on the apex of the deformity, all bunions become the same modified technique for Lapidus procedure can be performed regardless of the degree of deformity, always includes triplane correction, and deformity size becomes irrelevant...
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729801/hallux-valgus-deformity-and-treatment-a-three-dimensional-approach
#16
REVIEW
Jesse Forbes Doty, Wallace Taylor Harris
The cause and effect between hallux valgus and first ray hypermobility continues to be debated. Understanding the anatomic and radiographic examination of the first metatarsocuneiform (MTC) joint is critical to choosing an appropriate treatment algorithm for the surgical management of hallux valgus deformity. Some studies suggest hypermobility can be corrected without fusing the first MTC joint. Some think hypermobility arises secondarily from malalignment of the soft tissue constraints as the hallux valgus deformity progresses...
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729800/proximal-supination-osteotomy-of-the-first-metatarsal-for-hallux-valgus
#17
REVIEW
Ryuzo Okuda
Postoperative recurrence of hallux valgus is a relatively common complication and is associated with unsatisfactory surgical outcomes. Risk factors for postoperative recurrence include a round lateral edge of the first metatarsal head (a positive round sign) and incomplete reduction of the sesamoids. These risk factors may relate to residual pronation of the first metatarsal following surgery. A novel technique of a proximal supination osteotomy, in which varus and pronation of the first metatarsal can be corrected simultaneously, can achieve significant correction in moderate or severe hallux valgus deformity and a low rate of hallux valgus recurrence...
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729799/using-the-center-of-rotation-of-angulation-concept-in-hallux-valgus-correction-why-do-we-choose-the-proximal-oblique-sliding-closing-wedge-osteotomy
#18
REVIEW
Emilio Wagner, Cristian Ortiz, Pablo Wagner
Many different surgeries have been proposed for hallux valgus treatment, osteotomies being the currently recommended ones. Because of high recurrence rates, distal, diaphyseal and proximal osteotomies have been used to improve alignment and sesamoid reduction. The center of rotation of angulation (CORA) concept applies to any deformity and helps to completely realign 2 bone segments. When used with proximal osteotomies, bone displacement and angulation is performed obtaining complete deformity correction. The proximal oblique sliding closing wedge (POSCOW) osteotomy follows the CORA concept and permits preoperative planning...
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729798/how-do-i-use-the-scarf-osteotomy-to-rotate-the-metatarsal-and-correct-the-deformity-in-three-dimensions
#19
REVIEW
Eric Swanton, Lyndon Mason, Andy Molloy
The scarf osteotomy has become the workhorse procedure for a large proportion of foot and ankle surgeons, especially in Europe, in the treatment of hallux valgus. Such a versatile procedure should not be underestimated, and planning and thought should precede any such procedure. The angle of bone cuts and magnitude of translation dictate the final position, and all movement axes should be given equal attention.
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729797/how-i-use-a-three-dimensional-approach-to-correct-hallux-valgus-with-a-distal-metatarsal-osteotomy
#20
REVIEW
Daniel M G Winson, Anthony Perera
The role of uniplanar osteotomy in correction of multiplanar deformity in hallux valgus is a developing and promising concept. Careful consideration should be given to the literature when considering the concept of preexisting pronation of the metatarsal. Recent weight-bearing computed tomography studies contradict the existing literature and state that there is little or no rotation of the metatarsal; therefore, a multiplanar osteotomy should aim to correct the rotation caused by soft tissue imbalance at the tarsometatarsal and metatarsophalangeal joints rather than in the metatarsal itself...
June 2018: Foot and Ankle Clinics
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