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tarsometatarsal joint fusion

Troy J Boffeli, Katherine R Schnell
The Cotton osteotomy or opening wedge medial cuneiform osteotomy is a useful adjunctive flatfoot reconstructive procedure that is rarely performed in isolation. The Cotton procedure is relatively quick to perform and effectively corrects forefoot varus deformity after rearfoot fusion or osteotomy to achieve a rectus forefoot to rearfoot relationship. Proper patient selection is critical, because preoperative findings of medial column joint instability, concomitant hallux valgus deformity, or degenerative joint disease of the medial column might be better treated with arthrodesis of the naviculocuneiform or first tarsometatarsal joints...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Kumar Prashant, Tulsi Das Bhattacharyya, Herman Frank, Prema Ram
INTRODUCTION: Giant cell tumor (GCT) or osteoclastoma is an osteolytic, mostly benign but locally aggressive tumor occurring in young adults at the epiphysis. Area of predilection is mainly long bones (85-90%). 4% of GCT are also found in iliac bone, spine and only 2% in hand (of which GCT phalanges are more common than metacarpal). GCT of metatarsal is a very rare occurrence with very few cases being reported so far. We report a case of GCT 1(st) metatarsal in a 40-year-old male which is a very rare entity...
November 2016: Journal of Orthopaedic Case Reports
Tun Hing Lui
Dorsal boss of the foot also known as "tarsal boss," "dorsal exostosis," and "humped bone" is a bone spur that grows from one of the intertarsal or tarsometatarsal joints. It can occur with or without arthritis of the underlying joints. Surgery is indicated if the symptoms do not respond to conservative treatment. Excision of the dorsal boss with or without fusion of the underlying joint is the operative treatment of choice. We report an arthroscopic approach of resection of the dorsal exostosis. Arthroscopic arthrodesis if indicated can be performed through the same portals...
February 2017: Arthroscopy Techniques
Yu-Sen Qiao, Jun-Kun Li, Hao Shen, Hai-Yan Bao, Ming Jiang, Yan Liu, Wasim Kapadia, Hong-Tao Zhang, Hui-Lin Yang
OBJECTIVE: "Lisfranc joint injury" is comprised of a tarsometatarsal joint-complex injury. The Lisfranc complex injury is always a challenge for orthopedists, and the optimum treatment is still up for debate. Anatomic reduction and stable internal fixation prove to have no satisfactory outcomes. This research aims to compare the clinical curative effects, complications and radiographic features of arthrodesis and non-fusion of the Lisfranc joint in the follow-up of the patients who suffered Lisfranc injuries...
February 2017: Orthopaedic Surgery
Tun Hing Lui
Revision arthrodesis is indicated in symptomatic nonunion of the first tarsometatarsal joint. Revision by first tarsometatarsal arthroscopy cannot deal with the dilated screw tract and associated bone cysts. Revision by bone endoscopy is indicated in symptomatic nonunion of the first tarsometatarsal joint, which is previously fixed by transarticular screw along with loosening of the screw and bone cyst formation. The screw tract makes up the portal tract, with the proximal and distal ends of the tract corresponding to the proximal and distal portals, respectively...
August 2016: Arthroscopy Techniques
Adam H Biedrzycki, Barrie G Grant, Brett Nemke, Samantha L Morello, Mark D Markel
OBJECTIVE To evaluate the biomechanical properties of 4 methods for fusion of the centrodistal and tarsometatarsal joints in horses and compare them among each other and with control tarsi. SAMPLE 24 sets of paired tarsi without substantial signs of osteoarthritis harvested from equine cadavers. PROCEDURES Test constructs (n = 6/type) were prepared from 1 tarsus from each pair to represent surgical drilling; 2 medially to laterally placed kerf-cut cylinders (MLKCs); a single large, dorsally applied kerf-cut cylinder (DKC); and a dorsomedially applied locking compression plate (DMLCP)...
October 2016: American Journal of Veterinary Research
Christian Plaass, Leif Claassen, Kiriakos Daniilidis, Mariesol Fumy, Christina Stukenborg-Colsman, Andreas Schmiedl, Sarah Ettinger
BACKGROUND: The modified Lapidus procedure is an accepted treatment option for patients with moderate to severe hallux valgus. Placing a plate plantar on the tension side of the arthrodesis has been shown to be biomechanically superior and has provided good clinical results. There is some concern about interference of the plantar placed plates on the tendon insertions. The purpose of this study was to determine a "safe zone" for plantar plate placement without irritation of the tendons...
April 2016: Foot & Ankle International
Genbin Wu, Yunfeng Yang, Yilihamu Tuoerti, Shanzhu Li, Guangrong Yu
UNLABELLED: OBJECTIVE To review the advance of the first tarsometatarsal joint fusion (Lapidus operation) in treating hallux valgus. METHODS: The relevant literature about Lapidus operations in recent years was reviewed and analyzed. RESULTS: Lapidus operation is used to correct deformities through three steps of osteotomy, fusion, and fixation. With the development of this operation and its diversities, surgeons can make adjustment according to the individual differences of state of illness in patients...
January 2015: Chinese Journal of Reparative and Reconstructive Surgery
Kyle S Peterson, Jeffrey E McAlister, Christopher F Hyer, John Thompson
Severe hallux valgus deformity with proximal instability creates pain and deformity in the forefoot. First tarsometatarsal joint arthrodesis is performed to reduce the intermetatarsal angle and stabilize the joint. Dorsomedial locking plate fixation with adjunctive lag screw fixation is used because of its superior construct strength and healing rate. Despite this, questions remain regarding whether this hardware is more prominent and more likely to need removal. The purpose of the present study was to determine the incidence of symptomatic hardware at the first tarsometatarsal joint and to determine the incidence of hardware removal resulting from prominence and/or discomfort...
January 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Paul Simons, Rosemarie Fröber, Clemens Loracher, Matthias Knobe, Florian Gras, Gunther O Hofmann, Kajetan Klos
Fusion of the first tarsometatarsal joint is a widely used procedure for the correction of hallux valgus deformity. Although dorsomedial H-shaped plating systems are being increasingly used, fusion can also be achieved by plantar plating. The goal of the present study was to compare these 2 operative techniques based on the anatomic considerations and show the potential pitfalls of both procedures. Six pairs of deep-frozen human lower legs were used in the present cadaveric study. In a randomized manner, either dorsomedial arthrodesis or plantar plating through a medial incision was performed...
September 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Bing Xie, Jing Tian, Xin-wei Liu, Da-peng Zhou, Liang-bi Xiang
OBJECTIVE: To evaluate the clinical outcome of accessory navicular fusion for treatment of the painful accessory navicular bone of type II in adults. METHODS: From June 2006 to June 2012, a total of 38 feet (in 35 adult patients) with painful accessory navicular with type I underwent an fusion operation of the primary and accessory navicular bones,including 26 males and 9 females with a mean age of (32.4±7.3) years old ranging from 18 to 44 years old. The course of disease ranged from 3 to 10 months...
October 2014: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Hisateru Niki, Takaaki Hirano, Yui Akiyama, Hiroyuki Mitsui, Hiroto Fujiya
OBJECTIVES: We report the long-term outcome of joint-preserving surgery by combining metatarsal osteotomies for shortening for forefoot deformity in patients with rheumatoid arthritis (RA). METHODS: Forty-three patients (57 feet) aged 41.7-70.8 years (mean, 57.7 years) underwent a combination of first tarsometatarsal fusion and distal realignment (modified Lapidus procedure), shortening oblique osteotomies of the bases of metatarsals 2-4, and fifth ray osteotomy (modified Coughlin procedure)...
September 2015: Modern Rheumatology
Madeleine Willegger, Johannes Holinka, Robin Ristl, Axel Hugo Wanivenhaus, Reinhard Windhager, Reinhard Schuh
PURPOSE: First tarsometatarsal joint (TMTJ) arthrodesis is known as a powerful operative procedure to correct moderate to severe hallux valgus deformity. However, there is little evidence about actual complication rates and angular correctional power. The aims of the present study were to evaluate the (1) angular correction power and (2) complication rates of pooled data for this procedure and to perform subgroup analysis of different methods of fixation. METHODS: A systematic search for the MeSH terms "(hallux OR bunion) AND (lapidus OR TMT OR tarsometatarsal OR metatarsocuneiform) AND (fusion OR arthrodesis)" with use of the online databases MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews was conducted...
March 2015: International Orthopaedics
Josh R Baxter, Sriniwasan B Mani, Jeremy Y Chan, Ettore Vulcano, Scott J Ellis
BACKGROUND: Hallux valgus is a common deformity that is often treated with a fusion of the first tarsometatarsal (TMT) joint. Crossed-screws are currently the accepted standard but advances in plate systems present opportunities for improved clinical outcomes; however, in vitro testing should be performed prior to clinical implementation. The purpose of this study was to determine whether a locking plate with surgeon-mediated compression provides similar fusion stability compared to crossed-screws and if bone density or joint size are related to construct success...
April 2015: Foot & Ankle Specialist
Timo Schmid, Fabian Krause
Due to its proximal correction site and long lever arm, the Lapidus fusion, modified or not, is a powerful technique to correct hallux valgus deformities. The disadvantages are a high complication rate and a long postoperative rehabilitation period. It is only performed in 5% to 10% of all hallux valgus deformity corrections but remains, however, an important procedure, especially in moderate to severe deformities with intermetatarsal angles more than 14°, hypermobility of the first ray, arthritis of the first tarsometatarsal joint, and recurrent deformities...
June 2014: Foot and Ankle Clinics
Troy J Boffeli, Ryan R Pfannenstein, Jonathan C Thompson
Lisfranc fracture-dislocation can be a devastating injury with significant long-term sequelae, including degenerative joint disease, progressive arch collapse, and chronic pain that can be potentiated if not effectively treated. We present a case to demonstrate our preferred surgical approach, consisting of combined medial column primary arthrodesis, middle column open reduction internal fixation, and lateral column pinning, with the primary goal of minimizing common long-term complications associated with Lisfranc injuries...
September 2014: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Andrew B Shinabarger, Michael T Ryan, Matthew Dzurik, Patrick R Burns
Correction of a bunion deformity with the use of proximal first ray procedures has historically included additional distal soft tissue and bone work about the first metatarsophalangeal joint. We report the case of a young adult female who underwent isolated first tarsometatarsal fusion for correction of a bunion deformity. Moreover, we describe the published data related to this approach. This technique could have the potential to improve patient outcomes by avoiding postoperative arthrofibrosis of the first metatarsophalangeal joint...
September 2014: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Yan Wang, Zengyong Li, Ming Zhang
Complications of surgeries in foot and ankle bring patients with severe sufferings. Sufficient understanding of the internal biomechanical information such as stress distribution, contact pressure, and deformation is critical to estimate the effectiveness of surgical treatments and avoid complications. Foot and ankle is an intricate and synergetic system, and localized intervention may alter the functions to the adjacent components. The aim of this study was to estimate biomechanical effects of the TMT joint fusion using comprehensive finite element (FE) analysis...
November 2014: Medical Engineering & Physics
Nicole M Protzman, Melissa M Galli, Scott T Bleazey, Stephen A Brigido
This case series was conducted to assess the safety and efficacy of using an allogeneic cancellous bone sponge for augmentation of foot and ankle arthrodeses. Twenty-five patients were prospectively enrolled in the study prior to undergoing fusion and were then followed for 12 months postoperatively. There were 45 joints: 7 ankles, 12 subtalars, 12 talonaviculars, 6 calcaneocuboids, 1 naviculocuneiform, 6 first tarsometatarsals, and 1 second tarsometatarsal. Patient-reported outcomes of pain (visual analog scale) and function (American Orthopaedic Foot and Ankle Society score) were obtained preoperatively and postoperatively at 6 and 12 months...
March 2014: Orthopedics
Roya Mirmiran, Brandon Wilde, Michael Nielsen
Arthrodesis is a common procedure indicated for surgical treatment of end-stage degenerative joint disease of the foot and ankle. Many published studies have reviewed the union rate, focusing on specific technique or fixation. However, studies reporting on the average period required to achieve fusion, irrespective of the type of fixation or surgical method used, have been lacking. We report on the union rate and interval to fusion in patients who had undergone primary arthrodesis of various joints of the foot and ankle...
July 2014: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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