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distal tibial osteotomy foot and ankle

Xingchen Li, Yuan Zhu, Yang Xu, Bibo Wang, Jinhao Liu, Xiangyang Xu
BACKGROUND: Osteochondral lesions of the talus (OLTs) are amongst the most common foot and ankle disorders. Varus ankle malalignment causes stress concentration on medial side of the joint, resulting in OLTs and osteoarthritis. For large symptomatic OLTs (>10 mm), Osteochondral autograft transplantation is usually recommended. This article highlights biplanar distal tibial osteotomy as an approach and management for patients with concomitant large OLTs and varus ankle malalignment...
January 19, 2017: BMC Musculoskeletal Disorders
Carlo Biz, Michele Fosser, Miki Dalmau-Pastor, Marco Corradin, Maria Grazia Rodà, Roberto Aldegheri, Pietro Ruggieri
BACKGROUND: Minimally invasive surgery (MIS) represents one of the most innovative surgical treatments of hallux valgus (HV). However, long-term outcomes still remain a matter of discussion within the orthopaedic community. The purpose of this longitudinal prospective study was to evaluate radiographic and functional outcomes in patients with mild-to-severe HV who underwent Reverdin-Isham and Akin percutaneous osteotomy, following exostosectomy and lateral release. METHODS: Eighty patients with mild-to-severe symptomatic HV were treated by MIS...
December 5, 2016: Journal of Orthopaedic Surgery and Research
Kit Brogan, Edward Lindisfarne, Harold Akehurst, Usama Farook, Will Shrier, Simon Palmer
BACKGROUND: Minimally invasive surgical (MIS) techniques are increasingly being used in foot and ankle surgery but it is important that they are adopted only once they have been shown to be equivalent or superior to open techniques. We believe that the main advantages of MIS are found in the early postoperative period, but in order to adopt it as a technique longer-term studies are required. The aim of this study was to compare the 2-year outcomes of a third-generation MIS distal chevron osteotomy with a comparable traditional open distal chevron osteotomy for mild-moderate hallux valgus...
November 2016: Foot & Ankle International
Andrew B Bridgforth, M Tyrrell Burrus, Joseph S Park
UNLABELLED: During a cheerleading event, a 14-year-old female sustained a right ankle physeal fracture that was treated nonoperatively with casting. She developed a distal medial tibial physeal arrest, and as the onset of menses was at age 16, she subsequently developed a varus distal tibial deformity. At the age of 19, she was no longer able to participate in collegiate cheerleading due to lateral ankle pain, ankle instability, and peroneal subluxation. After failing conservative treatment, she underwent an ankle arthroscopy, Broström-Gould procedure, peroneal retinacular repair with peroneal tenolysis, and a distal tibial medial opening wedge osteotomy using a porous titanium metal wedge and a one-third tubular plate...
October 2016: Foot & Ankle Specialist
Kyungjei Woo, In-Sang Yu, Jun-Ho Kim, Ki-Sun Sung
BACKGROUND: The effect of lateral soft tissue release (LSTR) regarding the position of the sesamoid is not clear. The purpose of this study was to evaluate the effect of LSTR by comparing the radiologic and clinical outcomes of operative treatment for hallux valgus with or without LSTR. METHODS: This study included a consecutive series of chevron osteotomy of 119 feet of 90 patients with symptomatic hallux valgus with incongruent first metatarsophalangeal (MTP) joints...
December 2015: Foot & Ankle International
Hayato Kobayashi, Yasunori Kageyama, Yoji Shido
Although joint-preserving surgery for intermediate ankle osteoarthritis has been reported to be effective, failures of supramalleolar osteotomy and plafond-plasty can occur because of persistent malalignment of the distal tibia and incongruent ankle mortise. We introduce a novel opening wedge distal tibial osteotomy procedure (mortise-plasty) with rigid plate fixation combined with synthetic bone wedges. We performed 27 mortise-plasties in 25 patients with varus ankle osteoarthritis and instability. Six males (24%) and 19 females (76%), with a mean age of 63 (range 28 to 79) years, were followed up for a mean of 27...
January 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Abdul Razak Sulaiman, Zulmi Wan, Shukrimi Awang, Aminudin Che Ahmad, Ahmad Sukari Halim, Rajaei Ahmad Mohd Zain
This study was carried out to evaluate the long-term effect on the donor side of the foot and ankle following vascularized fibular graft resection in children. Eight patients underwent resection of the fibula for the purpose of a vascularized fibular graft by a surgical team who practiced leaving at least 6 cm residual distal fibula. The age of these children at the time of surgery was between 3 and 12 years. They were reviewed between 3 and 12 years after surgery. Two patients who underwent resection of the middle shaft of the fibula at 3 and 5 years of age developed abnormal growth of the distal tibia, leading to ankle valgus...
September 2015: Journal of Pediatric Orthopedics. Part B
Tae-Keun Ahn, Young Yi, Jae-Ho Cho, Woo-Chun Lee
BACKGROUND: Although the supramalleolar osteotomy can shift the weight-bearing axis laterally, it cannot reconstruct a widened ankle mortise caused by progression of medial ankle osteoarthritis. The aim of this study was to evaluate radiographic and clinical outcomes of distal tibial osteotomy without fibular osteotomy in patients with medial ankle osteoarthritis and mortise widening. METHODS: Distal tibial osteotomy without fibular osteotomy was performed in eighteen patients to treat medial ankle osteoarthritis with mortise widening...
March 4, 2015: Journal of Bone and Joint Surgery. American Volume
K B Lee, N Y Cho, H W Park, J K Seon, S H Lee
Moderate to severe hallux valgus is conventionally treated by proximal metatarsal osteotomy. Several recent studies have shown that the indications for distal metatarsal osteotomy with a distal soft-tissue procedure could be extended to include moderate to severe hallux valgus. The purpose of this prospective randomised controlled trial was to compare the outcome of proximal and distal Chevron osteotomy in patients undergoing simultaneous bilateral correction of moderate to severe hallux valgus. The original study cohort consisted of 50 female patients (100 feet)...
February 2015: Bone & Joint Journal
Thomas A Brosky, Joshua J Mann, Sean Patrick Dunn, Grant W Gonzalez
Damaging effects of joint function can occur after fractures of the lower extremity that have healed with an angular malunion. Surgical techniques have been described to restore the normal mechanics and establish a plantigrade foot, including osteotomy and fusion. In the present report, we describe a unique case of a 17-year-old male who had initially experienced a severe injury to his left lower extremity and foot when he had been run over by a jeep. Originally, a Lisfranc injury with navicular and cuboid fractures were surgically corrected...
July 2014: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
M Richter
OBJECTIVE: Restoration of a stable and plantigrade foot in deformities of the ankle and/or hindfoot and concomitant degenerative changes at the ankle and subtalar joints. INDICATIONS: Deformities at the ankle and/or hindfoot and concomitant degenerative changes at the ankle and subtalar joint. Failed (corrective) arthrodesis of the ankle and subtalar joints. Fused ankle and degeneration of the subtalar joint. Failed total ankle replacement with insufficient substance of talar body and/or degeneration of subtalar joint...
August 2014: Operative Orthopädie und Traumatologie
H-W Park, K-B Lee, J-Y Chung, M-S Kim
Severe hallux valgus deformity is conventionally treated with proximal metatarsal osteotomy. Distal metatarsal osteotomy with an associated soft-tissue procedure can also be used in moderate to severe deformity. We compared the clinical and radiological outcomes of proximal and distal chevron osteotomy in severe hallux valgus deformity with a soft-tissue release in both. A total of 110 consecutive female patients (110 feet) were included in a prospective randomised controlled study. A total of 56 patients underwent a proximal procedure and 54 a distal operation...
April 2013: Bone & Joint Journal
Bruno Iannò, Filippo Familiari, Marco De Gori, Olimpio Galasso, Francesco Ranuccio, Giorgio Gasparini
BACKGROUND: Minimally invasive distal metatarsal osteotomy (MIDMO) is a common technique used to correct the hallux valgus deformity, but controversy remains regarding the expected outcomes of this surgery. METHODS: Seventy-two patients (85 feet) suffering from hallux valgus underwent MIDMO with a modified Bösch technique. Patients were prospectively evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux score, and the AOFAS recovery rate was calculated...
July 2013: Foot & Ankle International
Vlasta Skolan, Igor Šmigovec, Tomislav Ðapić, Darko Antičević
Congenital diastasis of the inferior tibiofibular joint is an extremely rare variant of dysplastic tibial anomaly, which is usually associated with significant shortening of the lower leg and ipsilateral foot deformity due to talus incarceration in the distal tibiofibular mortise. The purpose of this study was to present the long-term results of reconstructive treatment and the functional outcome after a follow-up of 11-16 years. The principles of extremity preservation and reconstruction with the Ilizarov frame have shown a stable ankle joint, a plantigrade foot, and fully independent outdoor ambulation in both patients at the final follow-up...
September 2013: Journal of Pediatric Orthopedics. Part B
S Rammelt, W Schneiders, G Fitze, H Zwipp
Ankle fractures are the most frequent factures of weight-bearing joints in children while fractures of the hindfoot and midfoot are rare. Metatarsal fractures make up the greatest portion of foot fractures in children and mostly heal uneventfully. Generally, the fracture severity increases with increasing age and the fracture patterns in adolescents resemble those in adults but transitional fractures of the distal tibial epiphysis in adolescents between 12 and 14 years of age are an exception. A subtle clinical and radiographic examination is necessary to detect the injury pattern and to discriminate fractures from accessory bones, juvenile avascular necrosis and apophyses...
January 2013: Der Orthopäde
Markus Knupp, Alexej Barg, Lilianna Bolliger, Beat Hintermann
BACKGROUND: A known complication of the surgical treatment of clubfoot deformity is hindfoot valgus deformity of the ankle and/or the subtalar joint leading to calcaneofibular and/or anterior ankle impingement and flatfoot deformity. The purpose of this prospective study was to assess the radiographic outcome, pain relief, and functional improvement in patients with symptomatic overcorrected clubfoot deformity who were managed with a supramalleolar osteotomy. METHODS: Fourteen patients with an overcorrected clubfoot deformity and a mean age of 36...
August 1, 2012: Journal of Bone and Joint Surgery. American Volume
Marc Tompkins, Craig Eberson, Michael Ehrlich
If left uncorrected, valgus ankle deformity in multiple hereditary exostoses can cause significant disability in skeletally immature children and in adults. Various management methods have been described, including hemiepiphyseal stapling, transphyseal screw placement, fibular-Achilles tenodesis, distal tibial osteotomy, and ablative epiphyseodesis. In this article, we report the cases of 3 skeletally immature children who had undergone hemiepiphyseal stapling of the medial distal tibial epiphysis for correction of valgus ankle deformity in multiple hereditary exostoses...
February 2012: American Journal of Orthopedics
Daniel M Horn, Austin T Fragomen, S Robert Rozbruch
BACKGROUND: Supramalleolar osteotomy using circular external fixation with six-axis deformity correction is a rarely reported treatment method particularly well-suited for complex multidimensional deformities of the adult ankle. The purpose of this study was to assess the accuracy of deformity correction and change in functional status using this technique. METHODS: We present a retrospective review of 52 patients who underwent supramalleolar osteotomy with application of the Taylor Spatial Frame (Smith & Nephew, Memphis, TN)...
October 2011: Foot & Ankle International
Michael Aiona, Kosta Calligeros, Rosemary Pierce
BACKGROUND: External tibial torsion causes an abnormal axis of joint motion relative to the line of progression with resultant abnormal coronal plane knee moments and affects lever arm function of the foot in power generation at the ankle. However, it is unclear whether surgical correction of the tibial torsion corrects the moments and power. QUESTIONS/PURPOSES: We evaluated whether surgical correction of external tibial torsion in patients with cerebral palsy would correct the abnormal coronal plane knee moments and improve ankle power generation...
May 2012: Clinical Orthopaedics and related Research
J Michael Miller, Vafa N Ferdowsian, David R Collman
The Z-scarf osteotomy is used for hallux valgus deformity correction by foot and ankle surgeons worldwide. Inverting the Z-scarf osteotomy configuration strengthens the construct in both sawbone and cadaver models, but clinical results of this configuration have not been reported in the literature. This retrospective study evaluates the subjective and intermediate-term postoperative radiographic results of 73 inverted Z-scarf osteotomy procedures for hallux valgus correction in 55 patients from January 1994 to December 2003...
January 2011: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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